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2nd Amendment 05/22/2019 G�Rco Rra�1►► PA:P'C�'°';.- ►, Kevin Madok, CPA 3 �.=tt Clerk of the Circuit Court&Comptroller—Monroe County, Florida ►1%%‘' DATE: February 13, 2020 TO: Tina LoSacco, Sr. Technician FROM: Pamela G. Hanco 1 I.C. SUBJECT: May 22, 2019 BOCC Meeting Attached are electronic copies of the following items that were just received by this office for your records. C26 2nd Amendment to Contract with The Florida Keys Society for Prevention of Cruelty to Animals, Inc. for operation of the Marathon Animal Shelter reflecting a CPI-U increase of 1.9%effective November 15, 2019. The agreement amount will increase to $442,689.77/year or $36,890.81/month. C27 5th Amendment to the Amended and Restated agreement with The Florida Keys Society for Prevention of Cruelty to Animals, Inc. for the Key West Animal Shelter reflecting a CPI-U increase of 1.9% effective May 1, 2019. The agreement amount will increase to $550,886.80/year or $45,907.23/month. Should you have any questions, please feel free to contact me at (305) 292-3550. cc: County Attorney Finance File KEY WEST MARATHON PLANTATION KEY PK/ROTH BUILDING 500 Whitehead Street 3117 Overseas Highway 88820 Overseas Highway 50 High Point Road Key West,Florida 33040 Marathon,Florida 33050 Plantation Key,Florida 33070 Plantation Key,Florida 33070 305-294-4641 305-289-6027 305-852-7145 305-852-7145 • SECOND AMENDMENT TO CONTRACT (Operation of the Marathon Animal Shelter) THIS SECOND AMENDMENT TO CONTRACT is entered into this 22nd day of May, 2019, between Monroe County Board of County Commissioners (County) and Florida Keys Society for Prevention of Cruelty to Animals, Inc., a Florida not-for-profit corporation (FKSPCA/Contractor), in order to amend the Agreement dated November 14, 2017, and as amended on May 16, 2018, as follows; WHEREAS, as a result of the competitive solicitation issued by the County, the FKSPCA and County entered into an agreement dated November 14, 2017 whereby the FKSPCA will operate the Marathon Animal Shelter and provide animal control services from Mile Marker 16.7 to Mile Marker 70 (Agreement). The term of the Agreement is November 15, 2017 to June 30, 2020; and WHEREAS, the terms of the Agreement provide that the contract amount may be adjusted annually by 77 the percentage change in the Consumer Price Index (CPI) for all urban consumers (CPI-U) for the most recent 12 months available ending in December of each year; and WHEREAS, the Agreement was amended by a First Amendment dated May 16, 2018 to adjust the contract amount by 2.1%, which increases the contract to $434,435.50 per annum or$36,202.96 per month; and WHEREAS, the FKSPCA has timely requested a CPI adjustment as allowed under the agreement; and WHEREAS, the Agreement contains a scrivener's error and states that the CPI adjustments may be requested for the "upcoming contract period of May 1st" and the contract period as stated above is November 15th, so the language will be modified herein to reflect the contract period of November 15th and effective date of the CPI in accordance with the correct contract period; IN CONSIDERATION of the mutual promises contained herein, the parties hereby agree as follows: 1. Paragraph V, RENEWAL, will be amended to read as follows: The County shall have the option to renew this agreement after the original term, for one (1) additional five-year period. The contract amount agreed to herein may be adjusted annually in accordance with the percentage change in the consumer Price Index (CPI) for all urban consumers (CPI-U) for the most recent twelve (12) months ending in December of each year. In order to avoid retroactive CPI adjustments, the Contractor must request in writing CPI adjustments no later than January 31st of each year for the upcoming contract period of November 15th. Failure to timely request annual CPI adjustments will result in waiver of the CPI adjustment for that year. 2. In accordance with Paragraph V, RENEWAL the contract amount is hereby adjusted by 1.9% CPI for all urban consumers (CPI-U) for the most recent 12 months ending on December 31, 2018. Effective November 15, 2019, the total compensation paid to the Contractor for its services under this agreement shall be $442,689.77 per annum or$36,890.81 per month. 3. In all other respects, the remaining terms of the Agreement dated November 14, 2017, not inconsistent herewith, shall remain if full force and effect. [REMAINDER OF PAGE INTENTIONALLY LEFT BLANK] Page 1 of 2 Second Amendment to Contract (Operation of the Marathon Animal Shelter) SECOND AMENDMENT TO CONTRACT (Operation of the Marathon Animal Shelter) ,> r;r F r,.IN ITNg S W EREOF, the parties have caused these presents to be executed in the respective names. ''a Attest %/ �° \';' Y MAD.OK,CLERK BOARD OF COUNTY COMMISSIONERS �•''..- 3 `, -`` OF MONROE`v UN LORIDA B g B Y- Y• Deputy Clerk yor hairman Date: 1411 Z2-; 1'12 1 9 l-'tILLP i C/1--, THE FLORIDA KEYS SOCIETY FOR ess Signature THE PREVENTION OF CRUELTY TO ANIMALS, INC. \1-e G r'e.k vv11 l 1 (,1.ivil `S` 7_01 I Print Name Date By: rn GL 2.tf) //]]�� I-resident TY•easu er �i "J Date: 6120I tq Witness Signatu D t aika,L /i c' e sko l I Address: 5 7 1 Ct�l l Pie.Rd 1 Wems, t✓ 33040 Print Name Date c) N MONROE COUNTY ATTORNEY CD P D S TO FO xv CHRISTINE LIMBERT BARROWS • ASSISTANT COUNTY ATTORNEY r.� DATE:_ 57 I/i'? M :�E J - m w C) • Page 2 of 2 Second Amendment to Contract (Operation of the Marathon Animal Shelter) OP ID: CH AMR Cr CERTIFICATE OF PROPERTY INSURANCE DATE(MMIDDIYYYY) 07/18/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. CONTACT PRODUCER NAME: Atlantic Pacific-Key West PHHCN o,Ea*305-294-7696 FAX No):305-294-7383 1010 Kennedy Dr,Suite 203 EMAIL chernandez a ins.com Key West,FL 33040 ADDRESS: p Richard Horan PRODUCER FLOR-46 CUSTOMER ID: INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A:Lloyd's of London Florida Keys S.P.C.A. INSURER B:Citizens Insurance Company 5711 College Rd Key West, FL 33040 INSURER c:American Strategic Insurance INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: LOCATION OF PREMISES/DESCRIPTION OF PROPERTY (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) 10550 Aviation Blvd, Marathon FL 33050 Flood bldg-$131,000; Flood contents-$20,000 both with a$11,250 deductible THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION COVERED PROPERTY LIMITS LTR DATE(MMIDDIYYYY) DATE(MM/DD/YYYY) A XI PROPERTY RSK000167 ® 07/12/2019 07/12/2020 Y BUILDING s 131,000 CAUSES OF LOSS DEDUCTIBLES Y PERSONAL PROPERTY $ 21,000 X BASIC BUILDING 1,000 BUSINESS INCOME S BROAD CONTENTS EXTRA EXPENSE S SPECIAL 1,000 RENTAL VALUE S EARTHQUAKE BLANKET BUILDING S B X WIND 8,550 00023680 ' 07/03/2019 07/03/2020 BLANKET PERS PROP S C X FLOOD • 1,250 FLD311938 • 11/06/2018• • 11/06/20191, BLANKET BLDG 8 PP S y Wind-Bldg s 285,000 Y Wind-Content 20,000 • INLAND MARINE TYPE OF POLICY S CAUSES OF LOSS S NAMED PERILS POLICY NUMBER S s CRIME >;N R I AGEMEN7 TYPE OF POLICY BY DAT l S W_ALVER /A, S �} BOILER 8 MACHINERY 1 )A I'+ h' EQUIPMENT BREAKDOWN ���/ I 11 S SPECIAL CONDITIONS I OTHER COVERAGES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Listed as additional insured/interest-Monroe County Board of County Commissioners, 1100 Simonton St, Key West, FL 33040 CERTIFICATE HOLDER CANCELLATION MCBCCOM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Monroe County Board of County ACCORDANCE WITH THE POLICY PROVISIONS. Commissioners 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West, FL 33040 CA ACORD 24(2016/03) ©1995-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD (-(p.- CITIZENS PROPERTY INSURANCE CORPORATION ' 301 W BAY ST CITIZENS JACKSONVILLE FL 32202 PRIME:RI/INSURANCE CORPUR LION POLICY CHANGE SUMMARY POLICY NUMBER: 00023680-6 POLICY PERIOD FROM 07/03/2019 TO 07/03/2020 at 12:01 a.m.Eastern lime Transaction:AMENDED DECLARATIONS Effective: 07/18/2019 l ra 5 R NI O � s : Priigr P�1e ,lil pTtt1211fti�tl ' ;At tendetl PLYItCy Ilr�€ mrat axt: ik Lvrttdn$and BUlid�t�gS . 2:Marathon 1:Animal Shelter Additional Interest:MONROE COUNTY BOARD OF � Added COUNTY COMMISSIONERS(Landlord/Building Owner) ` t: Qom:•,• ,- 1 AGEMENT WAIVER N/A Y S_. LA)/0 tine v This summary is for informational purposes only and does not change any of the terms or provisions on your policy. Please carefully review your policy Declarations and any attached forms for a complete description of coverage. PCS 01 14 Page 1 of 1 \ ,11-.A A Io ' c9ppØIF CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY ST CITIZENS JACKSONVILLE FL 32202 PROPUHY INiNRRNCF:CORPORABON COMMERCIAL PROPERTY POLICY DECLARATIONS POLICY NUMBER: 00023680-6 POLICY PERIOD FROM 07/03/2019 TO 07/03/2020 at 12:01 a.m.Eastern Time a.maimume. '"'®` Transaction:AMENDED DECLARATIONS Effective: 07/18/2019 CNR-W Pay Plan: Citizens Full Pay Bill: Insured Billed Named Insured and Mailing Address Agent Fl.Agent Lic.# Florida Keys Society For The Prevention Of Cruelty to Christine Hernandez A117278 Animals, Inc. ATLANTIC PACIFIC INSURANCE 5711 COLLEGE RD 1010 KENNEDY DR STE 203 KEY WEST, FL 33040-4311 KEY WEST, FL 33040 Primary Email Address:tammy@fkspca.org Telephone: 305-294-4857 Telephone:305-294-7696 O O 0 0 to cc IN RETURN FOR THE PAYMENT OF THE PREMIUM,AND SUBJECT TO ALL THE TERMS OF THIS POLICY,WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. 8 W THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE FOR WHICH A PREMIUM IS INDICATED.THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENTS. o 0 PREMIUM o COMMERCIAL PROPERTY COVERAGE PART $4,671.00 Required Additional Charges: Catastrophe Financing Surcharge $701.00 Tax-Exempt Surcharge $82.00 TOTAL: $5,454.00 Change in Policy Premium: $0.00 MEIMIN See Form CDEC-FE-SCH—Commercial Policy Forms And Endorsements Schedule MENEM Countersigned:07/18/2019 Authorized By: Christine Hernandez BY: IMANNIN Issued Date:07/18/2019 MOIMO MNIMIM Barry J.Gilway President/CEO and Executive Director Citizens Property Insurance Corporation CDEC1 01 19 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 3 with its permission. CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY ST CITIZENS JACKSONVILLE FL 32202 P!)I'IilY INSURABCY:COKPGRAi11Xi COMMERCIAL PROPERTY POLICY DECLARATIONS Policy Number: 00023680-6 Effective Date: 07/03/2019 to 07/03/2020 Insured Name: Florida Keys Society For The Prevention Of Cruelty to Animals, Inc. LOCATION NO.2 BUILDING OR SPECIAL CLASS ITEM NO. 1 CSP Code:0921 BUSINESS DESCRIPTION: Pet Grooming DESCRIPTION OF PREMISES 2: Marathon Animal Shelter Location Address Group I Construction Group II Construction Protection Class BCEGS Grade 10600 AVIATION BLVD N/A Masonry N/A Ungraded MARATHON,FL 33050-3058 . Group I Territory Group II Territory Coastal Territory No.of Units N/A N/A Monroe-85 1 COVERAGES PROVIDED Insurance at the Described Premises Applies Only For Coverages For Which A Limit Of Insurance Is Shown. Total / _ _ Covered Replacement N Limit Of Causes CostIBPP Actual Coverage Insurance Of Loss Cash Value Coinsurance Rates Premium First Loss Building(Bldg) $285,000 Wind ✓ $285,000 90% Class $4,378.00 No Business Personal Property $20,000 Wind $20,000 ' 90% Class $293.00 • No (BPP) OPTIONAL COVERAGES Applicable Only When Entries Are Made In The Schedule Below Coverage Premium Replacement Cost Building Business Personal Property Yes No DEDUCTIBLE • Hurricane,Other Windstorm or Hail Percentage Deductible Deductible Percentage(Deductible Amount) Bldg:3%($8,550) BPP:($1,000) WINDSTORM MITIGATION FEATURES Terrain Year Built Roof Cover Roof Deck Roof-Wall SWR C 1989 N/A N/A Connection N/A N/A Building Type Roof Shape Windstorm FBC Wind Speed FBC Wind Design N/A N/A Protective Devices N/A N/A None Mortgageholder(s)&Other Policyholder Interest(s)—See Policy Interest Schedule. PREMIUM: $4,671.00 • CDEC1 01 19 Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 3 • with its permission. CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY ST CITIZENS JACKSONVILLE FL 32202 PRop3?NIN INSW(ANCF[COR*ORAHON COMMERCIAL PROPERTY POLICY DECLARATIONS Policy Number: 00023680-6 Effective Date: 07/03/2019 to 07/03/2020 Insured Name: Florida Keys Society For The Prevention Of Cruelty to Animals, Inc. FLOOD COVERAGE IS NOT PROVIDED BY THIS POLICY. WINDSTORM OR HAIL DEDUCTIBLES ARE CALCULATED ON TOTAL REPLACEMENT COST OR ACTUAL CASH VALUE, NOT THE LIMIT OF INSURANCE. THIS POLICY CONTAINS A CO-PAY PROVISION THAT MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU. CY O Coinsurance contract: The rate charged in this policy is based upon the use of M the coinsurance clause attached to this policy, with the consent of the insured. o ° O INFORMATION ABOUT YOUR POLICY MAY BE MADE AVAILABLE TO INSURANCE COMPANIES AND/OR AGENTS TO ASSIST ° THEM IN FINDING OTHER AVAILABLE INSURANCE MARKETS. TO REPORT A LOSS OR CLAIM CALL 866.411.2742 PLEASE CONTACT YOUR AGENT IF THERE ARE ANY QUESTIONS PERTAINING TO YOUR POLICY.IF YOU ARE UNABLE TO CONTACT YOUR AGENT,YOU MAY REACH CITIZENS AT 866.411.2742. MEMNON CDEC1 01 19 Includes copyrighted material of Insurance Services Office, Inc., I Page 3 of 3 with its permission. L CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY ST CITIZENS JACKSONVILLE FL 32202 PROW:filY INSURANCE CCIRPORAiION COMMERCIAL PROPERTY POLICY POLICY INTEREST SCHEDULE POLICY NUMBER 00023680-6 POLICY PERIOD FROM 07/03/2019 TO 07/03/2020 at 12:01 a.m.Eastern Time Named Insured Florida Keys Society For The Prevention Of Cruelty to Animals, Inc. Location No. Building No. Interest Type Name and Mailing Address 2 1 Landlord/Building Owner MONROE COUNTY BOARD OF COUNTY COMMISSIONERS 1111 12TH ST STE 408 KEY WEST, FL 33040-3005 d C C a C 0 C C C MOM MEM RESEM C C Issued Date:07/18/2019 Leaseholder Copy CDEC-PI-SCH 01 14 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 with its permission. CITIZENS PROPERTY INSURANCE CORPORATION 301 W BAY ST CITIZENS JACKSONVILLE FL 32202 pnnpuiryINSURANCI.CORPURA1ION r' COMMERCIAL PROPERTY POLICY FORMS AND ENDORSEMENTS SCHEDULE POLICY NUMBER 00023680-6 POLICY PERIOD FROM 07/03/2019 TO 07/03/2020 at 12:01 a.m.Eastern Time Named Insured Florida Keys Society For The Prevention Of Cruelty to Animals, Inc. An entry below of"All" indicates the form applies to all items scheduled in the policy Location No. Building No. Form No. Edition Date Description ALL ALL CIT 03 21 01 14 WINDSTORM OR HAIL PERCENTAGE DEDUCTIBLE ALL ALL CIT W14 20 02 14 CITIZENS CHANGES-PROPERTY NOT - - -COVERED-- -- - -ALL ALL IL 09 35 07 02 EXCLUSION OF CERTAIN COMPUTER- RELATED LOSSES ALL ALL IL P 001 01 04 U.S.TREASURY DEPARTMENT'S OFFICE OF FOREIGN ASSETS CONTROL("OFAC") ADVISORY NOTICE TO POLICYHOLDERS ALL ALL CIT W02 55 02 19 FLORIDA CHANGES-CANCELLATION AND NONRENEWAL ALL ALL IL 01 75 09 07 FLORIDA CHANGES-LEGAL ACTION AGAINST US ALL ALL CP 01 40 07 06 EXCLUSION OF LOSS DUE TO VIRUS OR BACTERIA ALL ALL IL 0017 11 98 COMMON POLICY CONDITIONS ALL ALL CP 00 90 07 88 COMMERCIAL PROPERTY CONDITIONS ALL ALL CIT W10 10 02 19 CAUSES OF LOSS-WINDSTORM OR HAIL FORM 2 ALL CIT CNRW 01 25 02 19 FLORIDA CHANGES 2 ALL CIT CNRW 00 03 02 19 TABLE OF CONTENTS-BUILDING AND PERSONAL PROPERTY 2 ALL CP 00 10 06 07 BUILDING AND PERSONAL PROPERTY COVERAGE FORM 2 1 CP 12 18 06 07 LOSS PAYABLE PROVISIONS 2 1 CP 12 19 06 07 ADDITIONAL INSURED-BUILDING OWNER Issued Date:07/18/2019 Leaseholder Copy CDEC-FE-SCH 01 14 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 1 with its permission. - OP ID:CH ACORO" CERTIFICATE OF PROPERTY INSURANCE DATE(MM/DD/YYYY) 01/28/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. CONTACT PRODUCER NAME: Atlantic Pacific-Key West (NC.PHO No.Ext):305-294-7696 FAX No):305-294-7383 1010 Kennedy Dr,Suite 203 E-MAIL chernandez@apins.com Key West, FL 33040 E MADDRESS: Richard Horan PRODUCER FLOR-46 CUSTOMER ID. INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A:Lloyd's of London Florida Keys S.P.C.A. American Strategic Insurance 5711 College Rd INSURERS: g Key West,FL 33040 INSURER C: INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: LOCATION OF PREMISES I DESCRIPTION OF PROPERTY(Attach ACORD 101,Additional Remarks Schedule,If more space is required) 10550 Aviation Blvd,Marathon,FL 33050 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION COVERED PROPERTY LIMITS LTR DATE(MM/DD/YYYY) DATE(MMIDD/YYYY) A X PROPERTY RSK000167 07/12/2019 07/12/2020 Y BUILDING $ 131,000 CAUSES OF LOSS DEDUCTIBLES Y PERSONAL PROPERTY $ 21,000 X BASIC BUILDING BUSINESS INCOME $ 1,000 — BROAD CONTENTS EXTRA EXPENSE $ SPECIAL 1,000 RENTAL VALUE S EARTHQUAKE BLANKET BUILDING $ WIND BLANKET PERS PROP $ B X FLOOD _ 1,250 FLD311938 11/06/2019 11/06/2020 BLANKET BLDG&PP $ B Flood-Bldg $ 144,100 B Flood-Cts $ 21,000 I INLAND MARINE TYPE OF POLICY 5 CAUSES OF LOSS $ NAMED PERILS POLICY NUMBER $ $ CRIME APPIRU l:� TYPE OF POLICY WAVER N/A �' l"BY �� _ $ C $ BOILER&MACHINERY/ $ —EQUIPMENT BREAKDOWN — $ $ SPECIAL CONDITIONS/OTHER COVERAGES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Additional insured listed as: Monroe County Board of County Commissioners, 1100 Simonton St,Key West,FL 33040 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Monroe County Board of ACCORDANCE WITH THE POLICY PROVISIONS. County Commissioners 1100 Simonton St Key West,FL 33040 AUTHORIZED REPRESENTATIVE ACORD 24(2016/03) ©1995-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD _____......%) FLOR-46 OP ID:CH ACOROW CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) �� 01/28/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 305-294-7696 CONTACT Atlantic Pacific-Key West PHONE 305-294-7696 I FAX 305-294-7383 1010 Kennedy Dr,Suite 203 1A/C,,No,E): (NC,No): Key West, FL 33040 ADpRI s_chernandez@apins.com Richard Horan INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Penn-America Insurance Co 32859 INSUREDKeys S.P.C.A. INSURERB:NGM Insurance Co. Florida 5711 College Rd INSURERC: Key West,FL 33040 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPEOFINSURANCE ADDL SUBR POLICYNUMBER POLICY EFF POLICY EXP LIMITS I TRINSD WVDIMMIDD/YYYYI IMM/DDIYYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE X OCCUR PAV0191856 07/01/2019 07/01/2020 DAMAGE TO RENTED 100,000 Y PRFMLSFS(Ea occurrence) $ A x Professional Liab PAV0191856 07/01/2019 07/01/2020 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMF APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JEOT- LOC PRODUCTS-COMP/OP AGG $ included C OTHER: Prof Liab $ 2,000,000 AUTOMOBILECOMBINED SINGLE LIMIT LIABILITY (Fa accident) $ ANY AUTO APPR V - i�. NA EMEM BODILY INJURY(Per person) $ - OWNED SCHEDULED BY AUTOS ONLY _ AUTOS DATE BODILY INJURY(Per accident) $ _ ALTOS ONLY _ NON-OWNED ONLY WAIVER N/A (PerraccidenDAMAGE $ $ - UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ - $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY OFFICER/MEM ER EXCLUDED?ECUTIVE N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B Employee Dishonest F271572N 06/26/2019 06/26/2020 Bond 100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Locations covered:5711 College Rd,Key West,FL 33040(including 21 acres of Mt Trashmore ; 10550 Aviation Blvd,Marathon,FL 33050; Parcels Q,R&S, Little KnockEm Down Key,FL 33042 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe CountyBoard of THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. County Commissioners 1100 Simonton St Key West,FL 33040 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NGM Insurance Company 4601 Touchton Rd East Ste 3400 Report of Execution - Renewal P.O.Box 16000 Jacksonville,FL 32245-6000 Agency Code: 09-0236 Bond Number: F-27 1572-N Atlantic-Pacific Ins Bond Effective Date: /26/2019 11382 Prosperity Farms Rd#123 Bond Expiration Date: " 6/26/2020 Palm Beach Gardens,FL 33410 Type of Renewal: Continuous Principal: Obligee: Florida Keys SPCA Inc 5711 College Rd Key West,FL 33040 Type of Bond Classification A Penalty Premium Insuring Agreement I:Blanket Emp yes Fid Non-profit Orgn/all Other $100,000 $0 DishonestyPer Loss , Endorsement include Agents and Non-Employees $258 TOTAL PREMJU $258� Description: , �1 ' 0,i.L-rAFaj VAU Remarks: `L��O �1tM�'{�rt..rni Urn N a5 prtbr y ear- Include Volunteer Workers Additional Principals: Additional Obligees: aide/aid4p �liihs t 1<W I". 5 = I'/ �! tnarn nn G .0 = z a'/. pa5ifihrn6 Z0.6 lE1E � BLE Attorney: Other: APR 2 2Q19 By SYSTEM PB/9 I I . ?` * * COMMERCIAL LINES COMMON POLICY DECLARATIONS * * INSURANCE IS PROVIDED BY THE COMPANY DESIGNATED BY AN"X": Stock * 'D . **fiup * Q PENN-AMERICA INSURANCE COMPANY Company * 0 PENN-STAR INSURANCE COMPANY I?AV0161601 rReni ewalitiV um o er ❑ PENN PATRIOT INSURANCE COMPANY i Bala Cynwyd, Pennsylvania 19004 g 04 trot Number Rewrite of NumberA94 $� POLICY NUMBER: PAV0191856 1. NAMED INSURED: rLQl'riA KEYS S.P.C.A. DBA: Prod Agent Christine Hernandez MAILING ADDRESS: Address: 11382 Prosperity Farms Road;#123 5711 College Rd Palm Beach Gardens FL 33410 Prod-Agcy: Atlantic Pacific Insurance,Inc. Key West, FL 33040 Address:. 11382 Prosperity Farms Road;#123 2 POLICY PERIOD: July 1,2019 Palm Beach Gardens FL 33410 From. To July.1,2020 at 12:01 A.M. Standard Time at your mailing address shown above. 3. FORM OF BUSINESS: Corporation OTHER DESC: 4 •1 BUSINESS DESCRIPTION: ANIMAL SHELTER IN RETURN FOR THE PAYMENT OF THE PREMIUM,AND-SUBJECT TO ALL THE TERMS OF THIS POLICY WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. 5 THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED. THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT. PREMIUM Commercial General Liability Coverage Part $ 3,612.00 Commercial Property Coverage Part $ NOT COVERED Commercial Crime Coverage Part $ NOT COVERED Commercial Inland Marine Coverage Part $ NOT COVERED Professional Liability Coverage Part $ INCLUDED Liquor Liability Coverage Part $ ' NOT COVERED Commercial Umbrella Coverage Part $ NOT COVERED Owners Contractors Protective Coverage Part $ NOT.COVERED TRIA $ NOT.COVERED 6. Y. TOTAL PREMIUM PAYABLE AT INCEPTION $ 3,612.00 Service Fee 35.00= Surplus Lines Tax. $ 182.35,I 00 Stamping Fee $ a�, $ 3.65. $ i Other: $ / n TOTAL 3,833.00 T 7 FORM(S)AND ENDORSEMENT(S)MADE A PART.OF THIS POLICY AT THE TIME OF ISSUE:* l AS PER FORM S1007(12/2000)SCHEDULE OF FORMS AND ENDORSEMENTS ATTACHED • "Omits applicable Forms and Endorsements if shown in specific Coverage Part/Coverage Form Declarations. THESE DECLARATIONS TOGETHER WITH THE COMMON POLICY CONDITIONS,COVERAGE PART DECLARATIONS COVERAGE PART COVERAGE FORM(S)AND FORMS AND ENDORSEMENTS,IF ANY,ISSUED TO FORM A PART THEREOF,COMPLETE THE ABOVE NUMBERED POLICY. Agency Code: 02169 a AmWINS Access Insurance Services, LLC 7108 Fairway Drive,Ste 200 By • Palm Beach Gardens, FL 33418 Authorized Representative DF/KZ 07/18/201.9 S1100(09/20.16) Page 1 of 1 1 11 ri; * * * Stock *,+ * COMMERCIAL GENERAL LIABILITY COVE GE PAI Company *Do * DECLARATIONS CQ�5, * opt, Id riP * Group '* 1 11. li 0. a Sal" 1 5 G.qi , -736,g1 POLICY NUMBER: PAV0191856 �I q r d� lcL , 1. NAMED INSURED: FLORIDA KEYS.S.P.C.A. � o,/' -`� 2 LIMITS OF INSURANCE-INSURANCE APPLIES ONLY FOR COVERAGE FOR WHICH A LIMIT OF 3� 3t . INSURANCE IS SHOWN. General Aggregate Limit(Other than Products/Completed Operations) $ 2,000,000 ., Products/Completed Operations Aggregate Limit $ Included Each Occurrence Limit $ 2 , , Rersonal& Advertising Injury Limit $ 2,000,000 Damage-to Premises Rented to You Limit $ 100,000 any one premises Medical Expense Limit $ 5,000 any one person 3. _ LOCATIONS.of all premises you.Own, Rent;or Occupy Address City Zip No. 1 1 Parcels Q,R&S,Lot 3 Section 23 Little KnockEm Down FL 33042 PREMIUM BASIS • RATES ADVANCE PREMIUM 4; CLASS** Code/ Exposure Prod/CO All Other Prod/CO All Other rIf Classifications are Numbered,the coverage applies to the corresponding Location No. No. 1 Bldg 1 49451 e) 13 Incl 1.982 Included 26.00 K V v Vacant Land Other than Not-For-Profit r No. 1 Bldg", V v 1 o) 1 Inc! Flat Included 750.00 h Increased GL Limit No. 1 Bldg 1 e) 2 Inc' Flat )f, Included 100.00 Adtlitional Insured-Managers or Lessors of Premises—Per Form CG2011' II No. 2 BldO 1 45450 , e) 26 Inc! 39.618 Included 1,030.00 Keflnels II No. 3 Bldgj, 1 45450 e). 42 Ind 39.618 Included 1,664.00 - Kerinels K1�` V V If Classilir cationsare Numbered;the coverage applies to the corresponding Locatioi No. , 1' TOTAL: $ 3,612.00 (s)1,gross sales-per$1000 (o) total cost-per $1000 (m)admissions-per 10LP (e) each I(p) payroll-per $1000 (a) area-per 1000 sq. fL (u) units - (o) other 5. Policy may be AUDITABLE (t) see classification notes In company-o • Commercia 'nines Manual 6. - SPECIFIC GENERAL LIABILITY FORMS/ENDORSEMENTS - AS per per S1007 G12-00] This pat ge alone does not provide coverage and must be attached to a Commercial Lines Common Policy Declarations Common Policy Conditions,Coverage Part Coverage Form(s)and any other applicable forms and endorsements.' S2000(06/01) - Page 1 of 1 * * Stock COMMERCIAL GENERAL LIABILITY COVERAGE PART Company :00A. * SUPPLEMENTAL DECLARATIONS Group * POLICY NUMBER: PAV0191856 Florada=Keys S:P. . O. LOCATIONS of all premises you Own, Rent,or Occupy 2 t 10550 Aviation Blvd; Marathon, FL 33050 acet-h 3 11 5711 College Rd, Key West, FL 33040 twoOCA44AS • NO. ¢ CLASS - PREMIUM BASIS. RATES ADVANCE PREMIUM Code/ Exposure Prod/CO All Other Prod/CO All Other 3 Bldg 1 49451 e) 21 Ind 1.982 Included 42.00 Vacant Land-Other than Not-For-Profit • • • M1 ,yff Total Premium This Page $ See Form S2000 Accumulative Total $ for Total Premium . • (sy gross sales-per$1000 (c) total cost-per$1000 (m)admissions-per 1000 (e) each (p) payroll-per$1000 (a) area-per 1000 sq.ft. (u) units Policy may be AUDITABLE SPECIFIC GENERAL LIABILITY FORMS/ENDORSEMENTS 1. • This page alone does not provide coverage and must be attached to a Commercial Lines Common Policy Declarations Common Policy Conditions, Coverage Part Coverage Form(s)and any other applicable forms and endorsements. S2001.(10/2013) Page 2 of 2 . ATLANTIC PACIFIC INC PRI:WRESJ/YE 11382 PRSPRTY FRM 123 COMMERCIAL PALM BCH GARDENS,FL 33410 Policy number: 06456454-7 Underwritten by: Progressive Express Ins Company Insured: MC BOARD COUNTY COM FL KEYS S.P.C.A. 1100 SIMONTON S June 8,2019 KEY WEST,FL 33040 Policy Period:Jun 30,2019-Jun 30,2020 Mailing Address / Progressive Express Ins Company J PO Box 94739 Additional insured endorsement . Cleveland,OH 44101 1-800-444-4487 Name of Person or Organization / For customer service,24 hours a day, MC BOARD COUNTY COM"' 7 days a week 1100 SIMONTON S KEY WEST,FL 33040 The person or organization named above is an insured with respect to such liability coverage as is afforded by the policy, but this insurance applies to said insured only as a person liable for the conduct of another insured and then only to the extent of that liability. We also agree with you that insurance provided by this endorsement will be primary for any power unit specifically described on the Declarations Page. Limit of Liability Bodily Injury - Not applicable Property Damage Not applicable Combined Liability $1,000,000 each accident AU other terms,limits and provisions of this policy remain unchanged. This endorsement applies to Policy Number:06456454-7 Issued to(Name of Insured):FL KEYS S.P.C.A. - Effective date of endorsement:06/30/2019 Policy expiration date: 06/30/2020 Form 1198(01/04) •r�U E ANAGEMENT DAT ,�' off'• �� WAIVER N/A Ujl after). le lt1'S , ATLANTIC PACIFIC INC /WOOIfE.Cr.D®G9r 11382 PRSPRTY FRM 123 COMMERCIAL PALM BCH GARDENS,FL 33410 Poky number: 064564544 Underwritten by: Progressive Express Ins Company May 18,2019 FL KEYS S.P.C.A. Policy Period:Jun 30,2019-Jun 30,2020 5230 COLLEGE RD KEY WEST,FL 33040 • iised Hi and potiiicy infra); ati kn is is ©sed This anfor lat on was revised on May 18 2019 Please Toulon,pan'porky&eailmet is today We send your renewal policy information early so that you have the opportunity to review it at your convenience. Your Commercial Auto Insurance Coverage Summary lists drivers,current driving history,the autos insured,the coverages selected and the premiums by coverage. Your current policy will expire on June 30,2019 at 12:01 a.m. If we recently sent you a Cancel Notice because the remaining balance on your current policy has not been received please pay that amount by the due date to avoid policy • cancellation. This bill does not saJPerrsedle any Cancellation Notice. If you have already sent this payment- thank you. If you do not make this payment,the offer to renew this policy is withdrawn. If you've scheduled a payment,it is not reflected in the amount due. Reviser premium and payment itynati©t • • Revised renewal policy premium $11,901.00 :<\). \\\\( blinadratim amount due $11,901.06 It date Anne 36,2019 To renew your policy,please pay the amount shown above,or call us for other available options,by the due date. To pay with a check or credit card by phone,call Customer Service at 1-877-278-1615,or login to progressiveagent.com. Please see traverse side for additional information. Continued on hack 0 0 0 0 0 0 0 0 0 0 0 0 e 0 0 0 e e 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 o 0 e 0 0 0 0 0 0 0 0 o e D u e co e e e coo u e e 0 o e e ay Neat C©u p 1•�%� �A� �5 �' Policy waembec:064364t4-7 Policyholder: FL KEYS S.P.C.A. iVi6aolaanaasrl amount due $11,901.00 It you pay by check,please allow 5 to 7 Dane data Ague 2019 days for your payment to reach us. Write your policy number on the check and make it Amount enclosed $ payable to Progressive Express Ins Company, If you wish to change your method of payment,please call Customer Service at '11111111111"1111191111111111111111'11'111111'1111'"1111'1.III 1-800-444-4487 before the scheduled PROGRESSIVE EXPRESS INS charge date. DEPT 0561 CAROL STREAM IL 6013 2-0561 Do not wrlte below this section of coupon. CA-MN 056106456454 09414 1190100 1190100 5000101 8857267 007006301902 • ii'Fs rlxti ATLANTIC PACIFIC INC 4;.+ 11382 PRSPRTY FRM 123 COMiZIERC/.4L PALM BCH GARDENS,FL 33410 • Named insured Policy number: 06456454-7 Underwritten by: • Progressive Express Ins Company May 18,2019 FL KEYS S.P.C.A. Policy Period:Jun 30,2019-Jun 30,2020 5230 COLLEGE RD Page 1 of 4 KEY WEST,FL 33040 progressiveapnt7.com Online Service • • Make payments,check billing activity,print • policy documents,or check the status of a claim. Comae 'c ll Auto 1-S61-624-1800 0msurance Coverage Summary ATLANTIC PACIFIC INC Contact your agent for personalized service. This as your revised Renewal 1-000-444-4487 Declarations Page For customer service if your agent is unavailable or to report a deim. Your policy information has changed This Renewal Declarations Page is effective only if the minimum amount due to renew your policy is received or postmarked by June 30,Z019. • Your coverage begins on June 30,2019 at 12:01 a.m. This policy expires on June 30,2020 at 12:01 a.m. This coverage summary replaces your prior one.Your insurance policy and any policy endorsements contain a full explanation of your coverage.The policy limits shown for an auto may not be combined with the limits for the same coverage on another auto,unless the policy contract allows the stacking of limits.The policy contract is form 6912(06/10).The contract is modified by forms 1652FL (08/12), 1198(01/04),4852FL (10/04),4881 FL (01/13)and Z228(01/11). The named insured organization type is a corporation. P®Oikgy changes affective Jima 30, 2019 Premium change: -$1,493.00 Changes: The driver information has changed. The changes shown above will not be effective prior to the time the changes were requested, Description Limits Deductible Premium Liability To Others $9,998 Bodily Injury and Property Damage Liability $1,000,000 combined single limit Uninsured/Underinsured Motorist Rejected Basic Personal Injury Protection • 251 Without Work Comp-Named Insured&Relatives $10,000 each person $0 Comprehensive 648 See Auto Coverage Schedule Limit of liability less deductible Collision 984 See Auto Coverage Schedule Limit of liability less deductible Subtotal Policy premium $11,8841 Fees 20 Total 12 month policy premium and fees $11,901 • Continued Form 6489 FL(01/15) Policy number: 06456454-7 FL KEYS S.P.C.A. Page 2 of 4 • Hated driver 1. MATT ROYER 2. TAMMY FOX 3. ADAM DAYTZ 4. LINDSEY THOMPSON 5. TIFFANY BURTON 6. DELBERT DUNSMORE 7. TARA M VICKREY 8. MARIE A SIMPSON 9. JENNIFER R SHOWALTER 10.HUGH J SMITH 11.SARA E BENTLEY 12.CECIL L LAWSON Auto coverage schedule a. g 1. 2014 Ford Econo/Cltab Wg+ra Actual Cash Value (plus$0,00 Permanently Attached Equip) = VIN: 1FTNE2EW4EDA90169 Garaging Zip Code: 33050 Radius: 100 Liability liability PIP Premium $2,423 $56 e MME re Camp Comp Collision Collision A Physical Damage Deductible Premium Deductible Premium • Auto Total e Premium $250 $127 $250 $178 $2,784 V = to o = o �_ 2. 2015 Miss NV 200 2.5s/Ser Stated Amount: *$22,100(including Permanently Attached Equip) VIN: 3NGCMOKNOFK718821 �L® Garaging Zip Code: 33040 Radius: 50 Liability Liability PIP a i Premium $1,980 $47 a Comp Comp Collision Collision Physical Damage Deductible Premium Deductible Premium Auto Total — Premium $250 $155 $250 $268 • .... ..• $2;450 3. 2005 Ford EconotClob Werra Actual Cash Value (plus$0.00 Permanently Attached Equip) VIN: 1FMRE11WX5HA98430 ppppp \ .) Garaging Zip Code: 33040 Radius: 50 1 Liability Debility PIP Premium $1,655 $46 Comp Camp Collision Collision Physical Damage Deductible Premium Deductible Premium Auto Total Premium $250 $88 $250 $65 $1,054 • Continued Form 6489 FL(01/151 Policy number: 06456454-7 FL KEYS S.P.C.A. Page3 of 4 • 4. 2000 Ford Fcono/Club Wgn Actual Cash Value (plus$0,00 Permanently Attached Equip) VIN: 1 FTNS24W76DA11489 i\ Garaging Zip Code: 33050 Radius: 100 Liability Uability PIP Premium $1,973 $56 Comp Comp Collision Collision Physical Damage Deductible Premium Deductible Premium Auto Total • Premium $250 $101 $250 $93 $2,223 5. 2018 Chevrolet Express G2500 Stated Amount: *$25,000(including Permanently Attached Equip) VIN: 1GCWGAFG4J1904199 Garaging Zip Code: 33040 Radius: 50 Liability Uablllty PIP Premium $1,967 $46 . Camp Camp Collision Collision Physical Damage Deductible Premium Deductible Premium Auto Total Premium $250 $177 $250 • $380 $2,570 *A vehicle's stated amount should indicate its current retail value,including any special or permanently attached equipment. In the event of a total loss,the maximum amount payable is the lesser of the Stated Amount or Actual Cash Value,less deductible. Be sure to check stated amount at every renewal in order to receive the best value from your Progressive Commercial Auto policy. Pve1itgm discounts Policy 06456454-7 Business Experience and Paid In Full Vehicle • 2014 Ford Econo/Club Wgn Anti-Lock Brakes and Air Bag 2015 Niss NV 200 2,5s/Sv Air Bag 2005 Ford Econo/Club Wgn Anti-Lock Brakes and Air Bag 2006 Ford Econo/Club Wgn Anti-Lock Brakes and Air Bag 2018 Chevrolet Express G2500 Anti-Lock Brakes and Air Bag Addritioaaal lammed irwf.onstti©1l 1 . Additional Insured MC BOARD COUNTY COM 1100 SIMONTON S KEY WEST,FL 33040 • Agent signature • Continued Form 6489 FL(01/15) ATLANTIC PACIFIC INC PROGREll/UE° 11382 PRSPRTY FRM 123 PALM 8CH GARDENS,FL 33410 COMMERCIAL FL KEYS S.P.C.A. Policy Number: 06456454-7 Underwritten by: Progressive Express Ins Company FL KEYS S.P.C.A. Date of Mailing: June 14,2019 5230 COLLEGE RD KEY WEST,FL 33040 Policy Period: Jun 30,2019-Jun 30,2020 Page 1 of 1 ATLANTIC PACIFIC INC 1-561-624-1800 Online Service progressiveagent.com Customer Service 1-800-444-4487 Commercial Auto Insurance Bill Your premium has changed Tired of writing checks? Save time and money with Electronic Funds Remaining balance $5,058.00 Transfer(ER)!Contact your agent Payments remaining 0 for more information. Minimlum amount due ? ;$.5:Tv o5'8'OOI To maintain your coverage,please pay the minimum amount due by the due date. Any amount you pay above your minimum will be credited to your next payment. If you've scheduled a payment, it is not reflected In the amount due. Billing detail forApril 14, 2019 -June 14, 2019 Payment on May 6-thank you -$696.00 Payment on June 6-thank you -$11,901.00 " • r Current amount(based on premium change) $5,058.00 . $5,058,00 .' Minimum amount due Payments received after June 14 will appear on your next statement. li�'1� W Policy Number: 06456454-7 Payment Coupon FL KEYS S.P.C.A. For immediate payment,please go to Remaining balance $5,058.00 progressiveagent.com or call 1-877-278-1615. Minimum amount due $5,058.00 If you pay by check,please allow five to seven days for your payment to reach us. Write your Due date June 30, 2019 policy number on the check and make it payable Amount enclosed $ to Progressive Express Ins Company. •rlillli.IIil1Il'Irli.l..n,L..Iln.Ili.nlruIilt..Ifl.11l.r PROGRESSIVE DEPT 0561 CAROL STREAM IL 60132-0561 Do not write below this section of coupon. CA-11092 Form 6265(10/10) • 056106456454 09414 0505800 0505800 5000118 4988547 007006301902 ATLANTIC PACIFIC INC 116:1EII®VE 11382 PRSPRTY FRM 123 CO/WME/?C/AL PALM BCH GARDENS,FL 33410 Named insured Policy number: 06456454-7 Underwritten by; Progressive Express Ins Company June 15, 2019 FL KEYS S.P.C.A. Policy Period:Jun 30,2019-Jun 30,2020 5230 COLLEGE RD Page 1 of 4 KEY WEST,FL 33040 progressiveagent.com Online Service Make payments,check billing activity,print policy documents,or check the status of a Cr')O x '���;: \EAU claim. 1-561-624-1800 InSa rt-Ine Coverage Sumii`iary ATLANTIC PACIFIC INC �✓ Contact your agent for personalized service. This is your Ded arat ons ' 'age 1.800.444-4497 Your coverage has changed For customer service if your agent is unavailable or to report a claim. Your coverage begins on June 30,2019 at 12:01 a.m. This policy expires on June 30,2020 at 12:01 a.m. This coverage summary replaces your prior one.Your insurance policy and any policy endorsements contain a full explanation of your coverage.The policy limits shown for en auto may not be combined with the limits for the same coverage on another auto,unless the policy contract allows the stacking of,limits.The policy contract is form 6912(06/10).The contract is modified by forms 1652FL (08/12), 1198(01/04),4852FL (10/04),4881FL (01/13)and Z228(01/11), The named insured organization type is a corporation. Policy changes effective lime a 30, 2019 Premium change: $5,058.00 Changes: The driver information has changed. The changes shown above will not be effective prior to the time the changes were requested. ®aatlome©f coverage Description Limits Deductible Premium Liability To Others $14,474 Bodily Injury and Property Damage Liability $1,000,000 combined single limit Uninsured/Underinsured Motorist Rejected Basic Personal Injury Protection 371 Without Work Comp-Named Insured&Relatives $10,000 each person $0 Comprehensive 648 See Auto Coverage Schedule Limit of liability less deductible Collision 1,446 See Auto Coverage Schedule Limit of liability less deductible 5ubtotai policy premium $16,939 Fees 20 Tetai 12 month policy premium and fees $16,959 Rated driver 1. MATT ROYER 2. TAMMY FOX continued Form 6489 FL(0 I115) r L.NG I J a.r.k...m. Page 2 of 4 3, ADAM DAYTZ 4. LINDSEY THOMPSON 5. TIFFANY BURTON 6. DELBERT DUNSMORE . 7. TARA M VICKREY 8. MARIE A SIMPSON 9. JENNIFER R SHOWALTER • 10.HUGH 1 SMITH 11.SARA E BENTLEY 12.CECIL L LAWSON 13.MARIA RODRIGUEZ • 14,AMBER MURPHY 15.LAUREN MOON • At©coveTage schedade 1, 2094 Ford cono/Club Ullgo Actual Cash Value (plus$0.00 Permanently Attached Equip) Miiai MZE3 VIN: 1FTNE2EW4EDA90169 Garaging Zip Code: 33050 Radius: 100 =el Liability Liability PIP /11:C.:1,!-'-.!' ,-1 .:?,.,L,1 Erat Premium $3,517 $83 •'? '??,7';? Comp Comp Collision Collision A M Physical Damage Deductible Premium Deductible Premium Auto Total 61 Premium $250 $127 $250 $262 0 1ms. $3.989 v GEZERM `8 0 . 2. 2015 Miss WV 200 2.5s/Sv Stated Amount: '322,100(including Permanently Attached Equip) U m=mm VIN: 3N6CMOKNOFK7.18821 Garaging Zip Code: 33040 Radius: 50 0 =a 8 .... . ..... ?= Liability Liability PIP Premium $2,865 $69 \-.. 9 I.I I 1 11:1MMI 1 a=o 1 a Comp Comp Collision Collision• Physical Damage Deductible Premium Deductible Premium Auto Total 2 W=ass Premium $250 $155 $250 $394 $3,433 3. 2005 Ford cono/Club tIlign Actual Cash Value (plus$0,00 Permanently Attached Equip) • VIN: 1FMRE11WX5HA98430 Garaging Zip Code: 33040 Radius: 50 Liability Liability PIP Li,s, I: S....„T,f., Premium $2,389 $68 A : .--, Pt) Comp Comp Collision Collision Physical Damage Deductible Premium Deductible Premium Auto Total Premium $250 $88 $250 $96 - $2.641 El Continued Form 6489 FL(0 I/15) • Policy number. 06456454-7 FL KEYS S,P.C.A. ' Page 3 of 4 4, 2006 Ford Econo/Club 1111gn Actual Cash Value (plus$0.00 Permanently Attached Equip) VIN: 1 FTNS24W76DA11489 Garaging Zip Code: 33050 Radius: 100 Liability Liability PIP 11,1 4�•. c',, i Premium $2,856 $83 sj , , , r_.... w , :':r—:� Comp Comp Collision Collision Physical Damage Deductible Premium Deductible Premium Auto Total Premium $250 $101 $250 $136 $3,176 5. 2Oa0 Chevrolet Eupress G2500 Stated Amount: *$25,000(including Permanently Attached Equip) VIN: 1GCWGAFG411904199 Garaging Zip Code: 33040 Radius: 50 Liability liability PIP V ''./ ,.,, =? Premium $2,847 $68 L '? J0cr f,.r Comp Comp Collision Collision Physical Damage Deductible Premium Deductible Premium Auto Total Premium $250 $177 $250 $558 $3,650 *A vehicle's stated amount should indicate its current retail value,including any special or permanently attached equipment. In the event of a total loss,the maximum amount payable is the lesser of the Stated Amount or Actual Cash Value,less deductible. Be sure to check stated amount at every renewal in order to receive the best value from your Progressive Commercial Auto policy. Premium discounts • Policy 06456454-7 Business Experience and Paid In Full Vehicle 2014 Ford Econo/Club Wgn Anti-Lock Brakes and Air Bag 2015 Niss NV 200 2.5s/Sv Air Bag 2005 Ford Econo/Club Wgn Anti-Lock Brakes and Air Bag 2006 Ford Econo/Club Wgn Anti-Lock Brakes and Air Bag 2018 Chevrolet Express G2500 Anti-Lock Brakes and Air Bag sAdak:snag Ensured information • • 1 . Additional Insured MC BOARD COUNTY COM 1100 SIMONTON 5 KEY WEST,FL 33040 Agent signaturre • Continued Form 5489 FL(01/15) 3 I . 0 fD • O P Ncrt PGULSOIK 016546 003 ' 003 003 <0301 > • 11111111111111111111111111111N11111111111111111111