Insurance Certificates
~CORQ.. CERTIFICA TE OF LIABILITY INSURANCE I DATE (MMlDDIYYVY)
07/13/2009
~CER 305.852.3234 FAX 305.152.3703 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMA TIOH
Regan Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
90144 Overseas Hwy. .. .-.-.-. ...... .AL TER..JHE-C.cVERAGE AFFORDED BY THE POLICIES BELOW.
Tavernier, FL 33070 f J: l'; . ' i ; ,
\ t, . t. IMSOrtER~AFFO RDING COVERAGE NAle ,
......---.- "-"
INSUReD 81g Pine Athletic Assoe INSURER A: tfauti us Insurance Co 17370
POBox 430089 JUL ,.. riN~Nl\B: i
Big Pine Key, FL 33043 ~NSt.~fK c: I
INSURER 0: f
------..-... ..-
I f ':"" ~ : 7'" t' :IN~RCR E:
COVERAGES ! " : ~. / :\'. . . - .!~' ~. .,.
. ~ -. ,.. t ': t
. ' ," '" . . .
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.
.. TYPE OP INSURANCE POLICY NUMBER ~~~ IF'ICTIVE DX'fa'lMIIID~ LIMITS
DATE M---.
GENERAL LIA.urv NC913028 07/10/2009 07/10/2010 EACH OCCURRENCE I 1
- ~_SYE:~) excl uclec
X COMMERCIAL GENERAL LIABILITY .
- ~ CLAIMS MADE 00 OCCUR
MED EXP (Anyone person) I excl udec
-
A X PERSONAL & ADV tNJURY I excluded
~
f-- GENERAL AGGREGATE I 1
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS. COM PlOP AGG , S excluded
n POLICY n ~r8i nLOC
AUTOMOBILE UABIUTY COMBINED SINGLE LIMIT
- I
ANY AUTO (Ee acc:ident)
-
ALL OWNED AUTOS BODILY INJURY II
----
SCHEDULED AUTOS (Per person) i
- !
HIRED AUTOS BODILY INJURY i
I-- il
NON-OWNED AUTOS (Per accident) i
I--
- 1\ PROPERTY DAMAGE S
(Per .~t)
GARAGE UABlUTY ?1\1\~ ~q- AUTO ONLY. EA ACCIDENT I
R NN AUTO OTHER THAN EA ACC I
AUTO ONt Y: AGO I
EXCEl.' UMBRELLA LIABILITY '-7 1 ] ~O\ t. . " '
EACH OCCURRENCE I
o OCCUR o CLAIMS MADE ':.... ' .' . . ., ,.. f .-_.
~ AGGREGATE I
. . ~~\ ~~ S
R DeDUCTIBLe 0 ;S
RETENTION S I
WORKERS COMPENSATION J)( 2t I I TORY LNITS! rOTH-
AND EMPLOYERS' UMlUTY ER
NN PROPRETORIPARTNERlEXECUnve[J C ~. fl.~ E.L. EACH ACCIDENT S
OFFICERlMEMBER EXCLUDED?
CMMCIatory In NH) 'D~ E.t. DISEASE. EA EMPLOYEE I
If m' describe under
S ECtAl PROVISIONS below E.L. DISEASE. POLICY LIMIT S
OTHER ~~-"."j
Dl!ICIUPT1ON OP OPERATIONS' LOCATIONS I VEHlCLEI/IXCLU8ION8 ADDED BV INDORSEMENT' SPECIAL PROVISIONS
Certificate holder is listed as an Additional Insured.
'theltic Parks and Playgrounds
[neludes Skate Park located at 31009 Atlantis BV, B;g Pine Key, Fl 33043
CERTIFICATE HOLDER
I
CANCELLATION
SHOULD ANY OF THE ABOVE DElCRlMD POLICII!S .. CANCeLLeD UllOM THE IXNATION
DATE THI!REOFt THE ISSUING INIURBfl WILL ENDEAVOR TO MAIL .J:!.. DAYS WNTTIN
NOTICE TO THE CERTIFICATE HOLDER NAIlED TO THE LEFT, BUT FAILURE TO DO 10 SHALL
IMPOSE NO OBLIGATION OR UABlUTY OF ANY KIND UPON THE INIURER. ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE ~~
John Crowell /BMONRO cr- ~ - /If ~-&
C 1981-2001 ACORD CORPORATION. All rights reMrved.
The ACORD name and logo are registered marks of ACORD
Monroe County Board Of Commissioners
Risk Manag....nt
POBox 1026
Ke~ West, FL 33041-1026
ACORD 25 (2~/01)
c.c.~
THIS CERTFlCAlE 18 IIIUED A8 A MATTER OF IFONMTION ON..Y AMJ COtFER8 NO
RIGHTS UPON THE CERTFlCAlE HOLDER. THIS CERTFlCATE DOES NOT MEND. EXTBI)
OR AL TEA TIE COVERAGE AFFORDED BY THE POLICIES BELOW.
PRODUCIIt
Work Comp AIIoci8tes, Inc.
P.O. Box 33297
Palm Beach Gardens, FL 33420-3297
USA
COMPANE8 AfFORDING COVERAGE
COMPANY
A Florida Retail Fed..tion SIF
COMPANY
B
COMPANY
C
COMPANY
D
INIUMD
Big Pine Athletic AuocI8tion, Inc.
P.O. Box 430089
Big Pine Key, FL 33043-0089
TtIS 18 TO CI!RrFY THAT. THE POLICIES OF IeJRANCE LISTED ROW HAVE BEEN IIIUED TO TtE INSURED IWED MINE FOR TtE POLICY PERIOD INDICATED.
NOTWITHSTANDIG NfY REQUlBENr. TEAM OR CONDITION OF AI<< CONTRACT OR onER DOCUMENT WITH AE8PECT TO WHOt THIS CERTFlCAlE MAY BE IIIUED OR MAY
PERTAIN. THE It8JRANCE AFFORDED BY 1lE POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXClUSIONS AND CONDITIONS OF SUCH POLICES. LIMITS SHOWN
MAY HAVE BEEN REDUCED BY PAID a.AIMS.
POLICY EFFECTIVE POLICY 1XPIRA11ON LMTI
DATI (IMDDIYY) DATE (IMDDIYY)
GENERAL. AGGREGATE
PRODUCTS · eot.FJOP $
PSIIONAL I AlN INJURY $
EAQt OCCURRENCE $
FR! DAIMGE (Any one tIN) $
lED EXP (Any one perIOn) $
(X)YIINEI) SINGLE LMT $
'f BODILY INJURY $
(Per Person)
tJfo~ BODILY INJURY $
(fW AccIcIn)
CC~ PROPERTY DAMAGE $
AUTO ON. Y · EA $
rfi) onER THAN AUTO ONLY:
EACH ACCIENT
AGGREGATE
EACH OCCURRENCE
AGGREGATE
9I3l2OO9 91312010 a EACH ACCIDENT 100 000
a DISEASE - POLICY LIMIT 500 000
EL DISEASE -EA BR.O 100 000
CO
LTR
TYPE OF -..IWICE
POLICY NUMBER
GI!NDAL LIMILITY
COMMERCIAL GENERAL LIABILITY
a.AIMS MADE 0 OCCUR
OWNERS. CONTRACTOR'S PROY
AUTOIIOBLE LIAIIILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GMAGa LIMILITY
Nt( AUTO
EXCElS LlA8LITY
UMBRELLA FORM
OTHER THAN UMBREUA FORM
WIORICIRI ~TION AND
A ....oYIRS' LIMLITY
TtE PAOPRETORl
PARTNERS/ EXECOrIVE
OFFICERS ARE:
OTHER
05202905900OO
~,.. OF 0PI!RA1'I)tIIft.OCATIONIIVIIICLDIINCIALITIIII
CC #~
h~~CL-
Monroe County Bo8rd of County Comlssloners
Monroe County Risk Management
Atb1: M8rIa Slavik
1100 Simonton Street
Key West. FL 33040
SHOULD ANY OF THE MtNE DE8CAIIED POLICES BE CANCELLED BEFORE 1HE
EXPIRATION DATE TtEREOF. TIE I88l-.G CDJIPANY wu. ENDEAVOR TO MAIL 10
DAYS WRITTEN NOTICE TO 11E CERTFICATE HOLDER HAlED TO nE LEFT. BUT
FAILUAE TO MAIL SUCH NOTICE atALL MIOIE NO oaJGAT1ON OR LIA8I..ITY OF ANY
KIND UPON THE COfIPANY. rrs AGENTS OR REPRESENTATIVES.
AUntORIZD ........,.A1MI ~/2!.