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Certificates of Insurance A�D 7/7/2022 Y) ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/ 022 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 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 NAME: Margaret Schneider CLIFFORD INSURANCE CENTER, INC HC No Ext: (352)245-5455 A/C,NO: (352)295-9866 9790 SE 160th Lane E-MAIL nargaret@cliffordinsurance.net ADDRESS: g INSURER(S) AFFORDING COVERAGE NAIC# Summerfield FL 34491 INSURERA:Southern Owners Insurance Co. 10190 INSURED INSURER B Gary The Carpenter Construction, Inc. INSURERC: Gary P Burchfield INSURER D: 800 Simonton St INSURER E: Key West FL 33040-7446 INSURER F: COVERAGES CERTIFICATE NUMBER:22/23 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DDNYYY MM/DDNYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE ❑OCCUR DAMAGE TO RENTED 300,000 PREMISES Ea occurrence $ X 78842358 5/16/2022 5/16/2023 MED EXP(Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 X JECT LOC PRODUCTS-COMP/OPAGG $POLICY ❑ PRO 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ APPROVED BY RISC MANAGEMENT Ea accident ANYAUTO BY BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS ^7 ^7/ BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS WAVER N/A YES Per accident UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LAB HCLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? F N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Qualifier: Gary P. Burchfield - License #s: CBC1250924 - RC29027091 - IH/106449 Monroe County Building Department is included as additional insured with respect to the General Liability coverage per form 55373 (5-17) . CERTIFICATE HOLDER CANCELLATION (305)289-2515 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Building Department THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 2798 Overseas Highway ACCORDANCE WITH THE POLICY PROVISIONS. Suite 300 Marathon, FL 33050 AUTHORIZED REPRESENTATIVE Linda Clifford/SS d ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) Agency Code 12-0307-00 Policy Number 112322-78842358 55373 (5-17) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Under SECTION II -WHO IS AN INSURED is in whole or in part, by"your work"for that Addi- amended. The following provision is added. tional Insured by or for you. Other insurance A person or organization is an Additional Insured, available to the Additional Insured will apply as only with respect to liability caused, in whole or in excess insurance and not contribute as primary part, by"your work"for that Additional Insured by or insurance to the insurance provided by this for you: endorsement. 1. If required in a written contract or agreement; or 2. The following condition is added. 2. If required by an oral contract or agreement only Other Additional Insured Coverage Issued By if a Certificate of Insurance was issued prior to Us the loss indicating that the person or organiza- If this policy provides coverage for the same tion was an Additional Insured. loss to any Additional Insured specifically shown B. SECTION III - LIMITS OF INSURANCE is as an Additional Insured in another endorsement amended. The following provision is added. to this policy, our maximum limit of insurance The limits of liability for the Additional Insured are under this endorsement and any other endorse- those specified in the written contract or agreement ment shall not exceed the limit of insurance in between the insured and the owner, lessee or con- the written contract or agreement between the tractor or those specified in the Certificate of Insur- insured and the owner, lessee or contractor, or ance, if an oral contract or agreement, not to exceed the limits provided in this policy, whichever is the limits provided in this policy. These limits are less. Our maximum limit of insurance arising inclusive of and not in addition to the limits of out of an 'occurrence", shall not exceed the limit insurance shown in the Declarations. of insurance shown in the Declarations, regard- C. SECTION IV- COMMERCIAL GENERAL less of the number of insureds or Additional LIABILITY CONDITIONS is amended. Insureds. 1. The following condition is added to 4. Other Insurance. All other policy terms and conditions apply. This insurance is primary for the Additional Insured, but only with respect to liability caused, 55373 (5-17) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 1 DATE(MM/DD/YYYY) AC "R" CERTIFICATE OF LIABILITY INSURANCE 07/07/2022 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 e Todd George g Bouchard Insurance for WBS-TG PHONE FAx PO Box 6090 A/c No Ext: (866)293-3600 ext.623 A/c NO): E-MAIL Clearwater, FL 33758-6090 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Zurich-American Insurance Company 16535 INSURED INSURER B: Workforce Business Services,Inc.Alt.Emp:Gary the Carpenter Construction Inc 1401 Manatee Ave.West Ste 600 INSURER C: Bradenton,FL 34205-6708 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:21FL079807619 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/YWY MM/DD/YWY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO TED CLAIMS-MADE OCCUR PREMISES Ea occurrence) $ A1""PN�44 '��ft BYItkm'xR b�istHW4�Ie(:IiI 1-11i,i„ MED EXP(Any one person) $ DIArC 7/7/2 PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY El PRO 1:1 LOC AViHrM rVA'"""°"'. JECT PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINEDSINGLELIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBER EXCLUDED? ❑ N/A WC 90-00-818-11 12/31/2021 12/31/2022 (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 Location Coverage Period: 12/31/2021 12/31/2022 Client# 002806 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Coverage is provided for Gary the Carpenter Construction Inc only those co-employees 800 Simonton St of,but not subcontractors Key West, FL 33040 to: CERTIFICATE HOLDER CANCELLATION Monroe County BOCC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1100 Simonton Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Key West, FL 33040 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE '"' . G ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and loao are reaistered marks of ACORD GARYB U R-01 REGAN L ACORO"° CERTIFICATE OF LIABILITY INSURANCE DAT7/7/2 D/YYYY) 022 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 Linda Regan NAME: Insurance Office of America PHONE FAX 13361 Overseas Highway (A/C,No,Ext): (305) 537-2782 (A/C,No): Marathon,FL 33050 E-MAIL Linda.Regan@ioausa.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Progressive Express Insurance Company 10193 INSURED INSURER B: Gary Burchfield dba Gary the Carpenter INSURER 7 800 Simonton Street INSURER D: Key West,FL 33040-3168 INSURER E 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 NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD MMIDD/YYYY MMIDD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE ❑ OCCUR DAMAGE TO RENTED 'V�I;(�"V D BY f,14K i6AINA(',J&N'fEN I° PREMISES Ea occurrence $ MED EXP(Any oneperson) $ DATE "a/J0 PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- AM�t I�NA hf1Y� POLICY JECT LOC PRODUCTS-COMP/OPAGG $ OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 100,000 Ea accident $ ANY AUTO X 08370079-3 11/19/2021 11/19/2022 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY X AUTOS BODILY INJURY Per accident $ X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 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. AUTHORIZED REPRESENTATIVE Monroe County BOCC 1100 Simonton Street . -A221073 Key West FL 33040 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD