Certificate of Insurance DATE(MM/DD/YYYY)
ACCOR" CERTIFICATE OF LIABILITY INSURANCE 5/12/2022
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
NAME: Illana Abbate
Marsh &McLennan Agency LLC PHONE FAX
9850 N.W. 41 st Street A/c No EXt: A/C,No):
E-MSuite 100 ADDRESS: FLCertificates@MarshMMA.com
Miami FL 33178 INSURER(S)AFFORDING COVERAGE NAIC#
INSURERA:Travelers Indemnity Co of America 25666
INSURED CHARLTOPPI INSURERB: Phoenix Insurance Company 25623
Charley Toppino &Sons Inc. INSURERC:Travelers Property Casualty Co of Amer 36161
Monroe Concrete Products Inc.
P.O BOX 787 INSURERD:Travelers Indemnity Company 25658
Key West FL 33041 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER:1507593346 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 DTC03202M181TIA22 5/19/2022 5/19/2023 EACH OCCURRENCE $2,000,000
CLAIMS-MADE OCCUR DAMAGE TO RENTED
PREMISES Ea occurrence $300,000
MED EXP(Any one person) $10,000
PERSONAL&ADV INJURY $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000
X POLICY� PE� LOC PRODUCTS-COMP/OP AGG $2,000,000
OTHER: $
D AUTOMOBILE LIABILITY Y 81004284482226G 5/19/2022 5/19/2023 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
C X UMBRELLA LIAB X OCCUR CUP3J6572212226 5/19/2022 5/19/2023 EACH OCCURRENCE $10,000,000
EXCESS LAB CLAIMS-MADE AGGREGATE $10,000,000
DED X RETENTION$1 n nnn $
B WORKERS COMPENSATION UB4K5263662226G 5/19/2022 5/19/2023 X PER OTH-
AND EMPLOYERS'LIABILITY Y/N STATUTEI 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
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
General Liability Aggregate applies per Project if required by written contract.
RE: Koehn Drainage and Roadway Improvement Project
Monroe County Board of County Commissioners and Florida Department of Transportation,their employees and officials,as Designated Organizations,are
Additional Insureds in respects to the General&Auto Liability. Umbrella follows form to the underlying policies as respects to Additional Insureds.All of the
above is applicable when required by written contract subject to the terms,conditions and exclusions of the policy.
CERTIFICATE HOLDER CANCELLATION "
SHOULD ANY OF THE
THE EXPIRATION I '
ACCORDANCE WITH �1�+P
Monroe County Board of County Commissioners (BOCC)
1100 Simonton Street AUTHORIZED REPRESENTATIVE
Key West FL 33040
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