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Certificate of Insurance
Client#: 4463 DLPORTER DATE(MM/DD/YYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 12/31/2020 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 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER '.. CONTACT NAME: Marsh &McLennan(CLW) PHONE 727 447-6481 FAX 727 449-1267 A/C,No,Ext: A/C,No 101 N Starcrest Dr. ADORIEss: certificates@bouchardinsurance.com Clearwater, FL 33765 INSURER(S)AFFORDING COVERAGE NAIC# 727 447-6481 INSURER A:Colony Insurance Co 39993 ''. INSURED INSURER B:Travelers Excess&Surplus Lines CO ''..29696 D L Porter Constructors, Inc. Amerisure Mutual Insurance Company 23396 INSURER C: P Y 6574 Palmer Park Circle Old Dominion Insurance Company 40231 INSURER D: p Y Sarasota, FL 34238-2777 ''..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 CONTRACTOR 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE.OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 103GLOO1647507 01/01/2021 01/01/2022 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X........ OCCUR PREMISES(Ea occu occurrence) $100,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO- POLICY X1 ECT X LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ D AUTOMOBILE LIABILITY Y Y B1T3307V 01/01/2021 01/01/202 EaaB,idens tlNGLELIMIT $1,000,000 X ANY AUTO OWNEDSCHEDULED Approved /RiskM an/a ement BODILY INJURY(Per person) $ AUTOS ONLY AUTOS A__ •_ .t.. �� BODILY INJURY(Per accident) $ X HIRED �AUTOS ONLY X NON-OWNED G�z�.Cv PROPERTY DAMAGE $ AUTOS ONLY 1-26-2021 ,...(Per accident) B X UMBRELLA LIAB X OCCUR Y Y ZUP81NO856421NF 01/01/2021 01/01/2022..EACH OCCURRENCE $5,000 000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000 000 DED X RETENTION$10000 $ C WORKERS COMPENSATION Y WC208074509 01/01/2021 01/01/2022..X PER OTH AND EMPLOYERS'LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? I Y..I N/A -- -- (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE.$1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 Leased/Rented Equ IM20593641302 01/01/2021 01/01/2022 $100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder is additional insured as respects General Liability,Auto and Umbrella only if required by written contract,and subject to the terms,conditions and exclusions as specified in the policy. Coverage is primary as respects to General Liability and non-contributory as subject to the terms, conditions and exclusions of your policy. (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION Monroe Count BOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Insurance Compliance ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 100085-FX DULUTH, GA 30096-9302 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) 1 of 2 The ACORD name and logo are registered marks of ACORD #S1357033/M1356868 GINDE DESCRIPTIONS (Continued from Page 1) Waiver of subrogation applies in favor of certificate holder as respects General Liability,Auto, Umbrella and Workers Compensation only if required by written contract,and subject to the terms,conditions and exclusions as specified in the policy. Umbrella follows form. Proprietors/Partners/Executive Officers/Members Excluded: Gary Loer, President SAGITTA 25.3(2016/03) 2 of 2 #S1357033/M1356868 From: ginadenman@bouchardinsurance.com To: monroecountyfl monroecountyfl@Ebix.com CC: Subject: Proof of Insurance Coverage (DLPORTER) Date: 12/31/2020 6:00:47 AM Attachment(s): At the request of our insured, we are pleased to provide the attached proof of insurance. This document is issued as a matter of information only and confers no rights upon the holder. This document does not affirmatively or negatively amend, extend or alter the coverage afforded by the policy or policies referenced. This document does not constitute a contract between the issuing insurer(s), authorized representative or producer and the holder. Under the terms of the Additional Insured and/or Waiver of Subrogation endorsement(s) there must be a written contractual requirement in order for that status to be provided. If no contract exists, a specific endorsement or endorsements will need to be added. If the holder is a loss payee, certain policies may require an endorsement. A statement on this certificate does not confer rights to the holder in lieu of such endorsements. Should you have any questions or need further assistance, please contact us at one of the following email addresses: CLCerts@BouchardInsurance.com for the general certificate team Certificates@BouchardInsurance.com if your account manager is one of the following: Julie Catalano, Paul Ram, Heather Rohrbach, Robin Staker or Tyler Weinberger Condos@BouchardInsurance.com for all residential condominium or homeowner associations Thank you and have a great day! DLPORTER DATE(MM/DD/YYYY) ACORDTM EVIDENCE OF PROPERTY INSURANCE F10/23/2020 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW.THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE ADDITIONAL INTEREST. AGENCY PHONE 727 447-6481 COMPANY A/C No Ext Marsh&McLennan(CLW) Praetorian Insurance Company 101 N Starcrest Dr. Clearwater, FL 33765 FAX(A/C, /C No):727 449-1267 ADDRESS:certificates@Bouchardlnsurance.com CODE: SUB CODE: AGENCY 4463 CUSTOMER ID#: INSURED D L Potter Constructors, Inc. LOAN NUMBER POLICY NUMBER 6574 Palmer Park Circle P00331M10741000 Sarasota FL 34238-2777 EFFECTIVE DATE EXPIRATION DATE NUED UNTIL 11/02/20 08/02/21 TERMINATED IF CHECKED THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION LOCATION/DESCRIPTION Location#1 3491 South Roosevelt Blvd. Key West, FL 33040-2777 Building#1 Maintenance Facility Project 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 EVIDENCE OF PROPERTY INSURANCE 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. COVERAGE INFORMATION PERILS INSURED I I BASIC BROAD X SPECIAL COVERAGE/PERILS/FORMS AMOUNT OF INSURANCE DEDUCTIBLE BUILDERS RISK COVERAGE INFORMATION Job Specific Completed Value: Loc.#1 Bldg.#1 1,900,000 5,000 Replacement Cost Valuation Special Form Windstorm Deductible(Subject to a$50,000 minimum) Included 5% Flood/Earthquake Excluded REMARKS(Including Special Conditions) APPROVED RISK MANAGEMENT 10-23-2020 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. ADDITIONAL INTEREST NAME AND ADDRESS X ADDITIONAL INSURED LENDER'S LOSS PAYABLE X LOSS PAYEE Monroe County BOCC MORTGAGEE 1100 Simonton St. LOAN# Key West, FL 33040 AUTHORIZED REPRESENTATIVE Ju� ACORD 27(2016/03) 1 of 1 S 32001 ©1993-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD TYLWE