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Certificate of Insurance F-DATE A�® CERTIFICATE OF LIABILITY INSURANCE 06/09/2022YYYY) 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: BIBERK PHONE 844-472-0967 FAX 203-654-3613 P.O. Box 113247 A/C No Ext: A/C NO): E-MAIL customerservice@biBERK.com Stamford, CT 06911 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER ABerkshire Hathaway Direct Insurance Company 10391INSURED INSURERB: Wellfleet Insurance Company 32280 Rockport Analytics INSURER C: 1610 Herron Ln INSURER D 7 West Chester, PA 19380-6432 INSURER E7 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 LTR POLICY NUMBER MM DD YYYY MM DD YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 DAMAG ToCLAIMS-MADE C OCCUR PREM SES Ea occED.nce $ 50,000 A X Hired&Non-Owned Auto X N9BP269912 08/13/2021 08/13/202 MMED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ Excluded GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY❑ PRO ❑ LOC I PRODUCTS-COMP/OPAGG $ 4,000,000 JECT & X OTHER: �tl ""'=„=.' $ AUTOMOBILE LIABILITY W ,„„. �. -. tl """ "'"""' COMBINED SINGLE LIMIT $ Ea accident ANY AUTO ww. , 8 2022 _.,._,,,�, BODILY INJURY(Per person) $ OWNED SCHEDULED '"' AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED t - ----- PROP ERTYDAMAGE AUTOS ONLY AUTOS ONLY Per accident $ L $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB L: CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER B ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? NIA N9WC637347 06/09/2022 06/09/2023 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Professional Liability (Errors & X N9PL236347 08/01/2022 08/01/2023 Per Occurrence/ $ 100,000/ Omissions): Claims-Made Aggregate $ 100,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Monroe County Board of County Commissioners is listed as additional insured as it pertains to general liability(see endorsement attached) Hired And Non-Owned Auto is included in the general liability policy limits(see endorsement attached) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street Key West FL 33040 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 1996 Edition MONROE COUNTY, FLORIDA Request For Waiver of Insurance Requirements It is requested that the insurance requirements, as specified in the County's Schedule of Insurance Requirements, be waived or modified on the following contract. Contractor: Rockport Analytics, LLC Contract for: Visitor Profile Survey Services Address of Contractor: 620 Chesapeake Ave Suite 100 Annapolis, MD 21403 Phone: 443-629-7150 Scope of Work: Collect and report visitor survey data Reason for Waiver: Organization has no Employees or Autos Policies Waiver will apply to: W rk rs Comp and Auto Signature of Contractor: Approved X Not Approved Risk Management: Date: 6/10/2022 County Administrator Appeal: Approved Not Approved Date: Board of County Commissioners Appeal: Approved Not Approved Meeting Date: Administration Instruction#4709.2