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Certificates of Insurance
BARRBUI-01 ....................M.M.C. I.MT O.S.H DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE [ 6/16/2021 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 NAME: Evergreen Insurance Agency PHONE FAX 583 1 05th Ave.N Suite 2 (A1C,No,Ext):(561)966-8883 (AJC,No):(561)964-8885 E-MAIL Royal Palm Beach,FL 33411 ADDRESS,info@evergreeninsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Evanston Insurance Company 35378 INSURED INSURER B:Mercury Insurance Group Barracuda Builders of Key West,Inc. NSURER C 5601 3rd Avenue INSURER D: Key West,FL 33040 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 swuEIR POLICY NUMBER POLICY EFF 7 POLICY EXP LTR INSD (MMIDDIYYYY),(MMIDDNYYY), LIMITS A X COMMERCIAL GENERAL LIABILITY 1,000,000 EACI I OCCURRENCE $ CLAIMS-MADE X OCCUR DAMAGE TO RENTED X 214/2021 214/2022 PREMISES(Ea occurrence) 100,000 M ED EXP(Any one person) 5,000 1,000,000 Approved Risk Management PERSONAL&ADV INJURY 2,000,000 GENERAL AGGREGATE GEN'LAGGREGAT LIMIT APPLIES PER. POLICY X PRO LOC PRODUCTS-COMPIOP AGO S 2,000,000 OTHER: 7-20-2021 B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 ,_{Ea awdentl X ANY AUTO X 4/30/2021 4130/2022 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS`ONLY (Per accident) PIP 10,000 UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS-MADE: AGGREGATE DED RE I-ENTION$ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR)PARTNER)EXiEcu I wL E L.EACH ACCIDENT OFFICER,MEMBER EXCLUDED? N/A: (Mandatory in NH) E L.DISEASE-EA EMPLOYEE S If yes,describe under DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Monroe County BOCC,as additional insured with respect to General Liability and Auto Liability. 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. Insurance Compliance PO Box 100085-FX Duluth,GA 30096 AUTHORIZED REPRESENTATIVE �7 ACORD 25(2016/03) Q 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD From:mbheUe@,everQrecninourance.com To:|nfm@bmrnmcudmhuikJer/.comiwfm@pharrmcudm6w||ders.mpm CC: monmnecmuntyf@Ebix.rom Subject. Monroe County Florida Certificate uf Insurance Req Date:8/18/2O211:O9:16PKn Autochment(s): Good afternoon, COI attached. Best regards, Michelle McIntosh Commercial Lines Advisor Evergreen Insurance 583 105th Ave. N' Suite #2 Roya| Pa|mBeach' FL. D3411 (561) 966-8883 XI10 office (S61) 964-8885 —fax michelle@evergreeninsurance.com Please keep us in mind for all your insurance needs including home,auto, life, health, commercial,and employee benefits.A no obligation quote isas close axa phone call away. CONFIDENTIALITY NOTICE:This e'emui|and the transmitted documents contain private, privileged and confidential information belonging to the sender.The information therein is solely for the use of the addressee. If your receipt of this transmission has occurred as the result of an error, please immediately notify us so we can arrange for the return of the documents. In such circumstances, you are advised that you may not disclose, copy, distribute, or take any other action, in reliance onthe information transmitted. A` DATE(MM/DD/YYYY) ACC OR"® EVIDENCE OF PROPERTY INSURANCE 10/02/2020 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 COMPANY A/C No Ext: US ASSURE INSURANCE SERVICES OF FLORIDA, INC. American Zurich Insurance Company P.O. BOX 10197 JACKSONVILLE, FL 32247-0197 FAX EMAIL A/C No: ADDRESS: @ g abet ever reenins.net CODE: A0094299 SUB CODE: AGENCY CUSTOMER ID#: INSURED LOAN NUMBER POLICY NUMBER Barracuda Builders of Key West, Inc ER73783850 5601 3rd Ave EFFECTIVE DATE EXPIRATION DATE Key West, FL 33040 CONTINUED UNTIL 11/01/2020 05/01/2021 TERMINATED IF CHECKED THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION LOCATION/DESCRIPTION 30451 Lyttons Way Big Pine Key, FL 33043 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 COVERAGE/PERILS/FORMS AMOUNT OF INSURANCE DEDUCTIBLE Builders Risk Coverage Form $1,500 Renovations and Improvements $350,000 Existing buildings or structures $100,000 All Covered Property at all Locations $450,000 REMARKS(including Special Conditions APPROVED RISK MANAGEMENT 10-5-2020 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 NAMEANDADDRESS MORTGAGEE ADDITIONAL INSURED Monroe County Board of County Commissioners ATIMA X LOSS PAYEE 1100 Simonton Street LOAN# Key West, FL 33040 AUTHORIZED REPRESENTATIVE ACORD 27 (2009/12) ©1993-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD -'� BARRBUI-01 MMCINTOSH CERTIFICATE OF LIABILITY INSURANCE DAT2/9/2 D/YYYY) �•� /9/2021 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 NAME: Evergreen Insurance Agency PHONE FAX 583 105th Ave.N Suite 2 (A/C,No,Ext): (561)966-8883 (A/C,No):(561)964-8885 Royal Palm Beach,FL 33411 E-MAIL-ADDRESS:info@evergreeninsurance.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Evanston Insurance Company 35378 INSURED INSURER B:Mercury Insurance Group Barracuda Builders of Key West,Inc. INSURER 7 5601 3rd Avenue INSURER D: Key West,FL 33040 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 MWDD/YYYY MWDD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 3AA453037 2/4/2021 2/4/2022 DAMAGE TO RENTED 100,000 X PREMISES Ea occurrence $ MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JECT1:1 LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ X ANY AUTO X BA090000013868 4/30/2020 4/30/2021 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X AUTOS ONLY X NON-OAUTO ONLY PROPERTY DAMAGE $ Approved Risk Man gement UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION - - AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: Blue Heron Park House Repairs. Monroe County Board of County Commissioners as additional insured with respect to general liability and auto liability. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of County Commissioners THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty ty ACCORDANCE WITH THE POLICY PROVISIONS. c/o Purchasing Department 1100 Simonton Street,Room 2-213 Key West,FL 33040 AUTHORIZED REPRESENTATIVE , — ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 0 DATE(MM(DDIMY) CERTIFICATE F LIABILITY INSURANCE 12/28/2020 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT CertlfiCateS Risk Transfer Insurance Agency,LLC _NAME: 47 E.Robinson Street (prc NE JAJ 0,N,?J:. .. Suite 200 E-MAIL Orlando,FL 32801 ADDREss:Certificateskymberlygroup.com INSURER(S)AFFORDING COVERAGE NAIL# INSURER A:Service American Indemnity Company 39152 INSURED INSURER B Kymberly Group Payroll Solutions,Inc. _- 1 W.Church Street,2nd Floor,Suite 200 INSURER C: Orlando,FL 32801 _ _ _ INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:K4FQCPRR 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� EFF ' POLICY EXP i .. LTR I TYPE OF INSURANCE N D'VM POLICY NUMBER MMIDDlYYYY) (MMIDD= LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ '.... _bAT1r�IA�ETON'I'55 _.. }. r CLAIMS-MADE OCCUR }PREMISES.(Ea occurrencaj }$ Approved Risk Management MED EXP(Any one person) $ _.__.. . .. ......_. ...__.. _. PERSONAL&ADV INJURY +$.... GEN'L AGGREGATE LIMIT APPLIES PER: PRO- i GENERAL AGGREGATE... +$ POLICY EI JECT ❑ LOC PRODUCTS COMPPOP AGO+$ FFF----Ilfl OTHER: _ I$ AUTOMOBILE LIABILITY 2-26-202 1 iCOMBINED SINGLE LIMIT 11Ea accidents ANY AUTO ,$_._. ..._.. BODILY INJURY(Per person) $ OWNED SCHEDULED (AUTOS ONLY AUTOS BODILY INJURY Per accident) , $ � '. HIRED NON-OWNED I `PROAERTY DAMAGE _.. } AUTOS ONLY AUTOS ONLY i (per sccidentl. 5 i UMBRELLA LIAB OCCUR F EACH OCCURRENCE EXCESSLIAB HCLAINIS,MADE. -i AGGREGATE f$. DED RETENTION$ g A WORKERS COMPENSATION RT21MWC6690005303 01101/2021 01/01/2022 X I PER OTH- AND EMPLOYERS'LIABILITY Y N STATUTE ER ANY PROPRIETORIPARTNERIEXECUT€VE E.L.EACH ACCIDENT `$ 1,000,000 (Manila(Mandatory in ER.EXCLUDED? O N i A E,L.DISEASE-EA EMPLOYEE S IMardatory In NH) 1,000,000 If yes,describe under ._. ... r _.. DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 ' S I $ DESCRIPTION OF OPERATIONS t LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Coverage is extended to the leased employees of alternate employer in all states except in monopolistic states(ND,OH,WA,WY): Barracuda Builders of Key West,Inc.: Added Eff 10114/18 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County ACCORDANCE WITH THE POLICY PROVISIONS, Board of County Commissioners Blue Heron Park House Repairs AUTHORIZED REPRESENTATIVE 30451 Lyttons Way ' Big Pine Key,FL 33043 ; Page 1 of 1 p 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD