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Cujoe Key Transfer Station Communications Duct Bank 04/22/2022 04.22.2022 Type text here Client#: 126333KEYIRONW DATE (MM/DD/YYYY) ACORD TM CERTIFICATE OF LIABILITY INSURANCE 07/07/2021 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 any rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER NAME: FAX PHONE USI Insurance Services LLC 855 874-0777 (A/C, No, Ext):(A/C, No): E-MAIL 2502 N Rocky Point Dr. Suite 400 ADDRESS: Tampa, FL 33607 INSURER(S) AFFORDING COVERAGENAIC # 855 874-1270 National Casualty Company 11991 INSURER A : INSURED Signal Mutual Indemnity Assn., Ltd.A56517 INSURER B : Key Iron Works Inc INSURER C : 5551 2nd Avenue INSURER D : Stock Island INSURER E : Key West, FL 33040 INSURER F : COVERAGESCERTIFICATE 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. INSRADDLSUBRPOLICY EFFPOLICY EXP TYPE OF INSURANCELIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSRWVD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE$ DAMAGE TO RENTED $ CLAIMS-MADEOCCURPREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY$ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE$ PRO- PRODUCTS - COMP/OP AGG$ POLICYJECTLOC $ OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY (Ea accident)$ BODILY INJURY (Per person)$ ANY AUTO OWNEDSCHEDULED BODILY INJURY (Per accident)$ AUTOS ONLY AUTOS HIREDNON-OWNED PROPERTY DAMAGE $ AUTOS ONLY (Per accident) AUTOS ONLY $ UMBRELLA LIAB EACH OCCURRENCE$ OCCUR EXCESS LIAB CLAIMS-MADEAGGREGATE$ $ DEDRETENTION$ PEROTH- WORKERS COMPENSATION AWCSIG3503630207/07/202107/07/2022X STATUTEER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$1,000,000 N / A OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$1,000,000 If yes, describe under 1,000,000 E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below BUSL&HN57126007/07/202107/07/2022 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) This Certificate of Insurance is issued as a matter of information only and confers no rights upon the holder and does not amend, extend or alter the coverage afforded by policies designated on the Certificate. CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of County Commissioners THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ATTN: Engineering Dept. 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West, FL 33040-0000 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD 1of 11of 1 #S32695058/M32695012#S32695058/M32695012MYLEW Y