Certificate of Insurance DATE(MM/DD/YYYY)
ACCOR" CERTIFICATE OF LIABILITY INSURANCE 3/18/2022
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 j NAME: ennlfer Alf
AWA Insurance Agency PHONE FAX
13700 Six Mile Cypress Pkwy A/C No Ext: 239-418-1100 vc,No):239-418-1164
E-MSuite# 1 ADDRESS: Jennifer@awainsurance.com
Ft.Myers FL 33912 INSURER(S)AFFORDING COVERAGE NAIC#
INSURERA:Allied World Insurance Company 22730
INSURED EARTTEC-01 INSURER B:Travelers Property Casualty Company of America 25674
Earth Tech Enterprises Inc INSURERC:Allied World Specialty Insurance Company 16624
6180 Federal Ct
Fort Myers FL 33905 INSURERD:Allied World National Assurance Company 10690
INSURER E: Bridgefield Casualty Insurance 10335
INSURERF: Markel American Ins Co 9933
COVERAGES CERTIFICATE NUMBER:770191039 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
A X COMMERCIAL GENERAL LIABILITY Y Y 60040954 10/1/2021 10/1/2022 EACH OCCURRENCE $1,000,000
B ZOH-71N44196-21-ND 10/1/2021 10/1/2022
DAMAGE TO S( RENTED
CLAIMS-MADE OCCUR
PREMISES Ea occurrence) $100,000
X APPROVED BY RISK MANAGEMENT HULL&P&I MED EXP(Any one person) $15,000
X Maritime BY,-.. ;'= ' -^^-" 7 •' '''"" PERSONAL&ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: DATE 412.I��Qz.G GENERALAGGREGATE $2,000,000
POLICY� PE� LOC WAVER.MA_YES— PRODUCTS-COMP/OP AGG $2,000,000
OTHER: $
C AUTOMOBILE LIABILITY Y Y 60001235 10/1/2021 10/1/2022 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
PIP BASIC $10,000
D X UMBRELLALIAB X OCCUR 03130864 10/1/2021 10/1/2022 EACH OCCURRENCE $5,000,000
B ZOX-41N43760-21-ND 10/1/2021 10/1/2022
EXCESS LAB CLAIMS-MADE AGGREGATE $5,000,000
DED RETENTION$ XS over HULL&P&I $5,000,000
E WORKERS COMPENSATION Y 0196-53784 10/1/2021 10/1/2022 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? FN] 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
F Inland Marine MKLM2IM0000380 10/1/2021 10/1/2022 Rented/Leased 800,000
E United States Longshoreman's and 0196-53784 10/1/2021 10/1/2022 Per Occurrence 1,000,000
Per Occurrence 1,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
Pollution coverage-2,000,000 Aggregate Evanston Insurance Co.
Project:West Martello Seawall Hurricane Repairs between Monroe County FL Where required by written contract,the Monroe county bocc its employees and
officials are included as additions Insureds on a primary and noncontributory basis with respects to the General Liability,Automobile Liability and work comp
policies all include waiver of subrogation where required by written contract and allowed by law,. Umbrella follows form.30 Day notice of cancellation applies
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 BOCC
1100 Simonton St The Gato Building, #2-205 AUTHORIZED REPRESENTATIVE
Key West FL 33040
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