Loading...
Certificates of Insurance WESTCON-11 EDENL CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) ...•w-� 12/30/2019 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. 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 License#OE67768 CONTACT Tara McKay NAME: Insurance Office of America,Inc. PHONE 561 296-6153 26053 FAX 561 776-0670 Abacoa Town Center (A/C,No,Ext): ( ) (A/C,No):( ) 1200 Universityy Blvd,Suite 200 E-MAIL Tara.McKay@ioausa.com Jupiter,FL 33468 INSURERS AFFORDING COVERAGE NAIC# INSURERA:Builders Mutual Insurance Company 10844 INSURED INSURER B: West Construction Inc INSURER C: 820 N 4th ST INSURER D: Lantana,FL 33462 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD MMIDD/YYYY MMIDD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE ❑ OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP(Any oneperson) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY ; COMBINED SINGLE LIMIT �, Ea accident $ ANY AUTO `,BODILY INJURY Perperson) $ OWNED SCHEDULED 9 AUTOS ONLY AUTOS ?' '" ' 'R- 4 - -"- BODILY INJURY Per accident $ HIRED NON-OWNED - PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY rJ/8/2 0 2 Per accident $ UMBRELLA LIAB OCCUR N EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN WCP1069688-0 1/1/2020 1/1/2021 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N/A X E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:Cudjoe Key New Fire Station General Contractor License#:CGC1516626 for Matthew Fielden West Waiver of Subrogation with respect to Workers'Compensation per form#WC000313. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County Board of County Commissioners AUTHORIZED REPRESENTATIVE 1100 Simonton Street Suite 1-213 u Key West FL 33040 `- ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 712/30/2019 E(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 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 CONTANAME:CT Anthony Entenza JDA Insurance Group A/CNNo Ext: (561)296-0373 q/c No): (561)828-0997 120 N Federal Hw Suite#301 E-MAIL danielle thejda rou com y�� ADDRESS: @ ) g p� INSURER(S)AFFORDING COVERAGE NAIC# Lake Worth FL 33460 INSURERA: Zurich American Insurance Company 16535 INSURED INSURERB: American Guarantee& Liability Insurance Company 26247 West Construction Inc.,West Architecture+ Design, LLC. INSURERC: American Guarantee& Liability Insurance Company 26247 820 N.4th St. INSURER D: INSURER E: Lantana FL 33462 INSURERF: 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MMIDD/YYYY MMIDD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 TE CLAIMS-MADE � OCCUR PREM SES DAMAGOEa occurrDence $ 500,000 X Contractual Liability MED EXP(Any one person) $ 10,000 A Y Y GL0039847303 01/01/2020 01/01/2021 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY� PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 4,000,000 JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED Y Y BAP039847403 01/01/2020 01/01/2021 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 C EXCESS LIAB CLAIMS-MADE Y Y AUC039847603 01/01/2020 01/01/2021 AGGREGATE $ 10,000,000 DED RETENTION$ -: -I $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE s"� - �, E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A 7p,� (Mandatory in NH) . 5 /S2 2020 E.L.DISEASE-EA EMPLOYEE $ If yes,describe under / - ®"`'"� DESCRIPTION OF OPERATIONS below � E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:Cudjoe Key New Fire Station General Contractor License#:CGC1516626 for Matthew Fielden West The Certificate Holder is named as additional insured including products and completed operations for general liability per form UGL1175FCW,automobile liability,and umbrella liability when required by written contract. General Liability and Auto Liability are primary and non contributory when required by written CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County Board of County Commissioners 1100 Simonton Street AUTHORIZED REPRESENTATIVE Suite1-213 �_ <, Key west FL 33040 �� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD • • AcoR ® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 01/03/2019 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. 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 CONTNAME:ACT Anthony Entenza JDA Insurance Group (A/CONIJ Fs (561)296-0373 (A/c.Not: (561)828-0997 120 N Federal Hwy.,Suite#301 E-MAIL danielle the da rou com ADDRESS: @ 1 9 P• INSURER(S)AFFORDING COVERAGE NAIC# Lake Worth FL 33460 INSURER A: Zurich American Insurance Company 16535 INSURED INSURER B: American Guarantee&Liability Insurance Company 26247 West Construction Inc.,West Architecture+Design,LLC. INSURER C: American Guarantee&Liability Insurance Company 26247 820 N.4th St. INSURER D: Florida Citrus Business&Industries Fund _INSURER E: Zurich American Insurance Company 16535 Lantana FL 33462 INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUM ER: THIS IS TO CERTIFY THAT THE POLICIES OF INSJRANCE 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 E BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP W LIMITS LTRINSD VD POLICY NUMBER IMM/DDIYYYYI IMMIDDIYYYYI X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 DAMAGE TO RETED CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 500,000.00 X Contractual Liability MED EXP(My one person) $ 10,000.00 A _ Y Y GL0039847302 01/01/2019 01/01/2020 PERSONAL&ADVINJURY $ 1,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000.00 POLICY X PROT , LOC PRODUCTS-COMP/OPAGG $ 2,000,000.00 JEC OTHER: $ AUTOMOBILE LIABILITY COMBINEDll SINGLE LIMIT $ 1,000,000.00 (Ea acciden X ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED AUTOS ONLY AUTOS Y Y BAP039847402 01/01/2019 01/01/2020 BODILYINJURY(Peraccident) $ _ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY _ AUTOS ONLY (Per accident) PIP $ 10,000.00 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 12,000,000.00 C EXCESS LIAB CLAIMS-MADE Y Y AUC039847602 01/01/2019 01/01/2020 AGGREGATE $ 12,000,000.00 DED RETENTIONS - $ WORKERS COMPENSATION X STA UTE OTH- ER AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000.00. D OFFICER/MEMBEREXCLUDED? N N/A Y 106-60973 01/01/2019 01/01/2020 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000.00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re:Cudjoe Key New Fire Station rN.(.)/E B A AGEMENTT General Contractor License#:CGC1516626 for Matthew Fielden West DATE- WAIVER A E_ The Certificate Holder is named as additional insured including products and completed operations for general liability per form UGL1175FCW,automobile liability,and umbrella liability when required by written contract.General Liability and Auto Liability are primary and non contributory when required by written 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 County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street AUTHORIZED REPRESENTATIVE Suite 1-213 � av titer '�L Key west FL 33040 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD M � AGENCY CUSTOMER ID: _ LOC#: A ® ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED JDA Insurance Group West Construction Inc.,West Architecture+Design,LLC. POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance by written contract.Waiver of subrogation applies to general liability,automobile liability,umbrella liability,and workers'compensation when required by written contract.Umbrella extends over general liability,auto liability and employer's liability.Should any of the above described policies be cancelled,notice will be deliverec in accordance with the policy provisions. ACORD 101 (2008/01) ©2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD • AC R® CERTIFICATE OF PROPERTY INSURANCE DATE(MMIDDIYYYY) 11/26/2018 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. PRODUCER CONT Anthony NAME: Entenza JDA Insurance Group (A/cNN,Ext): (561)296-0373 (A/c,No): (561)828-0997 120 N Federal Hwy.,Suite#301 E-MAIL Dill th anee e da rou ADDRESS: � 1 9 P•com PRODUCER JDA7257 CUSTOMER ID: Lake Worth FL 33460 INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Lloyd's of London West Construction Inc. INSURER B: 820 North 4th Street INSURER C: INSURER D: Lantana FL 33462 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: • LOCATION OF PREMISES/DESCRIPTION OF PROPERTY(Attach ACORD 101,Additional Remarks Schedule,if more space is required) 22352 Overseas Hwy.,Cudjoe Key,FL 33042 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/DDIYYYY) DATE(MM/DDIYYYY) X I PROPERTY X BUILDING $ 3,884,185 CAUSES OF LOSS DEDUCTIBLES - PERSONAL PROPERTY $ BASIC BUILDING BUSINESS INCOME $ NTENTBROAD CO 000 S EXTRA EXPENSE $ X SPECIAL RENTAL VALUE $ EARTHQUAKE BLANKET BUILDING $ A X ^nND 10,000 CSN0004808 11/20/2018 11/20/2019 BLANKET PERS PROP $ FLOOD - BLANKET BLDG&PP $ $ $ INLAND MARINE TYPE OF POLICY $ CAUSES OF LOSS $ NAMED PERILS POLICY NUMBER $ V£Dc 11C MENT $ CRIME $ TYPE OF POLICY �Y $ DATE BOILER&MACHINERY/ EQUIPMENT BREAKDOWN WAIVER NIA YES... ,— $ SPECIAL CONDITIONS/OTHER COVERAGES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Monroe County Board of County Commissioners shall be included as Loss Payee on the above referenced policy. 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 County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 500 Whitehead St AUTHORIZED REPRESENTATIVE Key West FL 33040 ©1995-2015 ACORD CORPORATION. All rights reserved. ACORD 24(2016/08) The ACORD name and logo are registered marks of ACORD AcciRO DIY® CERTIFICATE OF PROPERTY INSURANCE DATE 01/17/2019 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. PRODUCER NAMEACT 'Anthony Entenza JDA Insurance Group (A/CC.No,Ext): (561)296-0373 ONE FAX No): (561)828-0997 120 N Federal Hwy.,Suite#301 ADDRESS: Danielle@thejdagroup.com PRODUCER JDA7257 CUSTOMER ID: "" Lake Worth FL 33460 INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Lloyd's of London West Construction Inc. INSURER B: 820 North 4th Street INSURER C: INSURER D: Lantana FL 33462 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: LOCATION OF PREMISES/DESCRIPTION OF PROPERTY (Attach ACORD 101,Additional Remarks Schedule,if more space is required) 22352 Overseas Hwy.,Cudjoe Key,FL 33042 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(MM/DD/YYW) X PROPERTY X BUILDING $ 3,884,185 CAUSES OF LOSS DEDUCTIBLES PERSONAL PROPERTY S BASIC BUILDING BUSINESS INCOME $ BROAD l 0,000 EXTRA EXPENSE CONTENTS $ X SPECIAL RENTAL VALUE $ EARTHQUAKE BLANKET BUILDING $ A X WIND 10,000 — CSN0004808 11/20/2018 11/20/2019 BLANKET PERS PROP $ FLOOD BLANKET BLDG&PP $ $ INLAND MARINE TYPE OF POLICY $ CAUSES OF LOSS $ NAMED PERILS POLICY NUMBER $ $ CRIME p 11EDI NSK MAN ENEMY TYPE OF POLICY aY �J _ s BOILER&MACHINERY/ DATE _3 a ✓� EQUIPMENT BREAKDOWN WAIVER wA YES $ $ s SPECIAL CONDITIONS/OTHER COVERAGES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Monroe County Board of County Commissioners shall be included as Loss Payee on the above referenced BUILDERS RISK policy. 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 County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 500 Whitehead St AUTHORIZED REPRESENTATIVE Key West FL 33040 etAAA6t L4 � ©1995-2015 ACORD CORPORATION. All rights reserved. ACORD 24(2016/03) The ACORD name and logo are registered marks of ACORD