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Certificates of Insurance
DATE(MMIDD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 09/21/2022 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 Vicky Van Wormer NAME: Brown&Brown of Florida,Inc. a/cNr o Ext: (727)461-6044 a/c,No): (727)442-7695 83 Park Place Blvd,Suite 101 E-MAIL Vick .VanWormer bbrown.com ADDRESS: y INSURER(S)AFFORDING COVERAGE NAIC# Clearwater FL 33759 INSURERA: The Charter Oak Fire Insurance Company 25615 INSURED INSURER B: The Travelers Indemnity Company of America 25666 Kisinger Campo&Associates,Corp. INSURER C: Travelers Casualty and Surety Company 19038 201 N Franklin St,Suite 400 INSURER D: Admiral Insurance Company 24856 INSURER E: Tampa FL 33602 INSURER F: COVERAGES CERTIFICATE NUMBER: 22-23 Master 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FX OCCUR PREM SDAMAGES Ea oNcurDreme $ 300,000 MED EXP(Any one person) $ 10,000 A Y P-630-8254A604 10/01/2022 10/01/2023 PERSONAL&ADV INJURY $ 1,000,000 MOTHER LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,000 JECT: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANYAUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED Y 810-5N338364 10/01/2022 10/01/2023 BODI LY I NJ U RY(Pe r accide nt) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Uninsured motorist $ 1,000,000 UMBRELLA LIAB "`M "'y,_ OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION X1 STATUTE EORH AND EMPLOYERS'LIABI LI TY Y/N SOO,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ C OFFICER/MEMBER EXCLUDED? N/A UB-7J070308 10/03/2022 10/03/2023 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Professional Liability-Architects& Per claim 1,000,000 D Engineers E0000027205-09 10/01/2022 10/01/2023 Aggregate 1,000,000 Deductible 250,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) [Job#:KCA Contract#1202209.00 Job Type:On Call Prof Engineering Srvcs-Monroe County] The Certificate Holder,Monroe County,is an Additional Insured on a primary non-contributory basis including ongoing and completed operations with respect to General Liability if required by written contract and with respect to Auto Liability as per the Auto coverage form. A Waiver of Subrogation in favor of the Certificate Holder applies to General Liability,Auto Liability and Workers Compensation if required by written contract. Certificate Holder will be given 60 day notification of cancellation,expect 10 days for non-payment of premium. Ir 'a CERTIFICATE HOLDER CANCELLATION DA SHOULD ANY OF THE N WA THE EXPIRATION DA' 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