Certificates of Insurance
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: ....... . .......~..::::.::::":::.::.::.:.:..:~{:::::.:.::f1::.::~~::.::":'...'..:::::'~:..::::,::.::'::':':::'...~:~:.:" :.':;::/.....(J:j(::: ..::~..:~:..:: :::::.::::.::.:,..tJ:~:".':,,:,:.' :::>:.... :.':::::::'.. ':'" 02/23/1999
PRODUCER (30:5)"743'::0494" ........FAi{30S)i43.::0.S82................. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
eys Insurance Agency of Monroe County, Inc. HOLDER. THISCERTIFICATEDOESNOTAMEND,EXTENDOR
P.O. Box 500280 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Marathon, FL 33050-0280 COMPANIES AFFORDING COVERAGE
Attn: Gai 1 Cai n
INSURED . .
Marlna Resort Propertles,
DBA Marina Del Mar Resort
P.O. Box 1050
Key Largo, FL 33037-1050
Ext:
COMPANY
A
Inc. /
& Marina
COMPANY
B
COMPANY
C
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.
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DDIYY) DATE (MMlDDIYY)
LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE X OCCUR
BINDER990223
01/01/1999
GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
01/01/2000 ..P'ERSONAL & ADV INJURY
EACH OCCURRENCE
$ ...?,9.9.9.,g()()
$ 1,000,000
$.. ..}~()()(),9.9.9.
$:1,000,000
$ ....s.9.~0().<>
$ 1 000
FIRE DAMAGE (Anyone fire)
....................................
MED EXP (Anyone person)
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
COMBINED SINGLE LIMIT
$
ANY AUTO
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE $
AUTO ONLY - EA ACCIDENT $
OTHER THAN AUTO ONLY:
EACH
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
EACH OCCURRENCE
AGGREGATE
THE PROPRIETOR!
PARTNERSlEXECUTIVE
OFFICERS ARE:
OTHER
INCL
EXCL
EL EACH ACCIDENT $
EL DISEASE - POLICY LIMIT $
EL DISEASE - EA EMPLOYEE $
DESCRIPTION OF OPERATIONSlLOCATIONSlVEHICLESlSPECIAL ITEMS
Locations #3-lots #326, 327 & 354, the Certificate Holder is named as an add'l insured to this
location only.
:~ml@.'?::::::::::::::::::r:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
.....................................
...................
. . . . . . . . . . . . . . . . . .
.... ..... ::::::::::::g._l!qj\r:::::::::::::::::::::::f:::::r:ff
:::;::::::~:~:~:~:~:~:~::::~:~:~::::::~:~:f~:~:t~:i:~:~::::::;:::::;~;~:~;~~~:.:.:..:.:::...::., :'~'~':::::::'~"':': . . . . .
:.:.:.:.:.:.:.:.:::::::::::::::::::
Monroe County Board of County Commissioners
Att: Maria Del Rio, Risk Management
5100 College Road
Key West, FL 33040
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
~ 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
AUTHORIZED REPRESENTATIVE
:~:If.:Mmlg
.......... .......:::::::;::;:::j::::::ji:j)'t':0:::2:S:~:~::!'"
ACORQM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNY)
04/13/2000
PRODUCER (305) 743 -0494 (305) 743 -0582 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Keys Insurance Agency of Monroe County, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 500280 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Marathon, FL 33050-0280 INSURERS AFFORDING COVERAGE
INSURED Marlna Resort Propertles, Inc. INSURER A: Essex Insurance Company
DBA Marina Del Mar Resort & Marina INSURER s:
P.O. Box 1050 INSURER C:
Key Largo, FL 33037-1050 :2l~ INSURER D:
I INSURER E:
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 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I~f~ TYPE OF INSURANCE POLICY NUMBER P&k+'E T,r.'l~i8[)tW:: I Pgk!fJ,~'AA;~~N LIMITS
GENERAL LIABILITY ~CA1850 01/01/2000 01/01/2001 EACH OCCURRENCE $ 1,000,000
ex COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ 50,000
I CLAIMS MADE [K] OCCUR MED EXP (Anyone person) $ 1,000
A PERSONAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000
n nPRO. n
POLICY JECT LOC
AUTOMOBILE LIABILITY 'atn ~ COMBINED SINGLE LIMIT
f-- ~ '. :~~ / (Ea accident) $
ANY AUTO
f--
ALL OWNED AUTOS BODILY INJURY
f-- $
SCHEDULED AUTOS -LtJ --- (Per person)
f-- 7JDlJ __
HIRED AUTOS BODILY INJURY
f-- (Per accident) $
NON-OWNED AUTOS r"
f--
PROPERTY DAMAGE $
- (Per accident)
GARAGE LIABILITY ~J 'J?A fh. AUTO ONLY - EA ACCIDENT $
R ANY AUTO 17:-' OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY (( . Vt. .>'-\.. EACH OCCURRENCE $
tJ OCCUR D CLAIMS MADE D (Y)5 AGGREGATE $
$
R DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND T TORY L1MITsl IOJ~-
EMPLOYERS' LIABILITY
E.L EACH ACCIDENT $
E.L DISEASE - EA EMPLOYEE $ .-
E.L DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
r-ocation #3-lots #326, 327 & 354, the Certificate Holder is named as an additional insured to this
~ocation only.
CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Monroe County Board of County Commissioners -1.Q.. DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Maria Del Rio, Risk Manageme t BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
5100 College Road lJ~ OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
Key West, FL 33040 AUTHORIZED REPRESENTATIVE-{/
D^TE_ - Frederick Aiken \. 'J'\A iI /l~ '.i:J,.~)
ACORD 25-S (7/97) t 7'--. @ACORD CORPORATION 1988
INITIAL _ -><--- ) _._~~._'
08/13/01
MON 17:01 FAX 3057430582 KEYS INSURANCE AGENCY
E IF CA TE OF LIA ILITY INSU N
~001
ACORDm C RT I B RA CE I DAn IMMlU"'T
08/13/2001
~CER (305)743-0494 FAX (305)743-0582 I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Keys Insurance Agen<:y. In<:. ONLY AND CONFERS NO RlGKTS UPON THE CERTIFICATE
HOl..DER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 500ZIO A1.TER THE COVERAGE AFFORDED BV THE POLICIES BELOW.
Marathon. FL 33050-0210 INSURERS AFFORDING COVERAGE
INGURED Marina Resort propertles. Inc. INSURER A:. Essex Insurance ~y
P.o. Pox 10S0 INSURER 8;
Key Largo. FL 33037-1050 INSURER c:
INSURER D:
I INSURER E;
THE; POLICIES OF INSURANCE liSTED BELOW HAVE BEBlI5SUED ro Tl-IE INSURED NAMED ABOVE FOR THE POllCY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT. "TERM OR CONDITION OF AtN CONTRACT OR O~ER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECr TO AlL Ti'le TERMS. !:XClUSIOIIIS AND CONDITIONS OF SUCH
POLICIES. AGGREGAlE LIMITS SHOWN MAY I-lAVE BEEN REDUCED BY PAID C1.AlMS.
,1~llR T'tI'i. OF IlUUI'ANCE POUCY NUMIJER POLlCY EFFEC11VE I P21:'!:r,lOO'lRAllON Ulllrrs
LTR DA: DATE
~UABIUTY 12CA18S01l2 01/01/2001 01/01/2002 EACH OCCURRENCE $ 1.000.00
X COMMIiRCIAL GeNIiRAL UABIUTY FIRE DAMAGE (Atoi aM fire) $ 50.00
I ClAIMS MADE [!J oCCUR MED EXP (Any one pcr.:atI) S 1.00
A pERSONAL & ADV INJURY $ 1.000.00
-
- GENERALAGGRiGAlE $ 2.000.00
~'LAGGAEGATE= APfl PER: PRODUCTS - COMPIOI' AGG S 1.000.00
POLICY n JECl" LOC
~LEUAIIUTY coMBINED SINGLE I.lL4IT $
flNf AUTO (Ea accident)
~
AU. OWNeo AUTOS BODILY INJURY
I-- c,Y ~'f{'r~n:t (Per peI&CIl) $
SCHEDULSl AUTOS ~~.
'\ ' "~r~!_ .<~
I-- . ..':.
I-- HIRED AUTOS BODILY INJURY
:.i (pet accident) $
- NQN-owNEtl AUTOS GFE" .-..y{
- il nJ PROPEiIUY DAMAGIi $
, - (Per accIdr:nl)
GAIWJIi UABUJTY (,"'\'r-Q. ,,- L~ \/FS AUTO 0N1.. Y - EA ACCIoENT $
R- N(V AUTO .6lt.~ C> ~~ OTtIER TMAN EA ACe S
AUTO ONLY; NJq. $
EXCESS LIA8lUTY _. \,.) <.....-3 ~ EACH OCCUARliNCE S
o OCCUR 0 ClAIMS w.oE CL. \; AOORfGATIi $
( Drnt; s
8 DEDUc'nBUi - . $
RETENl10N $ s
WORKERS COIII'EJISA1lON AND I TORY LIMITS I ~.
EIIPLOVEftS" UABIlJTY EL EACH ACCIOENT $
1i.L. DlsEASli - lOA EMF'lOYliI $
E.L, D1S1:ASf: - POUCY uMll' S
OTNER
DUCRlf'TlON OF Of'ERAT1OHS11.OCATlONSNEHIC1..ES/EXCl.USON& jU)DED BY ENDORSeIlENT/SPECIAL PROVISIONS
Locat;on 13- lots 'J26.3Z7 a 354. The Certif;cate holder ;s Rallied as an additional insured to this
location only.
CERTlflCATE HOl..DER I X I ADDITIONAL INSURED; INSURU LE1iER: CANCEii.LLAnoN
SHOU\JI AK'f OF tHE NJDVE DE.SCRlBED POLICla BE CANCELLED IlEFORIi THE
EXl"lRATION DAre ntPEOF. ~ I$$UING COMl"AK'f WILL ENOEAYOR 10 MAIl..
Monroe County Board of County COIIlIIisioners ...!L. DAYS WRmEN NOTICE 10 'I'HE CEKTIf1CATE HOLDER NAJIED 10 tHE LEFT.
Mara Del Rio. Rbk Manag8ll\flllt BUT FAll.URE TO MAIL sUCH Nonce sHAll IllPOSE NO OBUGATION OR UABlLI'l'Y
Sl00 Co 11 ege Road OF NfY KlND UPON THE COIIPNfY.1TS AGiNTS OR REPRESENTATIVES.
Key West . FL 33040 ~7b~ 2'
A ,
CORD 25-S (1/97)
@ACORD CORPORATION 1988
COVERAGE;.$
COMMON POLICY DECLARATIONS
'This Declaration Page Is attached to and forms part of certificate provisions.
Previous No. NEW
Authority Ref. No. 0 1CWN2 97
Certificate No. GLSC2 0 0 12 62
1 Name and address
of the Assured
Marina Del Mar Bayside
Marr Bayside Resorts, Inc.
DBA
P.O. Box 1050
Key Largo FL 33037
Broker
Fred L. Aiken, III
Keys Ins Agency
PO Box 500280
Marathon FL
33050-0080
Business description: Hotel
Effective from 12 - 3 1 - 0 1 to 12 - 3 1 - 02
2 both days at 12:01 a.m. standard time
3 Insurance is effective with
Terra Nova Ins Group
Percentage
100%
4 This Certificate consists of the following Coverage Parts for which a Premium is indicated. This
Premium may be subject to adjustment.
Premium
Commercial Crime coverage Part
A~~. EMENT
BY or -=-
DATE ~
YES
WAIVER NIA. . ~
c5l1J~~
Cc.
$
$
$
$
$
$
$
Fees: $
Taxes: $
Total $
Not Covered
Commercial Property Coverage Part
Commercial Inland Marine Coverage Part
Commercial General Liability Coverage Part
Not Covered
30,083.00
Not Covered
Commercial Auto Coverage Part
Not Covered
Service Office Fee $ 90.66 ,Surplus Lines Tax $ 1,510.90
Countersignature Fee $ 35.00 ,Inspection Fee $ 100.00
135.00
1,601.56
31,819.56
5 Forms Applicable to all Coverage Parts:
See attached list of endorsements.
6 Service of Suit may be made upon: Ed Phoebus, Ten Parkway North, Deerfield, IL 60015
In return for the Payment of the premium, and subject to all the terms of this Certificate, we agree to provide the insurance as stated
in this certificate.
Dated January 22, 2002
Surplus Lines Agent: Donald E Waters,
Lic# A278403
THIS INSURANCE IS 'SSUED PURSUANT TO THE
FLORIDA SURPLUS LINES LAW. PERSONS INSURED
BY SURPLUS LINES CARRIERS DO NOT HAVE THE
PROTECTION OF THE FLORIDA INSURANCE
GUARANTY ACT TO THE EXTENT OF ANY RIGHT OF
RECOVERY FOR THE OBLlGAT'ON OF AN INSOLVENT
UNLICENSED INSURER.
Jr ~
by
Correspondent:
Clearwater Un erwrlters,Inc
2433 Gulf to Bay Blvd
Suite E
Clearwater FL 33765
Other Interest Copy
(OMNI+0544-09101 )020122-001
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SUPPLEMENTAL DECLARATIONS
GLSC2001262
These Supplemental Declarations form a part of Certificate number
LIMITS OF INSURANCE
General Aggregate Limit (other than Products/Completed Operations) $ 2,000,000
Products/Completed Operations Aggregate Limit $ 1 . nnn . nnn
Personal and Advertising Injury Limit $ 1. 000.000
Each Occurrence Limit $ 1. 000,000
Fire Damage Limit $ 50,000 anyone fire
Medical Expense Limit $ 1,000 anyone person
BUSINESS DESCRIPTION AND LOCATION OF PREMISES
Form of business:
0 Individual 0 Joint Venture 0 Partnership Qg Organization (other than Partnership or Joint Venture)
Business description:
Hotel
Location of all premises you own, rent or occupy:
1~ 99970 Overseas Hi~hway, Key Largo, Monroe, FL 33037
2 Lots 326, 327 & 3 4 Port Largo, 4th Add'n, Key Largo, Monroe, FL 33037
PREMIUM
Rate Advance Premium
Classification Code No. Premium Basis Pr/Co All Other Pr/Co All Other
Hotels and Motels 45190 1,400,000 Incl. 20.868 $Included$29215.0C
w/pools or beaches
less than four stories
(sales)
Buildin~s or Premises 61212 a) 1,000 Incl. 97.680 Included 98.0C
bank/of ice- mercantile
or manufacturing (LRO)
Wharf and Waterfront 49800 a) 500 Incl. 639.600 Included 320.0C
pro~erty- ferry docks
or ermlnals
Vacant Land- not for 49452 t) 3acres Incl. 116.180 Included 350.0C
profit only
Additional Insured t) 1 Incl. 100.00 Included 100.0C
FORMS AND ENDORSEMENTS (Other than applciable forms and endorsements shown elsewhere on the certificate.)
Forms and endorsements applying to this Coverage Part and made part of this certificate at time of issue:
$500 BI/PD Deductible- per claim
. (a) Area, (e) Total Cost, (m) Admission, (p) Payroll, (s) Gross Sales, (u) Units, (0) Other
THIS SUPPLEMENTAL DECLARATIONS AND THE COMMERCIAL LIABILITY DECLARATIONS, TOGETHER WITH THE COMMON
POLICY CONDITIONS, COVERAGE FORM(S) AND ENDORSEMENTS COMPLETE THE ABOVE NUMBERED CERTIFICATE.
SPLD(8195) Other Interest Copy (OMNI+5444-1l9lO1)020122-l101
Attached List of Other Interests
Reference number: GLSC2001262
Date: 12-31-01
* Additional insured
Monroe County Board of
County Commissioners
Maria Del Rio, Risk Mgm't
5100 College Road
Key West FL 33040
Gen Liab. # 1
Page 1
Other Interest Copy
ROI-9310
* - Receives Other
Interest Copy
020122-001
SCHEDULE OF FORMS AND ENDORSEMENTS
FORM NUMBERS
Attached to Policy number: GLSC2001262
CUI1010 (A) (4/89)
CG2146 (10/93)
CG2026 (11/85)
CG2101 (11/85)
NMA1331
CG2137 (11/85)
CG0001 (01/96)
IL0017 (11/85)
Communicable Disease
CG2139 (10/93)
CG0300 (10/93)
NMA2802 (12/17/97)
CG2147 (10/93)
CG2136 Exclusion
IL0175 (9/93)
NMA2340 (11/24/88)
CG2144 (11/85)
CG2150 (04/89)
MLD0002 (10/01)
IL0021 (11/85)
CG2149 (10/93)
CG2407 (11/85)
CUI526
NMAl191
NMA1998
NMA2 918 ( 10/ 0 8 / 0 1 )
DEF-OOOO
(OMNI+OOOO 9312) 020122.()()1
Date: 12-31-01
FORM TITLES
25% MINIMUM EARNED PREMIUM
ABUSE OR MOLESTATION EXCLUSION
ADDITIONAL INSURED-ORGANIZATION
ANIMAL EXCLUSION-TNGL14
ASBESTOS & SILICA DUST EXCLUSION
ASSAULT &/OR BATTERY EXCLUSION
ATHLETIC/SPORTS EXCLUSION
CANCELLATION CLAUSE
EMPLOYEES AS INSUREDS-EXCLUSION
COMMERCIAL GENERAL LIABILITY COVERAGE
CLASSIFICATION LIMITATION ENDORSEMENT
COMMON POLICY CONDITIONS
Communicable Disease Exclusion
CG2139 (10/93) Contractual Liability
Limitation
DEDUCTIBLE LIABILITY INSURANCE
EDRE
ELECTROMAGNETIC FIELDS EXCLUSION
EMPLOYMENT RELATED PRACTICES
CG2136 Exclusion-New Entities
IL0175 (9/93) Florida Changes
INDEPENDENT EMPLOYEES-EXCLUSION
LAND WATER AIR EXCLUSION
LEAD CONTAMINATION EXCLUSION
LIMITATION OF COVERAGE TO DESIGNATED
PREMIUM
LIMITATION OTHER INSURANCE
AMEND. LIQUOR LIABILITY EXCLUSION
MOLD EXCLUSION
NUCLEAR ENERGY LIABILITY EXCLUSION
OTHER INSURANCE-EXCESS COVERAGE
TOTAL POLLUTION EXCLUSION
PROD/COMPL OPS REDEFINED
US PRIVACY NOTICE
PROFESSIONAL SERVICES EXCLUSION
PUNITIVE/EXEMPLARY DAMAGES EXCLUSION
RADIOACTIE EXCLUSION
RADON GAS EXCLUSION
SERVICE OF SUIT-ED PHOEBUS
WAR & TERRORISM EXCLUSION
Other Interest Copy
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