Loading...
Certificates of Insurance CERTIFICATE OF COVERAGE ISSUED ON: 12/22/2021 COVERAGE PROVIDED BY:PREFERRED GOVERNMENTAL INSURANCE TRUST PACKAGE AGREEMENT NUMBER: WC FL5 0444002 21-02 COVERAGE PERIOD: 10/01/2021 TO 10/01/2022 12:01 AM COVERAGES:This is to certify that the agreement below has been issued to the designated member for the coverage 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 coverage afforded by the agreement described herein subject to all the terms,exclusions and conditions of such agreement. Mail to:Certificate Holder Designated Member Monroe County BOCC Key West Housing Authority 1100 Simonton Street 1400 Kennedy Drive Key West,Florida 33040 Key West,FL 33040 LIABILITY COVERAGE WORKERS'COMPENSATION COVERAGE Comprehensive General Liability,Bodily Injury,Property Damage WC AGREEMENT NUMBER: WC FL5 0444002 21-02 and Personal Injury: Limit Deductible Self Insured Workers'Compensation Employee Benefits Liability Limit Deductible Employment Practices Liability X Statutory Workers'Compensation Limit APPROVED BY RISK MANAGEMENT Deductible Public Officials Liability gY X Employers Liability Limit Deductible �1,000,000 Each Accident DATE 01/06/2022 $1,000,000 By Disease Law Enforcement Liability WAIVER NIA X YES S 1,000,000 Aggregate Disease Limit — — Deductible PROPERTY COVERAGE AUTOMOBILE COVERAGE Buildings&Personal Property Automobile Liability Limit:Per schedule on file with Trust Deductible Limit Deductible Note:See coverage agreementfor wind,food,and other deductibles. All Owned Rented,Borrowed and Leased Equipment Specifically Described Autos Limit:S 0 TIV See Schedule for Deductible Hired Autos Total All other Inland Marine Non-Owned Autos Limit:S 0 TIV See Schedule for Deductible Automobile Physical Damage CRIME COVERAGE Comprehensive See Schedule for Deductible Employee Dishonesty Collision See Schedule for Deductible Limit Deductible Hired Auto with limit of Forgery or Alteration Limit Deductible Garage Keepers Theft Disappearance&Destruction Liability Limit Limit Deductible Liability Deductible Computer Fraud Comprehensive Deductible Limit Deductible Collision Deductible NOTE:Additional Covered Party status is excluded for non-governmental entities. The most we will pay is further limited by the limitations set forth in Section 768.28(5),Florida Statutes(2010)or the equivalent limitations of successor law which are applicable at the time of loss. Description of Operations/Locations/Vehicles/Special items-(This section completed by member's agent,who bears complete responsibility and liability for its accuracy): This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend,extend or alter the coverage afforded by the agreement above. Administrator CANCELLATIONS Public Risk Underwriters@ SHOUTED ANY OF THE ABOVE DESCRIBED AGREEMENT BE CANCELLED BEFORE THE P.O.BOX 958455 EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE Lake Mary,FL 32795-8455 COVERAGE AGREEMENT PROVISIONS. Producer The Gehring Group -- 3500 Kyoto Garden Dr, Palm Beach Gardens,FL 33410 AUTHORIZED REPRESENTATIVE PGIT-CERT(I/19)PRINT FORM 12/22/2021 Print Date:12/22/2021 1111 0 DATE(MMIDDIYYYY) A - CERTIFICATE OF LIABILITY INSURANCE 12/22/2022 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 Stephen Blake NAME: p Hunt Insurance Group, LLC A/CNNo Ext: 850-385-3636 IC No: 2075 Centre Pointe Blvd Suite 101 E-MAIL ADDRESS: stephen.blake@huntins.com Tallahassee, FL32308 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: FPHASIF INSURED INSURER B: Key West Housing Authority INSURERC: 1400 Kennedy Drive INSURER D 7 Key West, FL 33040 INSURERE: 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 MMIDD/YYYY MMIDD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 TE CLAIMS-MADE � OCCUR PREM SES DAMAG ToEa occurrDence $ 50,000 MED EXP(Any one person) $ 5,000 A X 1827335 05/01/2021 05/01/2022 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑ PRO 2,000,000 JECT X LOC APPROVED BY RISK MANAGEMENT PRODUCTS-COMP/OP AGG $ OTHER: R- $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1 000000 DATE01/06/2022 Ea accident X ANY AUTO WAIVER NfAX YES_ BODILY INJURY(Per person) $ A OWNED SCHEDULED AUTOS ONLY AUTOS 1827335 05/01/2021 05/01/2022 BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ E OFFICER/MMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Public Officials Liability 1827335 05/01/2021 05/01/2022 $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County Board of County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street Key West, FL 33040 AUTHORIZED REPRESENTATIVE Stephen Blake°9aEl°"=EP9°e;kEE° ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Dal 1 n Gracey The Healthcare Froviders`lnsurance Specialists Delray Beach • Jacksonville • Miami • Orlando • Pensacola Date CERTIFICATE OF INSURANCE 11/10/2021 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 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). ISSUING AGENT INSURED Danna-Gracey, Inc. Housing Authority of the City of Key West, FL 255 NE Sixth Avenue dba Poinciana Gardens Delray Beach, FL 33483 1664 Dunlap Drive Tel. 561.276.3553 Fax 888.235.8008 Key West, FL 33040 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. CARRIER POLICY NUMBER POLICY EFF DATE POLICY EXP DATE RETRO DATE Starstone Specialty Insurance 72990D210AHL 2/25/2021 2/25/2022 2/1/2019 ❑ PROFESSIONAL LIABILITY I ❑ CLAIMS-MADE ❑ OCCURRENCE GENERAL AGGREGATE LIMIT APPLIES PER: ❑ POLICY ❑ PROJECT ❑ LOCATION EACH OCCURRENCE AGGREGATE DEDUCTIBLE ® GENERAL LIABILITY ❑ CLAIMS-MADE E30CCURRENCE EACH OCCURRENCE DAMAGE TO RENTED PREMESIS MED EXP (Any one person) (Ea occurrence-Fire Only) $1,000,000 $100 000 $5,000 PERSONAL&ADV INJURY GENERAL AGGREGATE PRODUCTS—COMP/OP AGG $1,000,000 $3,000,000 $1,000,000 DEDUCTIBLE $50,000 ❑ WORKERS COMPENSATION ANY PROP IETORY/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ YES ❑NO ❑WC STATUTORY LIMITS E.L. EACH ACCIDENT E.L. DISEASE—EA EMPLOYEE E.L. DISEASE—POLICY LIMIT ❑ OTHER $ $ $ DESCRIPTION OF OPERATIONS/LOCATIONS BY °`)"" m Monroe County additional insured for G/L DATE01/06/2022 1100 Simonton Street Key West, FL 33040 WAIVER N/AX YES_ CERTIFICATE HOLDER AUTHORIZED REPRESENTANTIVE Monroe County Board of County Commissioners William Gompers -#A099757 Danna-Gracey • 255 NE Sixth Avenue • Delray Beach, FL 33483 Tel. 800.966.2120 • Fax 888.235.5008 • www.dannagracey.com