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Certificates of InsuranceACORD CERTIFICATE OF LIABILITY INSURANCE OP ID AA MASTE-2 DATE(MM/DD/YYYY) 1 03/05/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Kahn- Carlin & Company, Inc. 3350 S. Dixie Highway ____ _ HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR THEDW RAGE AFFORDED BY THE POLICIES BELOW. G r' (-$, Miami FL 33133 -9984 Phone: 305 - 446 -2271 Fax: 305- 448 -31 7 tRS. FOR ING COVERAGE NAIC # INSURED ( INSURER A: t zaut lus Insurance Company 17370 2 .1 MAR I U ridgef eld Employers Ins Co 10701 I su c: $ 5000 Master Mechanical Services, nc o 15181 NW 33 Place Miami FL 33054 INSURER D: $5,000,000 I E: GENERAL AGGREGATE THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1100 Simonton Street POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE DATE MM /DD/YY DATE MM /DDIYY LIMITS GENERAL LIABILITY EACH OCCURRENCE s5,000,000 A X X COMMERCIAL GENERAL LIABILITY NC 8115 3 6 08/01/08 0 8/ 01 / 0 9 PREMI (Ea occurence) $3 CLAIMS MADE I X I OCCUR MED EXP (Any one person) $ 5000 PERSONAL &ADV INJURY $5,000,000 GENERAL AGGREGATE s5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG s5,000,000 POLICY 7 PRO— JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) BODILY INJURY $ ALL OWNED AUTOS SCHEDULED AUTOS (Per person) BODILY INJURY $ HIRED AUTOS NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY I (� 1 AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS /UMBRELLA LIABILITY EACH OCCURREN $ OCCUR CLAIMS MADE " AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ CCj WORKERS COMPENSATION AND WC STATU_ TORY LIMITS ER B EMPLOYERS' LIABILITY 83037562 03/14/09 03/14/10 E.L. EACH ACCIDENT $ 1000000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYEE $ 10 0 0 0 0 0 OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $1000000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Certificate Holder is named as additional Insured with respects to General Liability. CERTIFICATE HOLDER CANCELLATION MOLAR -12 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN Monroe County Board of County NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Commissioners 1100 Simonton Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Key West FL 33040 REPRESENTATIVES. AUTHORIZED ESENTAT E ACORD 25 (2001108) G �, : / - �� © ACORD CORPORATION 1988 Allstate. You're in good hands. CERTIFICATE OF INSURANCE EFFECTIVE DATE OF CERTIFICATE ALLSTATE INDEMNITY COMPANY 07/23/09 HOME OFFICE - NORTHBROOK, IL 60062 hereby certifies that the following insurance is in force: POLICYHOLDER POLICY NUMBER POLICY PERIOD MASTER MECHANICAL 048671447 BAP 07/23/09 TO 07/23/10 SERVICES INC AT 12:01 A.M. STANDARD TIME 15181 NW 33RD PLACE MIAMI GARDENS, FL 33054 -2400 The person or organization designated below is described in the policy as: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS 1100 SIMONTON ST KEY WEST, FL 33040 -3110 Coverages designated are afforded as stated below: LIABILITY: $1,000,000 EACH ACCIDENT AS THEIR INTEREST MAY APPEAR To the person or organization stated above: LIENHOLDER (Loss Payable Clause) X ADDITIONAL INTERESTED PARTY ADDITIONAL INSURED CERTIFICATE HOLDER x cc This policy, as respects the interest of the loss payee, additional interested party, additional insured or certificate holder named herein, may be cancelled by the Company during the policy period by giving such person or organization 10 days whatever longer period of time prescribed by state law. , or Proof of such mailing is deemed sufficient proof of such notice. This Certificate of Insurance neither affirmatively nor negatively amends, extends or alters the coverage afforded by the policy referred to above. BU1380 (05/06) PAGE 1 OF 1 BU114R -3 / WAllstate. You're in good hands. POLICY NUMBER: 048671447 BAP COMMERCIAL AUTO CA 20 0103 06 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LESSOR - ADDITIONAL INSURED AND LOSS PAYE This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: MASTER MECHANICAL SERVICES INC Endorsement Effective Date: JULY 23, 2009 Name: Countersignature Of Authorized Representative Title: Signature: Date: CA 20 01 03 06 Copyright, ISO Properties, Inc., 2005 BU114R -3 Page 1 of 3 7 Py �.:{ r SCHEDULE Insurance Company: ALLSTATE INDEMNITY COMPANY Policy Number: 048671447 BAP Expiration Date: JULY 23, 2010 Named Insured: MASTER MECHANICAL Address: 15181 NW 33RD PLACE MIAMI GARDENS, FL 33054 -2400 Additional Insured (Lessor): MONROE COUNTY BOARD OF COUNTY COMMISSIONERS Address: 1100 SIMONTON ST KEY WEST, FL 33040 -3110 Designation or Description of "Leased Autos ": AS THEIR INTEREST MAY APPEAR Coverages Limit Of Insurance Liability $ 1,000,000 Each "Accident" Actual Cash Value Or Cost Of Repair Whichever Is Less, Minus Comprehensive $ Deductible For Each Covered "Leased Auto" Actual Cash Value Or Cost Of Repair Whichever Is Less, Minus Collision $ Deductible For Each Covered "Leased Auto" Actual Cash Value Or Cost Of Repair Whichever Is Less, Minus Specified $ Deductible For Each Covered "Leased Auto" Causes Of Loss Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Coverage I. Any "leased auto" designated or described in the Schedule will be considered a covered "auto" you own and not a covered "auto" you hire or borrow. 2. For a "leased auto" designated or described in the Schedule, Who Is An Insured is changed to include as an "insured" the les- sor named in the Schedule. However, the lessor is an "insured" only for "bodily injury" or "property damage" resulting from the acts or omissions by: CA 20 01 03 06 Effective Date: JULY 23, 2009 SERVICES INC a. You; b. Any of your "employees" or agents; or c. Any person, except the lessor or any "employee" or agent of the lessor, oper- ating a "leased auto" with the permis- sion of any of the above. 3. The coverages provided under this en- dorsement apply to any "leased auto" de- scribed in the Schedule until the expiration date shown in the Schedule, or when the Copyright, ISO Properties, Inc., 2005 Page 2 of 3 Allstate® You're in good hands. lessor or his or her agent takes possession of the "leased auto ", whichever occurs first. B. Loss Payable Clause 1. We will pay, as interest may appear, you and the lessor named in this endorsement for "loss" to a "leased auto ". 2. The insurance covers the interest of the les- sor unless the "loss" results from fraudulent acts or omissions on your part. 3. If we make any payment to the lessor, we will obtain his or her rights against any other party. C. Cancellation 1. If we cancel the policy, we will mail notice to the lessor in accordance with the Cancella- tion Common Policy Condition. CA 20 01 03 06 BU114R -3 2. If you cancel the policy, we will mail notice to the lessor. 3. Cancellation ends this agreement. D. The lessor is not liable for payment of your pre- miums. E. Additional Definition As used in this endorsement: "Leased auto" means an "auto" leased or rented to you, including any substitute, replacement or extra "auto" needed to meet seasonal or other needs, under a leasing or rental agreement that requires you to provide direct primary insurance for the lessor. Copyright, ISO Properties, Inc., 2005 Page 3of3 4 acoRD CERTIFICATE OF LIABILITY INSURANCE OP ID AA DATE (MMIDDIYYYY) MASTE-2 01/27/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION POLICY EFFECTIVE DATE (MMOD" ,QTY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Rahn - Carlin & Company, Inc. ZEAL 111FICAll DOES NOT AMEND, EXTEND OR 3350 S . Dixie Highway ER AGE AF ORDED BY THE POLICIES BELOW. Miami FL 33133 -9984 EACH OCCURRENCE $1000000 Phone : 3 0 5- 4 4 6- 2 2 71 Fax : 3 0 5 - 4 4 8- 312 7 INSURERS AFFORDIN COV RAGE NAIC # INSURED JM REkA: -? M nal rust I aace Co 20141 INSURER B: Hridgefie d mpl era Ias co 107 PERSONAL & ADV INJURY RER FCCI nsur nce Comp 10178 Master Mechanical Services,Inc 15181 NW 33 Place Miami FL 33054 M968KDCOUNTY pop. GENERAL AGGREGATE 1 ��,. .,v N, COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INUK OWL LTR NSRE TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMOD" POLICY EXPIRATION DATE MWDD LIMITS GENERAL LIABILITY EACH OCCURRENCE $1000000 A X X COMMERCIAL GENERAL LIABILITY CLAIMS MADE [ OCCUR GL 0 0 0 8 8 9 21 08/01/09 0 8/ 0 1 / 10 PREMISES Ea occAurence $100000 MED EXP (Any one person) $50 PERSONAL & ADV INJURY $1000000 GENERAL AGGREGATE $2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2000000 POLICY PRO- LOC Emp Ben. 1000000 AUTOMOBILE LIABILITY A X X ANY AUTO CA0 014 0 6 91 08/01/09 0 8 / 01 / 10 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ X HIRED AUTOS X NON -OWNED AUTOS CA00140691 CA0 014 0 6 91 08/01/09 08/01/09 08/01/10 0 8 / 01 / 10 BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $4,000,000 C OCCUR CLAIMS MADE LYM 00095461 08/01/09 08/01/10 AGGREGATE $ 4,000,000 $ DEDUCTIBLE X RETENTION $10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 83037552 03/14/09 03/14/10 X TORY LIMITS ER E.L. EACH ACCIDENT $ 1000000 E.L. DISEASE - EA EMPLOYEE $ DI E - POLICY LIMIT $1000000 OTHER ,e t ' DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED WITH RESPECTS TO GENERAL LIABILITY COVERAGE AND AUTOMOBILE LIABILITY COVERAGE. l7 f • CERTIFICATE HOLDER CANCELLATION Monroe County Board of Comissioners 1100 Simonton Street #2 -284 Key West FL 33040 ACORD 25 (2001108) MOLAR -12 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPMSENTATA/E / Q ACORD CORPORATION 1988 �•�vs.�c�ea THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD WI)CATED. NI07YATHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THS 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. L TYPE OF INSURANCE POLICY NUMBER DATE LIMITS GENERALUAIIiUTY EACHOCCURRENCE $ 1000000 X COMME RCIAL GENERAL UABILITY GL00088921 08/01/09 08/01/10 PREMrs ES EsooN $ 1.00000 CLAIMS MADE X� OCCUR Lm MED EXP tarty ore person} $ 5000 PERSONAL S ADV INJURY 31000000 GENERAL AGGREGATE s 2000000 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMMP AGG s 200 0 000 Pwcy ImC E Sen 1000000 AUTOMOBILE LIABILITY A X X my&go CA 00140691 { I COMBI LIMIT 08/01/09 08/01/10 6110001000 ALL OWNED jWroS SCHEDULED AUTOS BODILY INJURY (Per person) $ X HRED AUTOS CA00140691 08/01/09 08/01 X NON- OVMEDAUTOS CA00140691 OWL.YINJURY 08/01/09 08/01/10 rwaddMj S - PR PE ER'TY DAMAGE S GARAGE LIABILIT'( AUTO ONLY - EA ACCIDENT S ANY AUTO THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA !LIABILITY EACH OCCURRENCE S 4 000 f 000 C OCCUR ILI I CLAIMS MADE UM00095461 08/01/09 08/01/10 AGGREGATE s � Oa0,000 S R dENXOTME S X RETEN U* $10,000 $ WORKERS COMPS SATION AND EIUIPL.anyERa•LwaILIR TORY LIMITS ER B T 8303'7582 ANY PRQPRIETQ �RlPARI�IE�TIVE 0 0 4/10 03/14/11 E -L EACH ACCIDENT $ 1000000 OFFICERIM EMBER EXCLUDED? It dosc t o under E-L DISEASE - EA EMPLOYE $1000000 SPECIAL. PRCMSIONS ea!aN ELL IXSEA 3 - E -ywcy ., wrr S 1000000 OTHER C, DIESCRIPWN OF OPERATIONS.! LOCATIONS I VEHICLES I EXCLUMNS ADDED BY OMRSEMENT / SPECIAL. PitCYisKm CERTIFICATZ HOLDER IS NAMSD AS ADDITIONAL IRSURRD WITH RESPECTS To CBNFRAL LIABILITY CRAGS AND AUT0110181LL LIABILITY COVERAGE. CERTIFICATE HOLDER CANCELLATION --12 S HOULD ANY OF THE ABOVE DESCRMD POLICIES BE CANCELLED KFOIE THE EXPIRATIO N DATE THEREOF THE ISSUING INSUROR WILL ENDLAYOR TO MAIL 30 DAYS WRETTER Monroe County Beard off' Camissioners --- NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT FLIT FAILURE TO DO 80 SHALL. 1100 SIVLOnt on Stroe t #2-284 IMPOSE NO OBLIGATUM OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR t We FL 33040 RIME8EN ACORD 25 {!"1ff0a) - 0 ACORD CORPORATION 1988 CERTIFICATE OF LIABII THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY At CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EX BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the pc the terms and conditions of the policy, certain policies may require an en c e rtif icate holder in lieu of such endorsement(s). PRODUCER Kahn - Carlin & Company, Inc. 3350 S. Dixie Highway Miami FL 33133 -9984 Phone:305- 446 -2271 Fax :30 5- 448 -3127 INSURED Master Mechanical Services,Inc 15181 NW 33 Place Miami FL - COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: ID CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS iorsement. A statement on this certificate does not confer rights to the CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, PHONE FAX A/C, No, Ext : (A/C, No): EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. PRODUCER CUSTOMER ID # MASTE - 2 INSURER(S) AFFORDING COVERAGE LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY INSURER B: Bridgefield Employers Ins Co 107 INSURER C: EACH OCCURRENCE $ 1000000 A X COMMERCIAL GENERAL LIABILITY GL 0 0 0 8 8 9 2 2 08/01/10 08/01/11 CLAIMS -MADE I X 1 OCCUR PREMISES (Ea occurrence) $100000 INSURER F: MED EXP (Any one person) $ 5 X PERSONAL & ADV INJURY $ 10 00000 GENERAL AGGREGATE $2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $2000 POLICY PRO- JECT LOC Emp Ben. $ 1.000000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT • ANY AUTO CA0 014 0 6 9 2 (Ea accident) $ 1,400 1 000 X ALL OWNED AUTOS � 08/ 1 /10 08/01/11 BODILY INJURY (Per person) $ SCHEDULED AUTOS X - ,—�, BODILY INJURY (Per accident) $ PROPERTY DAMAGE X HIRED AUTOS (Per accident) $ X NON -OWNED AUTOS $ • X UMBRELLA LIAB OCCUR LIMBO 0 0 9 5 4 61 08/01/10 08/01/11 EACH OCCURRENCE $4000000 EXCESS LIAB CLAIMS -MADE ., AGGREGATE $ 4000000 DEDUCTIBLE $ X RE T ENTiON $ 10,000 $ WORKERS COMPENSATION 83037562 AND EMPLOYERS' LIABILITY 03 /14/10 03 /14/11 X W TATU- H- $ Y / N ANY PRO PRIETOR /PARTNER /EXECUTIV OFFICER /MEMBER EXCLUDED'? N/A � -- � r TORY LIMITS ER E.L. EACH ACCIDENT $ 1000000 I (Mandatory in NH) / , - Cr If yes, describe under E.L. DISEASE - EA EMPLOYEE $1000000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $10 DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED WITH RESPECTS TO LIABILITY COVERAGE AND AUTOMOBILE LIABILITY COVERAGE. GENERAL CERTIFICATE HO ER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MONR — 12 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County ACCORDANCE WITH THE POLICY PROVISIONS. Board of Comi s s ioners AUTHORIZED REPRESENTATIVE 1100 Simoni:on Street #2 -284 Key West FL 33040 20 ACC I .All rights reserved. J/ ACORD 25 (2009/09) The ACORD name and logo are registered mark of ACORD .ITY INSURANCE OP ID AA DATE (MM/DD/YYYY) 08/02/10 ID CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 'END OR ALTER THE COVERAGE AFFORDED BY THE POLICIES CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED licy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to iorsement. A statement on this certificate does not confer rights to the NAME: PHONE FAX A/C, No, Ext : (A/C, No): ADDRESS: PRODUCER CUSTOMER ID # MASTE - 2 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: National Trust Insurance Co 20141 INSURER B: Bridgefield Employers Ins Co 107 INSURER C: INSURER D: INSURER E: INSURER F: