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Certificates of Insurance CI ient#: 1458462 GAFOO D DATE(MM/DD/YYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 1 12/08/2023 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: USI Insurance Services LLC PHONE FAX A/C,No,Ext: (A/C,No): 9910 Dupont Circle Dr. E E-MAIL ADDRESS: Suite 120 INSURER(S)AFFORDING COVERAGE NAIC# Fort Wayne, IN 46825 INSURER A:Pennsylvania Manufacturers Assoc.Ins. 12262 INSURED INSURER B:AXIS Surplus Insurance Company 26620 G.A. Food Services of Pinellas GuideOne National Insurance Company 14167 INSURER C: P Y County, LLC; 12200 32nd Ct., North Federal Insurance Company 20281 INSURER D: p Y Saint Petersburg, FL 33716 Hanover Insurance Company 22292 INSURER E: p Y INSURER F: Manufacturers Alliance 36897 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 CONTRACTOR 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 ADDLSUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY X X 3023000298901 3/15/2023 03/15/2024 EACH OCCURRENCE $1 90009000 CLAIMS-MADE 4 OCCUR PREMISESOERENTED r nce $1009000 APPROVED BY RISK MANAGEMENT MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1 90009000 GEN'L AGGREGATE LIMIT APPLIES PER: DATE i i o2624 GENERAL AGGREGATE $2,000,000 PRO- WAIVER N/A_YES_ PRODUCTS-COMP/OP AGO s2,000,000 POLICY JECTPRO- LOG OTHER: $ F AUTOMOBILE LIABILITY X X 1523750298901 A 3/15/2023 03/15/202 COMBINED SINGLE LIMIT 22> >000 000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PerOa c TY DAMAGE AUTOS ONLY AUTOS ONLY B X UMBRELLA LIAB X OCCUR P00100079730302 3/15/2023 03/15/2024 EACH OCCURRENCE s2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE s2,000,000 DED I I RETENTION$ $ A WORKERS COMPENSATION 202375029801 3/15/2023 03/15/202 X PER OTH- AND EMPLOYERS'LIABILITY TATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $190009000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,0009000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 C 2nd Layer Excess 56000299701 3/15/2023 03/15/202 $290009000 D 3rd Layer Excess 79892909 3/15/2023 03/15/202 $1090009000 E I Emply Dishonesty BDYH44261003 12/01/2023 12/01/202 $390009000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Additional Named Insureds: Linden Ventures, LLC;Jaguar Borrower, LLC;Jaguar Intermediate, LLC; Clossman Catering, LLC CYBER LIAB: Carrier:Travelers Casualty&Surety Co.of America; NAIC#31194; Policy#1075470367; Policy Dates: 12/1/2023 to 12/1/2024; Limits of Liability:$5,000,000 Deductible$25,000 Workers Compensation applies to the following states: AL,AR, CA, CO, FL GA, IL, KY, MO, NC, NJ,PA, SC,TN, (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION G.A. Food Services Of Pinellas SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN County LLC ACCORDANCE WITH THE POLICY PROVISIONS. 12200 32nd Ct, North Saint Petersburg, FL 33716-0000 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S42833032/M42833020 RXRAM DESCRIPTIONS (Continued from Page 1) TX,VA, OH, NY SAGITTA 25.3(2016/03) 2 Of 2 #S42833032/M42833020 Client#: 1458462 GAFOOD DATE(MMiDDNYYY) ACORD,. CERTIFICATE OF LIABILITY INSURANCE 1 311512021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME.ACT Renee Riles 11SI Insurance Services LLC PHONE- _ � . 260 432-3400 9910 Dupont Circle Dr.E E-MAILD ADDRESS, renee.riles@usi.com Suite 120 �- INSURER($)AFFORDING COVERAGE NAIL p Fort Wayne, IN 46825 INSURER A:Pennsylvania Manufacturers Assoc.Ins. 1,2262 INSURED INSURER 8.Federal Insurance Company 20281 GA Food Services of Pinellas County LLC INSURER c Hanover Insurance Company 22292 Jaguar Topco LLC; Jaguar Borrower LLC _ _... __-- INSURER D:Houston Casualty Company 42374 12200 32nd North INSURER E Saint Petersburg, FL 33716 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 CONTRACTOR 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 AbDLSUBR POLICY EIFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDDIYYYY) (MWD.DNYYY) LIMITS A X'COMMERCIAL GENERAL LIABILITY X X 3021000298901 0311512021 03/15/2022 EACH OCCURRENCE $1,000,004 i -CLAIMS-MADE _ X OCCUR S?(Ea acc.E Dncs) $100,000 Approved Risk Management with attachments MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 POLICY( ..... JECOT (LQc PRODUCTS COMPIOPAGG $2,000,000 ... OTHER: 3-18-2021 A AUTOMOBILE LIABILITY X X ,1521750298901 311512021 03/15/2022 COMBINEDa t)SINGLE LIMIT �1,000,000 X ANY AUTO BODILY INJURY(Per person) ' OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) _. _. HIRED NON OWNED -PROPERTY DAMAGE:- _$ X AUTOS ONLY X AUTOS ONLY I-.(Per accident) I. $ B X UMBRELLA LIAR X OCCUR 79892909 0311512021 03/15/2022 EACH OCCURRENCE $15,000,000 EXCESS LAB CLAIMS•ha1ADE AGGREGATE � 15,000,000 DED ( XI_RETENTIONSO 3 ------- _-- PER �O TH-ACRKERSCOMPENSATION X 2021750298901 311512021 03/15/2022 X AND EMPLOYERS'LIABILITY TArrE E ) Y7N ANY PROPRIETORJPARTNERtEXECUTIVEi DEL EACH ACCIDENT $1,000„000 OFFICER/MEMBER EXCLUDED? I N f A (Mandatory in NH) E L DISEASE EA EMPLOYEE $1,000,000 If yes,describe under _....._ _....-__... .. DESCRIPTION OF OPERATIONS below E=L.DISEASE POLICY LIMIT $1,000,000 ..— --..... .. _ _..- .._..... ..-- --__.._ _... C Emply Dishonesty BDYH44261000 12/0112020 12101/2021 $3,000,000 D Cyber Liability H2OPVS5026600 12/01/2020 12/01/2021 $5,000,000 DESCRIPTION OF OPERATIONS i LOCATIONS)VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If moire space is required) Additional Named Insureds:Jaguar Intermediate, LLC; Clossman Catering, LLC This certificate is issued for the named insured operations usual to maker of nutritious meals for healthcare patients,seniors,children, military and emergency responders to disasters Monroe County BOCC is included as an additional insured as it relates to the General and Automobile (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION Monroe Count BOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 Simonton St,2nd Floor ACCORDANCE WITH THE POLICY PROVISIONS. Key West, FL 33040-0000 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S31455834/M31452863 AXYZP DESCRIPTIONS (Continued from Page 1) Liability in accordance with the policy terms and conditions. Bayshore Manor is named as an additional insured as it relates to General Liability and Automobile Liability in accordance with the policy terms and conditions. SAGITTA 25.3(2016/03) 2 of 2 #S31455834/M31452863 Client#: 1458462 GAFOOD DATE(MMiDDNYYY) ACORD,. CERTIFICATE OF LIABILITY INSURANCE 1 311512021 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME.ACT Renee Riles 11SI Insurance Services LLC PHONE- _ � . 260 432-3400 9910 Dupont Circle Dr.E E-MAILD ADDRESS, renee.riles@usi.com Suite 120 �- INSURER($)AFFORDING COVERAGE NAIL p Fort Wayne, IN 46825 INSURER A:Pennsylvania Manufacturers Assoc.Ins. 1,2262 INSURED INSURER 8.Federal Insurance Company 20281 GA Food Services of Pinellas County LLC INSURER c Hanover Insurance Company 22292 Jaguar Topco LLC; Jaguar Borrower LLC _ _... __-- INSURER D:Houston Casualty Company 42374 12200 32nd North INSURER E Saint Petersburg, FL 33716 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 CONTRACTOR 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 AbDLSUBR POLICY EIFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDDIYYYY) (MWD.DNYYY) LIMITS A X'COMMERCIAL GENERAL LIABILITY X X 3021000298901 0311512021 03/15/2022 EACH OCCURRENCE $1,000,004 i -CLAIMS-MADE _ X OCCUR S?(Ea acc.E Dncs) $100,000 Approved Risk Management with attachments MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 POLICY( ..... JECOT (LQc PRODUCTS COMPIOPAGG $2,000,000 ... OTHER: 3-18-2021 A AUTOMOBILE LIABILITY X X ,1521750298901 311512021 03/15/2022 COMBINEDa t)SINGLE LIMIT �1,000,000 X ANY AUTO BODILY INJURY(Per person) ' OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) _. _. HIRED NON OWNED -PROPERTY DAMAGE:- _$ X AUTOS ONLY X AUTOS ONLY I-.(Per accident) I. $ B X UMBRELLA LIAR X OCCUR 79892909 0311512021 03/15/2022 EACH OCCURRENCE $15,000,000 EXCESS LAB CLAIMS•ha1ADE AGGREGATE � 15,000,000 DED ( XI_RETENTIONSO 3 ------- _-- PER �O TH-ACRKERSCOMPENSATION X 2021750298901 311512021 03/15/2022 X AND EMPLOYERS'LIABILITY TArrE E ) Y7N ANY PROPRIETORJPARTNERtEXECUTIVEi DEL EACH ACCIDENT $1,000„000 OFFICER/MEMBER EXCLUDED? I N f A (Mandatory in NH) E L DISEASE EA EMPLOYEE $1,000,000 If yes,describe under _....._ _....-__... .. DESCRIPTION OF OPERATIONS below E=L.DISEASE POLICY LIMIT $1,000,000 ..— --..... .. _ _..- .._..... ..-- --__.._ _... C Emply Dishonesty BDYH44261000 12/0112020 12101/2021 $3,000,000 D Cyber Liability H2OPVS5026600 12/01/2020 12/01/2021 $5,000,000 DESCRIPTION OF OPERATIONS i LOCATIONS)VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If moire space is required) Additional Named Insureds:Jaguar Intermediate, LLC; Clossman Catering, LLC This certificate is issued for the named insured operations usual to maker of nutritious meals for healthcare patients,seniors,children, military and emergency responders to disasters Monroe County BOCC is included as an additional insured as it relates to the General and Automobile (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION Monroe Count BOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 Simonton St,2nd Floor ACCORDANCE WITH THE POLICY PROVISIONS. Key West, FL 33040-0000 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S31455834/M31452863 AXYZP DESCRIPTIONS (Continued from Page 1) Liability in accordance with the policy terms and conditions. Bayshore Manor is named as an additional insured as it relates to General Liability and Automobile Liability in accordance with the policy terms and conditions. SAGITTA 25.3(2016/03) 2 of 2 #S31455834/M31452863 Client#:1458462 GAFOOD ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD'rvm 3/06/2020 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:N the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. II 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 any rights to the certificate holder In lieu of such endorsement(s). PRODUCER Ur' Margo L.Kyser,CIC,CISR,AIS USI Insurance Services LLC PHONE FAX-- ROC,No,E1�60-435-4238 W WAIL,Na): 866-702-7119 9910 Dupont Circle Dr.East EMAIL Suite 120 ADDREss: margo.kyser®usi.com INSURER(S)AFFORDING COVERAGE NAMC Fort Wayne,IN 46825 INSURER A:H•nrve cn.•ny a.nnn..Cemp•ny 29424 INSURED INSURER B:nniand insuranutompwy 20281 G.A.Food Services of Pinellas -- - - -- —- INSURER C:Peinnd•nls Manueewnn.une.ins. 12262 County Inc. - -- -- 12200 32nd Ct.,North INSURER o:F•a•,•Iln..nnm Co. 20281 _INSURER E:H•mr ..d RNInr.nc.comp.ny 19682 Saint Petersburg, FL 33716 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 CONTRACTOR 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 ADDLSUBR POLICY EFF , POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER OAM/DONYW) LIMITS p. % COMMERCIAL CI:xERAIyABanY X X 36UENZV6433 3/15/2020 03/15/2021 EACH OCCURRENCE Is 1,000,000 _ I CLAIMS-MADE 1 X OCCUR DAMA T RENTED J PREMIGXPBQEaonnrersn) '$30Q000 AW .",1/�.Y' AGEMENT MEDONAL&y one person) 's5_000 6`( •ry - PERSONAL a ADE INJURY $1,000,000 =EN'LAGGREGATE LIMIT APPLIES PEA: DAZE laGlt••rilin W(AV GENERAL AGGREGATE $3,000,000 " PRO- - dal _ POLICY I._.I JECT LOC PRODUCTS-COMP/OP AGG 1$2,000,000 OTHER. ''1 $ E PU�TOMueILEZImILIrr X X E 36UENZV5917 13/15/2020 03/15/2021 lEae aeDISINCLE LIMIT $1,000,000 H X ANY AUTO _ BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $_ AUTOS ONLY i AUTOS _ ',HIRED NON-OWNED PROPERTY DAMAGE Xi AUTOS ONLY X AUTOS ONLY (Per accEenl) �$ X$1,000 Comp X I$1,000 Coll. $ B % UMBRELLA LIAR X OCCUR 79892909 13/15/2020 03/15/2021 EACH OCCURRENCE $15,000,000 EXCESS LIAR ,CLAIMS-MADE AGGREGATE I$15,000,000 LIED % RETENTION SO _ $ C WORKERS COMPENSATON X 2020750298901 13/15/2020 03/15/2021 X Fa OTH AND EMPLOYERS'UABILITY YIN, STATUTE Fq "- ANYPROPRIETORPARTNER/EXECUTIVE - E L EACH ACCFDENT $1000,000 OFFICER/MEMBER EXCLUDED? LN I N(A (Mandatory In NH) —' EL.DISEASE-EA EMPLOYEE $1,000,000 If yes describe under DESCRIPTION OF OPERATIONS below ;_. __ _ E.L DISEASE.POLICY LIMIT $1,000,000 _ D Crime 82508244 13/15/2020 03/15/2021 $500,000 Employee ' 1 Dishonesty w/$2,500 Ded DESCRIPTION OF OPERATONS/LOCATIONS(VEHICLES(ACORD I D1,Additional Remarks S[Mdole,may be anached N more space Is required) Monroe County BOCC is included as an additional insured as It relates to the General and Automobile Liability in OUCVIU rice with the policy terms and conditions. Bayshore Manor is named as an additional insured as It relates to General Liability and Automobile Liability In accordance with the policy terms and conditions. CERTIFICATE HOLDER CANCELLATION Monroe County BOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 Simonton St,2nd Floor ACCORDANCE WIn1 THE POLICY PROVISIONS. Key West,FL 33040 AUTHORIZED REPRESENTATIVE )1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #528155496/M28152391 SECZP Client#:1458462 GAFOOD ACORDT. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DONYVY) 3/06/2020 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 Inn ADDITIONAL INSURED,the policy(les)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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Margo L.Kyser,CIC,CISR,AIS_ USI Insurance Services LLC PHONE E - 260-435-4238 FAX 9910 Dupont Circle Dr.East E-MAIL ___— (uc,No 866-702-7119 Suite 120 ADDRESS: margo.kyser@usi.com INSURER(S)AFFORDING COVERAGE ' NAICI Fort Wayne,IN 46825 INSURER A:wmrm Caroaly Inswar CflP•m 29424 INSURED G.A.Food Services of Pinellas INSURER e:F.a,N n.,..,,�CemP..r 20281 INSURER C_PanneHnxP ummedunra Pa,a.Fa 12262 County Inc. - -- 12200 32nd Ct.,North INSURER°'`°°°+a.e,.m,Co. 20281 Saint Petersburg,FL 33716 INSURER E:wmrm Rm Ma„w,rs Cwnpnr 19682 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 ADDLSUER -- - POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER _ (MM/D/YYYY) (MM/DD/YVYV) LIMITS A % COMMERCIAL GENERAL % X 36UENZV6433 13/15/2020 03/15/2021'EACH OCCURRENCE $1,000,000 I CLAIMS-MADE I XI OCCUR I FAMMENTgence $300,000 gPPF I! ( ��I,.P AG^8NT M (A person) $5,000 DATA 'i4#M Mg SD I PERSONAL B AOV INJURY $1,000,000 GEPI'L AGGREGATE LIMIT APPLIES PER'. IGENEHAL AGGREGATE $3,000,000 I--, PRO- I POLICY i_ _I JECT % LOC 'PRODUCTS-COMP/OP AGG $2,000,000 OTHER E % X 36UENZV5917 13/15/2020 03/15/2021 $ ,AUTOMOBILE LIABILITY — I COMRNE()SINGLE LIMIT watt„Gwent) __$1.000,000 X ANY AUTO .BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ _AUTOS ONLY ,AUTOS HIRED ANON-OWNED 'PROPERTY DAMAGE X,AUTOS ONLY X AUTO$ONLY (Per acctle iL_._. $ X$i,000 Comp -X $1,000 Coil. $ B X UMBRELLA use X OCCUR I 79892909 .3/15/2020 03/15/2021 EACH OCCURRENCE $15,000,000 _ EXCESS LNa CLAIMS-MADE AGGREGATE $15,000,000 _ _ I DED I X, RETENT,ON$0 1 ____ 1 $ )ANY!OFFICER/MEMBER R/MEMEReEXCLUDED' N NIA PER _ oT4 D WORKERS COMPENSATION X 2020750298901 .3/15/2020 03/15/20211X AND EMPLOYERS'LIABILITY V/N STATUTE 'ER ANY PROPRIETOR/PARTNER/EXECUTIVE E L.EACH ACCIDENT $1�000,000 1(Mantlelory In NH) E L.DISEASE.EA EMPLOYEE $1,000,000 r IDESCRIPTION OF OPERATIONS below i E.L.DISEASE-POLICY LIMIT $1,000,000 D Crime 82508244 .3/15/2020 03/15/20211$500,000 Employee Dishonesty w/$2,500 Ded DESCRIPTION OF OPERAI1ONSJ LOCATIONS/VEHICLES(ACORD 101,Add(Uonal Remarks Schedule,may be attached II more space Is required) RE:Bid-SSD Food Services&Meal Catering For Monroe Co Nutrition Program Monroe County Board of County Commissfoilersfsmtluded as an additional Insured as it relates to the General and Automobile Liability in accordance with the policy terms and conditions. CERTIFICATE HOLDER CANCELLATION Monroe County BOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1100 Simonton Street,Room 1-213 ACCORDANCE WITH THE POLICY PROVISIONS. Key West,FL 33040 AUTHORIZED REPRESENTATIVE ' 01988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #528155497/M28152391 SECZP