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Certificates of Insurance ACOR" CERTIFICATE OF LIABILITY INSURANCE F DATE(MM/DD/YYYY) 08/24/2021 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 Jeff Searcy United Atlantic Insurance Group ACNE. Ext: (305)748-2134 a/c No): (305)768-0250 3426 Duck Avenue E-MAIL-ADDRESS: -MAIL e uai ADDRESS: jeff@uaigkw.com C g INSURER(S)AFFORDING COVERAGE NAIC# Key West FL 33040 INSURERA: CENTURY SURETY CO 36951 INSURED INSURER B On the Hook Marine Services, Chris Webster, Pump Out INSURER 7 930 Truman Ave#75 INSURER D: INSURER E: key west FL 33040 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 EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MWDD/YYYY MWDD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000/waterci DAMAGE TO CLAIMS-MADE � OCCUR PREMISES (E.occurrDence) $ MED EXP(Any one person) $ A X ARG4512789 09/04/2021 09/04/2022 PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY jECT � LOC PRODUCTS-COMP/OP AGG $ X OTHER: "P Pollution Liabilty $ $1,000,000 AUTOMOBILE LIABILITY A I COMBINED SINGLE LIMIT $ SK Ea accident ANY AUTO By OWNED SCHEDULED -"- BODILY INJURY(Per person) $BODILY INJURY(Per accident) $ """�"' AUTOS ONLY AUTOS . 2 5 . 2 O 21 HIRED NON-OWNED ��" - PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident WOW -G—`" $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- 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) VESSELS: PER SCHEDULE,TOTAL SCHEDULE VALUE: $17,796.00 VESSEL DEDUCTIBLE: $1,000.00 PROTECTION AND INDEMNITY/WATERCRAFT LIABILITY: LIMIT:$1,000,000.00 CSL POLLUTION LIABILITY: LIMIT:$1,000,000 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. 1100 SIMONTON STREET AUTHORIZED REPRESENTATIVE KEY WEST FL 33040 ° ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC#: AC"J?o ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED United Atlantic Insurance Group On the Hook Marine Services, Chris Webster, Pump Out POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance DEDUCTIBLE: $2,500.00 EXCEPT$5,000 WRECK REMOVAL ACORD 101 (2008/01) ©2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD Dlgimlty signed by Jatlyn Flatt Jaclyn Flatt pate,'..'..'op.fl6g­-us" 08125/2021 00 Policy number: 026066081 Underwritten by: 41-Progressive Express Insurance Co. Certificate of Insurance Certificate Holder Insured Agent Additional Insured Monroe County and its board of county ON THE HOOK MARINE USAA INS AGCY INC commissioners SERVICES LLC 9800 FRDRCKSBRG HSVCW 1100 Simonton S 930 TRUMAN AVE#75 SAN ANTONIO TX78288 Key West, Florida 33040 KEY WEST FL 33040 (800)531-8722 This document certifies that insurance policies identified below have been issued by the designated insurer to the insured named above for the period(s)indicated.This certificate is issued for information purposes only. It confers no rights upon the certificate holder and does not change,alter,modify,or extend the coverages afforded by the policies listed below.The coverages afforded by the policies listed below are subject to all the terms,exclusions,limitations,endorsements,and conditions of these policies. Policy Effective Date: Policy Expiration Date: 09/17/2021 09/17/2022 Insurance covera®®(s) Ltrnits Bodily Injury Property Damage LiabilitylResidual Bodily Injury 300 Combined Single Limit Liability coverage UninsuredlUnderinsured Motorist Bodily Injury coverage 300 Combined Single Limit,Non-stacked Personal Injury Protection coverage $10,000 wl work comp-Named insured and relative Comprehensive coverage $1,000 Deductible Collision coverage $1,000 Deductible Description of Location/VehicleslSpecial Items Scheduled autos only 2004 Nissan Titan 1 N6AAO7B74N540184 Bodily Injury Property Damage Liability/Residual Bodily Injury Liability coverage 300 Combined Single Limit/ UninsuredfUnderinsured Motorist Bodily Injury coverage 300 Combined Single Limit,Non-stacked/Personal Injury Protection coverage$10,000 w/work comp-Named insured and relative/ Comprehensive coverage$1,000 Deductible/Collision coverage $1,000 Deductible 2004 Boat Trailer Bodily Injury Property Damage Liability/Residual Bodily Injury Liability coverage 300 Combined Single Limit/Personal Injury Protection coverage$10,000 wt work comp-Named insured and relative Certificate number 23721 MTGO81 Please be advised that additional insureds and loss payees will be notified in the event of a mid-term cancellation. ... ,.: Form 5241(10102)