Certificates of Insurance
A~~~.lllt.
CERTIFICATE OF INSURANCE
ISSUE DATE (MM/DD/YY)
9/10/99
PRODUCER
SeaCoast Underwriters, Inc.
2200 Lucien Way, Suite 330
Maitland, FL 32751
Agent
Lupfer-Frakes, Inc.
222 Church Street
Kissimmee, FL 32741
INSURED
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
f~T~~~NY A SAFECO Surplus Lines Insurance Company
f~T~~NY B
Michael Design Associates, Inc.
400 W. New England Ave., Ste. 1
Winter Park, FL 32789
f~~~NY C
f~~~~Y D
COMPANY E
LETTER
COVERAGES
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.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRA nON
DATE (MM/DD/YY) DATE (MM/DD/YY)
LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON.OWNED AUTOS
GARAGE LIABILITY
..,y
GENERAL AGGREGATE $
PRODUCTS.COMP/OP AGG. $
PERSONAL & ADV. INJURY $
EACH OCCURRENCE $
FIRE DAMAGE (Anyone fire) $
MED. EXPENSE (Anyone person) $
CLAIMS MADE
OCCUR.
OWNER'S & CONTRACTOR'S PROTo
Wt.'VFP:
.. ~
i\!.~' .~__ YFS
COMBINED SINGLE $
LIMIT
BODIL Y INJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
EACH OCCURRENCE $
AGGREGATE $
[1!,TE
Excess LIABILITY
UMBRELLA FORM
OTi-iER THAN UMBRELLA fORM
AND
EMPLOYERS' LIABILITY
STATUTORY LIMITS
EACH ACCIDENT
$
WORKER'S COMPENSATION
DISEASE-POLICY LIMIT $
DISEASE-EACH EMPLOYEE $
OTHER
A Professional
Liability
CM 7850892A
12/2/98
12/2/99
$1,000,000 Each Claim
$1,000,000 Aggregate
I
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! DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/SPECIAL ITEMS
, This is a claims made policy. Coverage applies only to those claims which first occur
; and are first reported to the Company during the policy term.
I
)CERTIFICATE HOLDER
CANCEL LA TION
33050
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL....J.!L DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
MONROE COUNTY
2798 Overseas
Suite 400
Marathon, FL
BOCC
Highway
, ACORD 25-S (7/90)
AUTHORIZED REPRESENTATIVE
q~~
@ACORD CORPORATION 1990
..
ACORD.
.......I$.t$Eilml"lmE.t~mIIIBlruiliIIlIR~jIE~fI~l@e$~:.\................... DATE (MMlDDNY)
............H?'.M...}..LL.:...:)~~~)Lm.::S?~.H?'~)itt~f'}<............ 09/24/99
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTifiCATE DOES .NOT- AMEND-i.EXTEND- OR .
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
PRODUCER
Lup:fer- i!-rakes - msur-a-:noe ---
222 Church street
Kissimmee FL 34741
Phone No. 407-847-2841 Fax No.
INSURED
COMPANY
A Assurance Co. of America
COMPANY
B Everest National Insurance
Michael Design, Inc.
400 W.New England Ave.,Ste 1
Winter Park FL 32789
COMPANY
C
SAFE CO Surplus Lines Ins. Co.
COMPANY
o
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.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPtRATION LIMITS
LTR DATE (MMlDDNY) DATE (MMIOOIVY)
GENERAL LIABILITY GENERAL AGGREGATE S 2000000
A X COMMERCIAL GENERAL LIABILITY PPS32777543 03/12/99 03/12/00 PRODUCTS - COMP/OP AGG S 2000000
CLAIMS MADE [!] OCCUR PERSONAL & ADV INJURY S 1000000
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE S 1000000
FIRE DAMAGE (Anyone fire) S 1000000
MED EXP (Anyone person) S 10000
AUTOMOBILE LIABILITY S 1000000
PPS32777543 03/12/99 03/12/00 COMBINED SINGLE LIMIT
A ANY AUTO
ALL OWNED AUTOS BOOIL Y INJURY
S
SCHEDULED AUTOS (per person)
X HIRED AUTOS ., BODILY INJURY
(per lICCident) S
X NON-OWNED AUTOS
LIY
PROPERTY DAMAGE S
-;-
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S
ANY AUTO \\'-"\'[9: i'~~. ," " _/"'YFs OTHER THAN AUTO ONLY:
EACH ACCIDENT S
AGGREGATE S
EXCESS LIABILITY EACH OCCURRENCE S 1000000
A X UMBRELLA FORM PPS32777543 03/12/99 03/12/00 AGGREGATE s 1000000
OTHER THAN UMBRELLA FORM S
WORKERS COMPENSATION AND
EMPLOYERS" LIABILITY S 500000
B THE PROPRIETOR! INCL USA 001018 SEC1800028 OS/22/99 OS/22/00 s 500000
PARTNERSlEXECUTlVE
OFFICERS ARE: EXCL EL DISEASE - EA EMPLOYEE S 500000
OTHER
A Comm Application PPS32777543 03/12/99 03/12/00
A Property Section PPS32777543 03/12/99 03/12/00
DESCRIPTION OF OPERATlONSlLOCATlONSlVEHICLESlSPECIAL ITEMS
Engineers or Architects-Consulting-Not Engaged in Construction SUP!lrvision.
Cert. Holder named Additional Insured wit res~cts to General Liab;lity and
Auto Liability. *10 day notice in the event 0 non-payment of preDU.UJIl.
Monroe County BOCC
2798 Overseas Highway Ste. 400
Marathon FL 33050
MONROEB SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAlL
30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIN UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED RE ESENTATlVE
..iW5qq)'#JQQRfi:@iQitlQ~1~M
ACORD.
C>ERTlFICATE OF: L.IAeltriY:1N:Sl.JRANCBp:ftit~::: DATE (MMlDDNY)
.:...:.....:.:...........:.:.:...:.:.....:.....:...:...:...:.:.:. ...:...:...:. .......:.:...:...:.......:.:...:.....:...:.:...:.........:.....:...:.:.............:.....:.:.....: .~~.Cn~. S:. 09/11/00
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
PRODUCER
Lupfer-Frakes Insurance
222 Church Street
Kissimmee FL 34741
Special Accounts
Phone No. 407 - 847 - 2 841 Fax No.
INSURED
COMPANY
A
Assurance Co. of America
COMPANY
B
Everest National Insurance
Michael Design Associates
Ste 1
400 W. New England Ave
Winter Park FL 32789
COMPANY
C
SAFECO Surplus Lines Ins. Co.
COMPANY
D
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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.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MMlDDNY) DATE (MM/DDNY)
LIMITS
GENERAL LIABILITY GENERAL AGGREGATE $ 2000000
-
A X COMMERCIAL GENERAL LIABILITY PPS32777543 03/09/00 03/09/01 PRODUCTS.COM~OPAGG $ 2000000
I CLAIMS MADE ~ OCCUR PERSONAL & ADV INJURY $ 1000000
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $1000000
-
- FIRE DAMAGE (Anyone fire) $ 1000000
MED EXP (Anyone person) $ 10000
AUTOMOBILE LIABILITY
- COMBINED SINGLE LIMIT $1000000
A ANY AUTO PPS32777543 03/09/00 03/09/01
-
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS 1 ~'~~tS (Per person)
-
X HIRED AUTOS -. BODILY INJURY
- $
X NON.OWNED AUTOS (Per accident)
- v
u' () I~lr@
- PROPERTY DAMAGE $
n'TC
GARAGE LIABILITY , AUTO ONLY. EA ACCIDENT $
- ..L. vrs
ANY AUTO \tl"\TQ: i~t ;" OTHER THAN AUTO ONLY:
-
- EACH ACCIDENT $
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $1000000
A M UMBRELLA FORM PPS32777543 03/09/00 03/09/01 AGGREGATE $1000000
OTHER THAN UMBRELLA FORM $
WORKERS COMPEN8ATION AND ! WC STATU- I 10TH-
iRkf LIMITS ER ......
EMPLOYERS' LIABILITY
EL EACH ACCIDENT $ 500000
B THE PROPRIETOR! RINCL 3300000066991 08/01/00 08/01/01 EL DISEASE - POLICY LIMIT $ 500000
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL EL DISEASE. EA EMPLOYEE $ 500000
OTHER
A Property Section PPS32777543 03/09/00 03/09/01
A Crime Section PPS32777543 03/09/00 03/09/01
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
Engineers or Architects-Consulting-Not Engaged in Construction Supervision.
Cert. Holder named Additional Insured witfi res~ects to General Liab~lity and
Auto Liability. *10 day notice in the event o~ non-payment of prem1um.
PER.TiF.lpAti:: J;lQLpeF.f . . .
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. . : .CAN(?ELLAtION".
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MONROEB
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE , ~
.......~~~~f~~...~~~~\1.Ilt~..~AC~ON.1~66;....
Monroe County BOCC
Mayra Fax:305-289-2854
2798 Overseas Highway Ste.
Marathon FL 33050
400
ACeRO :i~$ :(1f$~}...
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