Certificates of Insurance DATE(MM/DD/YYYY)
ACTOR" CERTIFICATE OF LIABILITY INSURANCE 3/28/2024
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: Certificate Department
She Insurance Group, Inc. PHONE FAX
1021 Douglas Avenue A/C No Ext: 407-869-5490 A/c,No):407-389-3580
E-MAltamonte Springs FL 32714 ADDRESS: Certificates@sihle.com
INSURER(S)AFFORDING COVERAGE NAIC#
INSURERA:Zenith Insurance Company 13269
INSURED FISHDOM-01 INSURER B: Main Street America Protection Insurance 13026
Fishback Dominick LLP INSURERC: Old Dominion Insurance Company 40231
1947 Lee Road
Winter Park FL 32789 INSURERD:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:825256565 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 MM/DD MM/DD
B X COMMERCIAL GENERAL LIABILITY Y BPG2795Z 4/1/2024 4/1/2025 EACH OCCURRENCE $1,000,000
CLAIMS-MADE OCCUR DAMAGE TO RENTED
PREMISES Ea occurrence $500,000
MED EXP(Any one person) $10,000
PERSONAL&ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
POLICY❑ PRO ❑
JECT LOC PRODUCTS-COMP/OP AGG $2,000,000
X
OTHER: $
B AUTOMOBILE LIABILITY BPG2795Z 4/1/2024 4/1/2025 COMBINED SINGLE LIMIT $1,000,000
Ea accident
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 UMBRELLALIAB X OCCUR CUG2795Z 4/1/2024 4/1/2025 EACH OCCURRENCE $5,000,000
EXCESS LAB CLAIMS-MADE AGGREGATE $5,000,000
DED X RETENTION$1 n nnn Pers/Adv Injury $5,000,000
A WORKERS COMPENSATION Z830138836 1/3/2024 1/3/2025 X PER OTH-
AND EMPLOYERS'LIABILITY Y/N STATUTE ER
ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000
OFFICE R/M EMBER EXCLUDED? ❑ N/A
(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
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
Monroe County included as Additional Insured with respect to General Liability when required by contract or agreement.
i T
4.1.24
CERTIFICATE HOLDER CANCELLATION WAS
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
1111 12th St Ste 408 AUTHORIZED REPRESENTATIVE
Key West FL 33040
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
DATE(MM/DD/YYYY)
ACCOR" CERTIFICATE OF LIABILITY INSURANCE 3/22/2023
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: Certificate Department
She Insurance Group, Inc. PHONE FAX
1021 Douglas Avenue A/C No Ext: 407-869-5490 A/c,No):407-389-3580
E-MAltamonte Springs FL 32714 ADDRESS: Certificates@sihle.com
INSURER(S)AFFORDING COVERAGE NAIC#
INSURERA:The Continental Casualty Insurance Company 35289
INSURED FISHDOM-01 INSURERB:Zenith Insurance Company 13269
Fishback Dominick LLP
1947 Lee Road INsuRERc: Continental Casualty Company 20443
Winter Park FL 32789 INSURERD:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:1174769190 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 MM/DD MM/DD
C X COMMERCIAL GENERAL LIABILITY Y B6045299435 4/1/2023 4/1/2024 EACH OCCURRENCE $1,000,000
CLAIMS-MADE OCCUR DAMAGE TO RENTED
PREMISES Ea occurrence $1,000,000
MED EXP(Any one person) $10,000
PERSONAL&ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
POLICY❑ PRO ❑
JECT LOC PRODUCTS-COMP/OP AGG $2,000,000
X
OTHER: $
C AUTOMOBILE LIABILITY B6045299435 4/1/2023 4/1/2024 COMBINED SINGLE LIMIT $1,000,000
Ea accident
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
A X UMBRELLALIAB X OCCUR B6045299483 4/1/2023 4/1/2024 EACH OCCURRENCE $5,000,000
EXCESS LAB CLAIMS-MADE AGGREGATE $5,000,000
DED X RETENTION$1 n nnn $
B WORKERS COMPENSATION Z830137735 1/3/2023 1/3/2024 X PER OTH-
AND EMPLOYERS'LIABILITY Y/N STATUTE ER
ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000
OFFICE R/M EMBER EXCLUDED? ❑ N/A
(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
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
Monroe County included as Additional Insured with respect to General Liability when required by contract or agreement.
APPROVED BY RISK MANAGEMENT
r
DATE U'2312023
WAIVER NIA YES
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
1111 12th St Ste 408 AUTHORIZED REPRESENTATIVE
Key West FL 33040
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
AC40 R" CERTIFICATE OF LIABILITY INSURANCE DATE"
03/20/220/2023
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).
PRODUCER CONTACT
NAME:
Professional Risk Specialty Group (PRSG) HONNo Ext 954-453-6295 AC,
A No:
E-MAIL
655 N Franklin St., Suite 2000 ADDRESS:
Tampa, FL 33602 INSURER(S)AFFORDING COVERAGE NAIC#
INSURER A: Swiss Re Corporate Solutions American Ir 29874
INSURED INSURER B:
Fishback Dominick LLP INSURERC:
1947 Lee Road INSURER..D:
Winter Park, FL 32789-1834
INSURER E:
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 POLICY NUMBER MMIDD YWY MM/DD/YYYY
COMMERCIAL GENERAL LIABILITY WLA308011495206 04/01/2023 04/01/2024 EACH OCCURRENCE $7,000,000
X CLAIMS MADE a OCCUR RETRO: FPA DAMAGE TU RENILD
PRFMISFS Fa orcurrenc;e $
A X LAWYERS PROF LIAR MFD FXP(Any one person) $
PERSONAL&ADV INJURY $
GFN'1...AGGREGATE I...IMITAPPI IFS PFR: GFNFRAI...AGGREGATE $7,000,000
POLICY u PRO-JL'Cf u LOC PRODUC I S COMP/OP AGO $H ..
OTHER: $
AUTOMOBILE LIABILITY COMI`.31NFD SINGI...F I...IMI I $
Fa accident
ANY AUTO BODILY INJURY(Per person) $
ALL OOSWNED SCIIEDULED BODII...Y INJURY(Per accident) $
AUT AUTOS
NON OWNED PROPERIYDAMAGE........ $..
HIRED AUTOS Al1TOS Per arcidenl
UMBRELLA LIAR OCCUR EACH OCCURRENCE $
EXCESS LIAB CI AIMS-MADE AGGRFGATE $
DFD I I RETENTION $ $
WORKERS COMPENSATION PLR 01 H-
AND EMPLOYERS'LIABILITY Y/N SIATUI E .....LR
ANY PROPRII IOR/PARR NER/FXF...... E ❑ F.I.FACT I ACCIDFNT $
OFI ICFR/MI MBFR FXCI UDLDY N/A
(Mandatory in NH) E.L.DISEASE EA EMPLOYEE $
If yes,describe under
DESCRIPTION OI 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)
Lawyers Professi..onea.l.. Liability
Deductible: $25,000 Per Claim
APPROVED BY RISK MANAGEMENT
Y
DATE 3/20/2023
WAIVER N/A YES
CERTIFICATE HOLDER CANCELLATION
Monroe County Board of County Commissioners
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
1111 12th Street, Suite 408 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Key West, FL 33040 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
fV
0198 014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
DS#2873949