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Certificates of Insurance
DATE(MM/DD/YYYY) ACoR" CERTIFICATE OF LIABILITY INSURANCE F5J14/2021 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: Illana Abbate Marsh &McLennan Agency LLC PHONE FAX 9850 N.W.41 st Street A/C No Ext: A/C No), Suite 100 ADDRESS: certsmiami@mma-fl.com Miami FL 33178 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Travelers Indemnity Co of America 25666 INSURED CHARLTOPPI INSURER B: Phoenix Insurance Company 25623 Charley oante Products Inc.no&Sons Inc. C Monroe Concrete INSURER C:Travelers Property Casualty Co of Amer 36161 P.O BOX 787 INSURER D:Travelers Indemnity Company 25658 Key West FL 33041 INSURER E: Evanston Insurance Company 35378 INSURER F: COVERAGES CERTIFICATE NUMBER:636797687 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 POLICYNUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY DTC03202M181TIA21 5/19/2021 5/19/2022 EACH OCCURRENCE $2,000,000 Am CLAIMS-MADE � OCCUR SES�a occurrDence $300,000 Approved Risk Management PRIM MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: _'�6-ZOZ GENERAL AGGREGATE $4,000,000 X POLICY PE LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ D AUTOMOBILE LIABILITY 81004284482126E 5/19/2021 5/19/2022 COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident C X UMBRELLA LIAB X OCCUR CUP3J6572212126 5/19/2021 5/19/2022 EACH OCCURRENCE $10,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000 DED X RETENTION$1 n nnn $ B WORKERS COMPENSATION UB4K5263662126G 5/19/2021 5/19/2022 X PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 E POLLUTION LIABILITY MMAENVO02248 2/2/2021 2/2/2023 Limit 5,000,000 Retention 25,000 Policy Aggregate 5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) General Liability Aggregate applies per Project if required by written contract. Monroe County Board of County Commissioners,its employees and officials,as Designated Organization, is an Additional Insured as respects General&Auto Liability. Umbrella follows form to the underlying policies as respects to Additional Insureds.All of the above is applicable when required by written contract subject to the terms,conditions and exclusions of the policy. 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(BOCC) 500 Whitehead St 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