Certificates of Insurance 2018 Edition
MONROE COUNTY,FLORIDA
REQUEST FOR WAIVER OF INSURANCE REQUIREMENTS
It is requested that the insurance requirements,as specified in the County's Schedule of Insurance
Requirements,be waived or modified on the following contract.
ContmctorNendor: Pedro Falcon Contractors, Inc.
Project or Service: Marathon Airport Site Lighting Rehabilitation
ConttactorNendor
Address&Phone#: 31160 Ave C
Big Pine Key, FL 33043
General Scope of Work: Security Sight Lighting Rehabilitation
Reason for Waiver or Flood Insurance not obtainable, see attached
Modification: letter from insurance agent. Providing
Installation Floater coverage for full price
of- contract.
Policies Waiver or
Modification will apply to: Builders Risk Insurance
— u _
Signature of ContractorNendor. ° m ,... I] } �� 'r c i
,
Date: 4-27-2021 Approved
-7�,� x Not Approved
Risk Management Signature:_ `/'/�
Date:
County Administrator appeal:
Approved: Not Approvcd:
Date:
Board of County Commissioners appeal:
Approved: Not Approved:
Meeting Date: ... w.._
Administrative Instruction 7500.7
104
MICLETTE
BOWEN,MICLETTE&BRITT
OF FLORIDA,LLC
1020 N.Orlando Avenue,Stc. 200
Maitland,Florida 32751
Main:(407)647-1616
fall Toll Free:(800)474-5686
Fax:(407)628-1635
April 19,2021
RE: Florida Keys Marathon International Airport
Security Site Lighting Rehabilitation
Flood Insurance Availability
To Whom It May Concern:
With regards to the above referenced project,we can provide coverage for the full limit on an
Installation Floater policy. This policy would include the perils of wind and hail. The policy does not
cover flood. Typically,we would utilize the National Flood Insurance Program (NFIP)to effect coverage,
but because this project is not a "building"the NFIP and other related carriers cannot offer Flood
Coverage.
If you have any questions, please feel free to contact me.
Sincerely,
Matthew Nilles
Regional Vice President
386-871-0252
Insurance/ Bonds/Risk Management
www.brnbinc.com
DATE(MM/DD/YYYY)
A�" CERTIFICATE OF PROPERTY INSURANCE
4/23/2021
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.
PRODUCER CONTACT
NAME: Michelle Rushing
Bowen, Miclette& Britt of FL PHONE 407-647-1616 FAX 407-628-1635
1020 N. Orlando Avenue A/C No EXt: vc,No
Suite#200 ADDE-MRESS: mrushing@bmbinc.com
Maitland FL 32751 PRODUCER PEDROFALCO
CUSTOMER ID:
INSURER(S)AFFORDING COVERAGE NAIC#
INSURED INSURERA: Amerisure Mutual Insurance Company 23396
Pedro Falcon Electrical Contractors Inc
31160 Avenue C INSURERB:
Big Pine Key FL 33043-4516 INSURER C7
INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 1345709520 REVISION NUMBER:
LOCATION OF PREMISES/DESCRIPTION OF PROPERTY (Attach ACORD 101,Additional Remarks Schedule,if more space is required)
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 NUMBER POLICY EFFECTIVE POLICY EXPIRATION COVERED PROPERTY LIMITS
LTR DATE(MM/DD/YYYY) DATE(MM/DD/YYYY)
PROPERTY BUILDING $
CAUSES OF LOSS DEDUCTIBLES Approved Risk Managem nt PERSONAL PROPERTY $
BASIC BUILDING BUSINESS INCOME
BROAD CONTENTS EXTRA EXPENSE $
SPECIAL 4-23-2021 RENTAL VALUE $
EARTHQUAKE BLANKET BUILDING $
WIND BLANKET PERS PROP $
FLOOD BLANKET BLDG&PP $
INLAND MARINE TYPE OF POLICY $
CAUSES OF LOSS $
NAMED PERILS POLICY NUMBER $
CRIME
TYPE OF POLICY $
BOILER&MACHINERY/ $
EQUIPMENT BREAKDOWN
A Installation Floater IM209294406 11/2/2020 11/2/2021 X Job Site Limit $575,000
SPECIAL CONDITIONS/OTHER COVERAGES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
Monroe County Board of County Commissioners is included as Additional Insured&Loss Payee with respect to the property described herein.
CERTIFICATE HOLDER 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.
Monroe County Board of County Commissioners
1100 Simonton Street Suite 2-213 AUTHORIZED REPRESENTATIVE
Key West FL 33040
@ 1995-2015 ACORD CORPORATION. All rights reserved.
ACORD 24(2016103) The ACORD name and logo are registered marks of ACORD
POLICY NUMBER: COMMERCIAL INLAND MARINE
THIS ENDORSEMENT AMENDS YOUR POLICY. PLEASE READ THIS CAREFULLY.
All Other~lenns~and Conditions Remain Unchanged.
INSTALLATION FLOATER --," SPECIFICALLY DESIGNATED ADDITIONAL
NAMED INSUREDS COVERAGE ENDORSEMENT Named |na«nad
Pedro Falcon Electrical Contractors Inc.
Effective Date 11/2/3021
The coverage afforded through this endorsement|oeffective on the date stated above oi12:O1 A.M. Standard Time, unless
othmmvioeamendedbyendomememtettanhedhothepo|icy. Thisendormmmentiasubjeottnthm ''hernma''. onndiUomaand
exc|uaionsofthe "|nntm||oUonF|nobar'CovaragaFnrmandiaapmrtofthaCovqnagaFonmtovvhirhitioattmched.
This endorsement modifies the following forms:
INSTALLATION FLOATER COVERAGE FORM
The following specifically named individuals or entities are designated as additional named insureds under this coverage
form. If specific jobsites are listed in the Jobsite column next to their name(s), then the designee is only considered an
additional named insured specifically for those jobsites. If no jobsites are listed in the Specific Jobsites column, then the
designee is considered an additional named insured for all jobsites covered under this coverage form.
Designated
Monroe County Board of County Commissioners
11O0SimontonSt.
Key West, FL33O4O
ProjanbLooaUon: F|orida Keys Marathon International Airport
Security Site Lighting Rehabilitation Project
Q4OO Overseas Highway, Marathon, FL3305O
|K0QQ231O15
2018 Edition
MONROE COUNTY,FLORIDA
REQUEST FOR WAIVER OF INSURANCE REQUIREMENTS
It is requested that the insurance requirements,as specified in the County's Schedule of Insurance
Requirements,be waived or modified on the following contract.
ContmctorNendor: Pedro Falcon Contractors, Inc.
Project or Service: Marathon Airport Site Lighting Rehabilitation
ConttactorNendor
Address&Phone#: 31160 Ave C
Big Pine Key, FL 33043
General Scope of Work: Security Sight Lighting Rehabilitation
Reason for Waiver or Flood Insurance not obtainable, see attached
Modification: letter from insurance agent. Providing
Installation Floater coverage for full price
of- contract.
Policies Waiver or
Modification will apply to: Builders Risk Insurance
— u _
Signature of ContractorNendor. ° m ,... I] } �� 'r c i
,
Date: 4-27-2021 Approved
-7�,� x Not Approved
Risk Management Signature:_ `/'/�
Date:
County Administrator appeal:
Approved: Not Approvcd:
Date:
Board of County Commissioners appeal:
Approved: Not Approved:
Meeting Date: ... w.._
Administrative Instruction 7500.7
104
MICLETTE
BOWEN,MICLETTE&BRITT
OF FLORIDA,LLC
1020 N.Orlando Avenue,Stc. 200
Maitland,Florida 32751
Main:(407)647-1616
fall Toll Free:(800)474-5686
Fax:(407)628-1635
April 19,2021
RE: Florida Keys Marathon International Airport
Security Site Lighting Rehabilitation
Flood Insurance Availability
To Whom It May Concern:
With regards to the above referenced project,we can provide coverage for the full limit on an
Installation Floater policy. This policy would include the perils of wind and hail. The policy does not
cover flood. Typically,we would utilize the National Flood Insurance Program (NFIP)to effect coverage,
but because this project is not a "building"the NFIP and other related carriers cannot offer Flood
Coverage.
If you have any questions, please feel free to contact me.
Sincerely,
Matthew Nilles
Regional Vice President
386-871-0252
Insurance/ Bonds/Risk Management
www.brnbinc.com