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Certificates of Insurance
DATE(MWDD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 08/10/2021 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 CONTACT Triton Global NAME: Triton Insurance Group HCONN. Ext: (866)400-7674 100 a/c,No): (866)657-3678 100 N State Road 7 E-MAIL ADDRESS: q tritona .comuote enc @ g y Unit 304 INSURER(S)AFFORDING COVERAGE NAIC# Margate FL 33063 INSURERA: Nationwide Insurance Company OfAmerica 23787 INSURED INSURER B: Infinity Assurance 39497 CEILING TO FLOOR CLEANING INC. INSURERC: Old Republic Surety Company 40444 PO BOX 880 INSURER D INSURER E: FORT LAUDERDALE FL 33302-0880 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2172016584 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 MAYBE 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 INSURANCEAUULbUbK POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FX OCCUR PREM SDAMAGES Ea oNcurDrence $ 100'000 MED EXP(Any one person) $ 5,000 A Y Y ACP3007831364 07/28/2021 07/28/2022 PERSONAL&ADV INJURY $ 1,000,000 MOTHER LAGGREGATE LIMITAPPLIES PER: Approve{ Isk St1SgC ent GENERAL AGGREGATE $ 2,000,000 POLICY ❑ PRO ❑ LOC CC //JJ �/ PRODUCTS-COMP/OPAGG $ 2,000,000 : Personal&Advertising $ 1,000,000 AUTOMOBILE LIABILITY ®2�2 QO a INdEeDt SINGLE LIMIT $ 1,000,000 . ANYAUTO BODILY INJURY(Per person) $ B X OWNED �/ SCHEDULED Y 509820033119001 04/02/2021 04/02/2022 BODILY INJURY(Pe r accide nt) $ /� AUTOS ONLY /� AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ 1,000,000 AUTOS ONLY AUTOS ONLY Per accident PIP-Basic $ 10,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ElN/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ SERVICE BOND EMPLOYEE C W150317805 06/11/2021 06/11/2022 DISHONESTLY $10,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) ADDITIONAL INSURED STATUS AFFORDED WHERE REQUIRED BY WRITTEN CONTRACT WITH THE INSURED. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Monroe County BOCC ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton St. AUTHORIZED REPRESENTATIVE 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 Aco 0 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 05/26/2020 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 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 CONTACT AP Intego Insurance Group, LLC AP INTEGO INSURANCE GROUP, LLC PHONE 888.289.2939 FAX A/C No Ext: A/C No): 375 Woodcliff Dr. E-MAIL ADDRESS: certs@apintego.com Suite 103 INSURER(S)AFFORDING COVERAGE NAIC# Fairport NY 14450 INSURERA: NorGUARD Insurance Company 31470 INSURED Ceiling To Floor Cleaning, Inc. INSURER B 7 PO BOX 880 INSURER 7 Fort Lauderdale FL 33302 INSURER D7 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 EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MWDD/YYYY MWDD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE ( RENTED PREMISESS Ea occurrence) $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO LOC $ JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ A OFFICE/MEMBER EXCLUDED? ❑ N/A CEWC078556 07/11/2019 07/11/2020 500000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) ( Y: 5/26/2020 CERTIFICATE HOLDER CANCELLATION Monroe County Board of County Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1 11 1 —12th Street, Suite 408 ACCORDANCE WITH THE POLICY PROVISIONS. Key West FL 33040 AUTHORIZED REPRESENTATIVE @ 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Clear All 2018 Ldttinn MONROE COUNTY,FLORIDA REQUEST FOR WAIVER OF INSURANCE REQUIREMENTS It Is requested that the insurance requirements, ,-,pecified in the County's Schedule of Insurance Requirements,be wal*ved or�r odirir l on the following contract, r1` Contractor!Vendor: , Project or Service: Contraactori Vendor ,Address 8t Phone 0: X t? General Scope of Work: Reason for Waiver or r 6l` , Policies Waiver or Modification will apply to: .� l x Signature of Conrractor'Vendor: � Ctate...,Q 14 2a20 ,gyp-proved xx Not Approved Risk Management Signature. .., Date County Administrator appeal; Approved- Not Approved: fate: Board of County Commissioners appeal: Approved a.. . Not Approved, Meeting Date: Administrative Instruction 7500.7 104 MONROE COUNTY,FLORIDA REQUEST FOR WAIVER OF INSURANCE REQUIREMENTS It is requested that the insurance requirements,as specified in tfte County,s Schedule of Insurance Requirements,be waived ors modified on the following contract. Contrtmctor,'Vendcor: Project or CrY+9ce; Contrartorz Vendor -AXC t AddressPhone#: � L l General Scope of Work; �� '�.,..... r Reason for Waiver or Modiffcatiott. ► 4 Policies Waiver or Modification will apply to: .e 10 - r' ? l _ X m Signature of t=ontraclori Vendor• ;,r" .� Date.—0-5.71,472020 Approved xx Not Approved Risk Management'Signature. late. County Administrator appeal: Approved _... . , , Not Approved: Date: Board of County Commissioners appeal. Approver!. a Not Approved: !Meeting fate. Adrninis ra ive Instruction 7500.7 164 CERTIFICATE OF LIABILITY INSURANCE DATE IMh9IBDiYYYY) - THIS CERTIFICATE IS ISSUED A$A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.TH S20t2020 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 be endorsed. If SUBROGA IS WAIVED,WAIVED,sutject to the terms and conditions of the policy„certain policies inlay require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s), PRODUCER NAME; Triton Global Triton insurance Group PHONE - NJ�. � (866)400-7674 xIIIIJ rAx Ises}€sv-as7e�,� 100 N State Road 7E-MAIL No Unit 304 ADDRESS: quote@ tritonagency.com. Margate FL 33063 RNSURERIS AFFORDING COVERAGE NAIC INSURED-- -.. _. INSURERA:De-ositerS Tnsurance Co an —.. 42E87 INSURERS:INFINITY AUTO INSURANCE Ceiling to Floor Cleaning Inc Re�rublic y Co 1431 SW S may INSURER c;Old�.. Suret �_. INSURER.D:. � I7eert4ipld BeachFL 33441 INSURER E- ...q,—_.... .�..-w—.�.e..—__._ AGtiESNUMBER: _ INSURER F COVER : _ CERTIFICATE NUMBER:CL20A201346A REVISION NUMBER- THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED, FOR THE POLICY PERIODINDICATED NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 _. ADDL LTR TYRE OF INSURANCE POLICY EFF POLICY E%P 70 COMMERCIAL GENERAL LIABILITY POLICY NUMSER MM}DO'dYYYY IPMID YY LIMITS EACH OCCURRENCE -. $ 1,000,000 A _ CIAIM5 MADE. OCCUR AMA TO RENTED PREMISES Ea occurrence $ 100,000 T7edca t;.a,b1e:S5U0 Per C CC ACz 300783135*4 7/28/2019 7/28/2020 -_. MED EXP(Any one person) 5. 5,000 PERSONAL&ADV IN.3UR1' $ 1,000,000 GEN'tAGGREGATE LJMrTAPPLIES PER: -- --.. —. POLICY UECT D LCJC GENERALAGGREGATE S 2,0©0,GOO ....... OTHER: PRODUCTS-COMPIOPAGG $ 2,000,000. _.. _. --. _ AUTOMOBILE LIABILITY S 50962003.31,,19001 04/02/202G 04142'./2'621 COMBINED SIN LE LIMIT ANYAUTO fFaaccident)__ $ 1,00-0,0U0.00 ALL OWNED SCHEDULED BODILY INJURY(Per person) $ AUTOS AUTOS X BODILY INJURY(Per accident) $ rHIREDAUTsOS NON-OWNED AUTOS PROPERTY DAMAGE I'SK Per accident, $ S _ UMBRELLA CRAB OCCUR q� .,i. EACH OCCURRENCE $ EXCESS LIAB CLAWS MADE 7 - rv,. _. ;wn 5/13/2 0 2 0 AGGREGATE D RETEMnOFS S _d,�.,�,� WORKERS COMPENSATION W -...,PER t1TH AND EMPLOYERS'LIABILITY STATJTE ER � •t-, . AMY PRORRIETc�.RIPARTMER+EkECUTSL E OFFICERIMEMBER EXCLUDED? YIN N , NIA E.L.EACH ACCIDENT $ ;Mandatory in NH) If yes,descrbe under E.L.DISEASE-EA EMPLOYEE S _ _ -_-. DESCRIPTION 4F OPERATIONS below E.L,DISEASE-POLICY LIMIT $ BONDW150317805 06/11/2€}19 d6/11/2020 EMPLOYEE DISH�,ONETY -_. _. _. C $10,000 DESCRIPTION OF OPERATIONS I LOCATIONS IONS f Afforded EE (ACORD 101, dreonateRemarks Schedule,envy be attached if morn space is required)required bywritten contract with the insured. Certificate bolder is listed as a Loss Payee in regards to the Bond. CERTIFICATE HOLDER - CANCELLATION -- _- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 8EFORE Monroe County SOCC THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Board. of County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton St. - Key West, 'FL 33040 AUTHORIZED REPRESENTATIVE rd tlicl?aud,/GLO.BAT Q 1988.2014 ACORD CORPORATION, All rights reserved'. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025(201401)