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Certificates of Insurance DocuSign Envelope ID:616421 BE-F340-48AB-132139-C91 DCD5F7442 CUSTOMER NUMBER: 2209874 RUN DATE: 06-30-21 M&K AGENCY INC 10631 N KENDALL DR STE 105 MIAMI, FL 33176-1560 JC CONSTRUCTION MANAGEMENT INC; DESIGN CENTER INC 6677 OVERSEAS HWY MARATHON, FL 33050-2734 Go green . Go paperless . Switch to Paperless Delivery* and help reduce your carbon footprint. View your policy and billing documents, notifications and confirmations of payments online. Register now through Commercial My Account, on All'state.com *State exceptions may apply Insured Full Copy DocuSign Envelope ID:616421 BE-F340-48AB-132139-C91 DCD5F7442 Policy Number 648854333 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMON POLICY CHANGE ENDORSEMENT Endorsement No. 002 Allstate Insurance Company Named Insured JC CONSTRUCTION MANAGEMENT INC; Effective Date: 06-01-21 (SEE NAMED INSURED ENDORSEMENT) 12:01 A.M., Standard Time Agent Name M&K AGENCY INC This endorsement will not be used to decrease coverages, increase rates or deductibles or alter any terms or conditions of coverage unless at the sole request of the insured. COVERAGE PART INFORMATION -Coverage parts affected by this change as indicated by x❑below. ❑ Commercial Property ❑ Commercial General Liability ❑ Commercial Crime ❑ Commercial Inland Marine ❑ COMMERCIAL AUTOMOBILE NO CHARGE The following item(s): 1-1 Insured's Name Insured's Mailing Address Policy Number El Company 1-1 Effective/Expiration Date Insured's Legal Status/Business of Insured Payment Plan Premium Determination Additional Interested Parties Coverage Forms and Endorsements Limits/Exposures Deductibles Covered Property/Location Description Classification/Class Codes EJRates Underlying Exposure/Insurance is (are) changed to read (See Additional Pages)) THE FOLLOWING ADDITIONAL INTEREST (ADDITIONAL INSURED - OTHER) HAS BEEN ADDED TO THE POLICY: MONROE COUNTY BOCC 1100 SIMONTON ST KEY WEST FL 33040-3110 The above amendments result in a change in the premium as follows: This premium does not include taxes and surcharges. ❑ No Changes To be Adjusted at Audit Additional NO CHARGE Return NO CHARGE Tax and Surcharge Changes Additional Return Countersigned By: M&K AGENCY INC AUTHORIZED AGENT DM CW 30 01 10 Allstate Insurance Company Insured Full Copy DocuSign Envelope ID:616421 BE-F340-48AB-132139-C91 DCD5F7442 Policy Number 648854333 COMMON POLICY CHANGE ENDORSEMENT Endorsement No. 002 Allstate Insurance Company Named Insured JC CONSTRUCTION MANAGEMENT Effective Date: 06-01-21 12:01 A.M., Standard Time Agent Name M&K AGENCY INC POLICY CHANGES ENDORSEMENT DESCRIPTION (CONT'D) ALL OTHER TERMS AND CONDITIONS REMAIN THE SAME REMOVAL PERMIT If this policy includes the Commercial Property Coverage Part, the following applies with respect to the Coverage Part: If Covered Property is removed to a new location that is described on this Policy Change, you may extend this insurance to include that Covered Property at each location during the removal. Coverage at each location will apply in the proportion that the value at each location bears to the value of all Covered Property being removed. This permit applies up to 10 days after the effective date of this Policy Change; after that, this insurance does not apply at the previous location. DM CW 30 01 10 Allstate Insurance Company Insured Full Copy DocuSign Envelope ID:616421 BE-F340-48AB-132139-C91 DCD5F7442 Policy Number 648854333 SCHEDULE OF NAMED INSURED(S) Allstate Insurance Company Named Insured JC CONSTRUCTION MANAGEMENT Effective Date: 0 6—0 1—2 1 12:01 A.M., Standard Time Agent Name M&K AGENCY INC DM CW 30 (cont. ) THE NAMED INSURED ON FORM DM CW 30 IS AMENDED TO READ: JC CONSTRUCTION MANAGEMENT INC; DESIGN CENTER INC DM CW 03 01 10 Allstate Insurance Company Insured Full Copy DocuSign Envelope ID:616421 BE-F340-48AB-132139-C91 DCD5F7442 DM CW 12 01 10 Policy Number 648854333 SCHEDULE OF FORMS AND ENDORSEMENTS Allstate Insurance Company Named Insured JC CONSTRUCTION MANAGEMENT Effective Date: 06-01-21 12:01 A.M., Standard Time Agent Name M&K AGENCY INC COMMON POLICY FORMS AND ENDORSEMENTS DM CW 30 01-10 COMMON POLICY CHANGE ENDORSEMENT DM CW 03 01-10 SCHEDULE OF NAMED INSURED (S) DM CW 12 01-10 SCHEDULE OF FORMS AND ENDORSEMENTS AUTOMOBILE FORMS AND ENDORSEMENTS CA 20 48 10-13 DESIGNATED INSURED DM CW 12 01 10 Allstate Insurance Company Insured Full Copy DocuSign Envelope ID:616421 BE-F340-48AB-132139-C91 DCD5F7442 Cl CW A0210 11 CERTIFICATE OF INSURANCE This certificate is issued for informational purposes only. It certifies that the policies listed in this document have been issued to the Named Insured. It does not grant any rights to any party nor can it be used, in any way, to modify coverage provided by such policies. Alteration of this certificate does not change the terms,exclusions or conditions of such policies. Coverage is subject to the provisions of the policies, including any exclusions or conditions, regardless of the provisions of any other contract, such as between the certificate holder and the Named Insured. The limits shown below are the limits provided at the policy inception. Subsequent paid claims may reduce these limits. Certificate Holder: Named Insured: MONROE COUNTY BOCC JC CONSTRUCTION MANAGEMENT INC; 1100 SIMONTON ST DESIGN CENTER INC KEY WEST, FL USA 330403110 6677 OVERSEAS HWY MARATHON FL 33050-2734 Automobile Liability Insurer Name:Allstate Insurance Company Poli Number: 648854333 1 --Any Auto 2-Owned Autos Only 3-Owned Priv.Pass.Autos Only 4--Owned Autos Other Than Priv. 5-Owned Autos Subject to 6-Owned Autos Subject to a Compulsory UM Law Pass.Autos Only X No Fault x 7--Specifically Described Autos 8-Hired Autos Only 9-Nonowned Autos Only Policy Effective Date: 0 6-01-2 0 21 1 Policy Expiration Date: 0 6-01-2 0 2 2 Limitsof $1,000,000 Combined Single Limit(each accident) Insurance: BI Per Person I BI Per Accident PD Per Accident Description of Operations/Locations/Vehicles/Endorsements/Special Provisions Approved Risk Management -36®2621 Interested Party Type: Additional Insured - All Other THIS CERTIFICATE DOES NOT GRANT ANY COVERAGE OR RIGHTS TO THE CERTIFICATE HOLDER. IF THIS CERTIFICATE INDICATES THAT THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED, THE POLICY(IES)MUST EITHER BE ENDORSED OR CONTAIN SPECIFIC LANGUAGE PROVIDING THE CERTIFICATE HOLDER WITH ADDITIONAL INSURED STATUS. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED ONLY TO THE EXTENT INDICATED IN SUCH POLICY LANGUAGE OR ENDORSEMENT. Producer. M&K AGENCY INC Authorized Representative: DocuSigned by: F UL uYi6s Date: 06-30-21 BEB24413901`51460... Includes copyrighted material of Insurance Services Office, Inc., with its permission CI CW A02 10 11 Allstate Insurance Company Page 1 of 1 Insured Full Copy DocuSign Envelope ID:616421 BE-F340-48AB-132139-C91 DCD5F7442 POLICY NUMBER: 648854333 COMMERCIAL AUTO CA20481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are"insureds"for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: JC CONSTRUCTION MANAGEMENT INC; Endorsement Effective Date: 0 6—01—2 0 21 SCHEDULE Name Of Person(s) Or Organization(s): MONROE COUNTY BOCC 1100 SIMONTON ST KEY WEST, FL USA 330403110 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured"for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A-1. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 ©Insurance Services Office, Inc., 2011 Page 1 of 1 Insured Full Copy ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 04/27/2021 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 HOUSE NAME: Kelly White&Associates Insurance, LLC a/CNNo Ext: 904-880-8881 FA//X No: P.O. Box 350909 E-MAIL ADDRESS: kelly@kwhiteinsurance.com kwhiteinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# Jacksonville FL 32235 INSURERA: RLI Insurance Co AM Best A+XI 13056 INSURED INSURERB: Travelers Property&Casualty Company Coffin Marine Services, Inc INSURERC: P O Box 430538 INSURER D: Everest National Insurance Company INSURERE: Great American Insurance Company 16691 Big Pine Key FL 33043 INSURER F: COVERAGES CERTIFICATE NUMBER: COFF21042709051004 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 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 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES Ea occurrence $ 50,000 X P&I including Jones Act MED EXP(Any oneperson) $ 5,000 A X Salvors Liability X MRP0200000 09/23/2020 09/23/2021 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X ❑PRO- ❑ Approved Risk Management POLICY JECT LOC -7�i/ / PRODUCTS-COMP/OP AGG $ 1,000,000 OTHER: Protection&Indemnity $ $1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X ANYAUTO 4-28-2021 BODILY INJURY(Per person) $ B OWNED SCHEDULED X BA4902R108 08/17/2020 08/17/2021 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Personal Injury $ 10,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ r $ WORKERS COMPENSATION XJPER STATUTE X EORTH IncludeslUSL&H'. AND EMPLOYERS'LIABILITY Y/N D OFFICER/MEMBER/EXCLUDE/D ANY ECUTIVEPROPRIETORPARTNEREX � N/A 9700000381-201 12/21/2020 12/21/2021 E.L.EACH ACCIDENT $ 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Per co Schedule $1,000,000 E Vessel Pollution OMH1440763 09/23/2020 09/23/2021 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate Holder is listed as Additional Insured as required per written contract. 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. 2798 Overseas Highway AUTHORIZED REPRESENTATIVE Ste 420 Marathon FL 33050 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 3/9/2021 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 NAME:CONTACT PLYMOUTH INSURANCE AGENCY Plymouth Insurance Agency AHONo,Ext: 727-682-4040 /C,No):877-491-7980 2739 US Hwy 19 North AfDFIEss:Certs@plymouthinsuranceagency.com Holiday, FL 34691 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: Kinsale Insurance Company 38920 INSURED Design Center, Inc, JC Const Mgmt Inc, INSURER B:AGCS Marine Ins Co 22837 Royal Crest Co.Inc,dba Royal Crest Bldrs INSURER C 6677 Overseas Hwy INSURER D Marathon, FL 33050 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1, 000, 000 CLAIMS-MADE CI OCCUR PREMISES Ea occurrence $ 100, 000 0100115940-0 5/26/2020 5/26/2021 MED EXP(Any one person) $ 5, 000 A Y PERSONAL&ADV INJURY $ 1, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2, 000, 000 X POLICY CI PRO- C LOC PRODUCTS-COMP/OP AGG $ 2, 000, 000 Approved Risk Management OTHER: $ AUTOMOBILE LIABILITY / COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY 3-9-2021 (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DIED RETENTION$ $ WORKERS COMPENSATION PER TH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? C N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ f yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Builder's Risk MXI930798249842 12/15/2020 6/15/2021 prop Occur 10, 000 B Loss Occur 329,500 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Project: Marathon Terminal Airport addres: 9000-9400 Overseas Highway, Marathon, FL. 33050 Monroe County BOCC is an additional insured and loss payee with respect to General Liability and Builder's Risk. 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 1100 SIMONTON STREET ACCORDANCE WITH THE POLICY PROVISIONS. KEY WEST, FL 33040 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD25(2016/03) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABIL17Y INSUPANCE =1/27/2021 Plymouth Insurance enc This Ceedficift Is issued 10 as a nufter of Inflornotion only and conifers no 2739 U.S. Highway 19 N. flghb upon the Cerifficalla Holiday, FL 1 °� the Policies below. , (727)938-5562 Iristrivs Affbinling Coverage NAIC c South East Personnel Leasing, Inc. &Su idirie 1 Ac Lion insurance Company 11075 2739 U.S. Highway 19 N. ' r B' Holiday, FL 34691 I C: Insurer. o: Inniffpr_ e Coverages rice m" r ro ram r arty requrremeM or with to Lila may i may br tyre�IIaa5 rreretn is�bjed ro ali the erns,a and conai or m,dr aides. ®rd remits m4 have n by paid claims. INSR Pdrey Policy LTR NSRD T of Ins P NmnW Data Date Lms D/Y )M ® GENERALUTY Each Occurrence CommereW General Liabft Damage to rented premises(FA Claim Made ) Mod Esp General e lit* lies P Adv Injury per Policy 13 LOC General Aggregate Agg AUTOMOEMLE UMUTY Mned Combisingle Limit Any Auto (EA Accident)All �Autos Y ytiduy Autos (PerPerson) ScheduledDATE— Hired Autos y►ems Non-Owned Autos (Per Accide t) PmpwV Damage (Per C Each ch Claims Made Aggregate Deductible A Workem Compensallon and WC 71949 01/01/2021 01/01/2022 x WC OTH- o it m omits ER q Any t®r/ oflfi r/member E.L.Each Accident $7, , orl u E.L DI -Ea Employee $1,000,000 If Yes,describe under special provisions below. EL DI -Policy L(mft Si. , Other I 1 1 Descriptionsof Opomtione/LocatkmWehiclestExclusiorts added by EndomernentfSpecial Provisions: Client ID: 91-69-030 Coverage only applies to afire employee(s)of South Fast Personnel Leasing,Inc&Subsidiaries that are leased to the following"Client Company': Royal Crest .Inc.&7C Construction f4a Inc.dba Design Center Inc. Coverage only applies to injuries incurred by South East Personnel Leasing,Inc&Subsidiaries active employees),while working in:FL Coverage does riot apply to statutory empbyeKS)or( s)of the Client Company or any other entity. A list of the active empl s)teased to the Client Company can be obtained by faxing a request to(727)937-2138 or email aerMcabes@ilonhwranmAmmpany.com MTH TEItMINAL MTERIOR REHABILITATION,9000 OVEILSEAS HWY,MARATHON FL 33050 ISSUE 11-16-20(SS).REISSUE 0147-21(SS) PWIFICATE HOLDER C MON MONROE COUNTY BOCC amy the po riles be�n�lled ttm ron issts i wig end r to mail 30 wdten notice to tw holder named to the IsM but failure to do so III impose no obiigetion or liability of any kind upon the insurer,its agents or representatives. 1100 SIMONTON STREET KEY WEST, FL 33040 %,r.®.a/ ,�' -M®•,„t—