07/28/1993 AgreementBRANCH OFFICE
3117 OVERSEAS HIGHWAY
MARATHON, FLORIDA 33050
TEL. (305) 289-6027
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CLERK OF THE CIRCUIT COURT
MONROE COUNTY
500 WHITEHEAD STREET
KEY WEST, FLORIDA 33040
TEL. (305) 292-3550
M E M O R A N D U M
To: Randy Ludacer, County Attorney ppcc
From: Isabel C. DeSantis, Deputy Clerk9•(,•�"'1
Date: September 7, 1993
BRANCH OFFICE
88820 OVERSEAS HIGHWAY
PLANTATION KEY, FLORIDA 33070
TEL. (305) 852-7145
On July 28, 1993, the Board authorized the execution of the
Ground and Operating Leases with Key's Hospital Foundation, Inc.
regarding Mariner's Hospital, with Addendums, as proposed by the
County Attorney.
Attached for return to "Mariners" is a fully -executed duplicate
original of the subject Agreements and Addendums.
cc: County Administrator, w/o document
Risk Management, w/o document
Finance
File
GROUND LEASE
THIS LEASE AGREEMENT is made by and between the Keys
Hospital Foundation, Inc., a Florida not -for -profit corporation,
hereinafter referred to as "MARINERS", and the Board of County
Commissioners of Monroe County as the Mariners Hospital Taxing
District, hereinafter referred to as "THE DISTRICT", which term
T -n
shall include the successors and assigns of the resp4tiv,
parties wherever and whenever applicable. c
WITNESSETH, that MARINERS does hereby lease unto' TH"
_0 rl
DISTRICT, for the purpose of constructing a hospital bui^Ydi4
thereon the following described property,r' ' situate, located and
being in Monroe County, Florida, and being described more
particularly in Exhibit "A" attached hereto, the said property
for a term of 99 years to be the property of THE DISTRICT in
accordance with the terms and conditions as hereinafter set
forth.
�:Tui
The term of this lease shall be for a period of 99 years
commencing on the 28th day of July 1993 .
II. RENT
The rent payable to MARINERS by THE DISTRICT for this lease
shall be the sum of ONE DOLLAR ($1.00) and such other
considerations as are hereinafter set forth.
III. WARRANTIES OF TITLE
MARINERS covenants that it is seized of the demised premises
in fee simple free and clear of all encumbrances and has full
right and title to make this lease and that the Lessee shall have
quiet and peaceable possession of the demised premises during the
term hereof.
IV. DELIVERY OF POSSESSION
MARINERS agrees if, for any reason whatsoever, it cannot
deliver possession of the demised premises at the commencement of
the term hereof, or that any impediment exists to the
construction of the hospital properties as hereinafter set forth,
then this lease shall be void and each party shall be discharged
from all covenants herein and any other collateral understandings
existing between the parties with reference to this subject
matter.
V. USES PROHIBITED
THE DISTRICT shall not use, nor permit the demised property
or any part thereof, to be used for any purpose or purposes other
than the purpose of constructing and operating a hospital hereon.
During the term of this lease THE DISTRICT shall comply with
all applicable laws affecting the demised premises, the breach of
which might result in any penalty on MARINERS or forfeiture of
MARINERS title to the demised premises.
VT. SUBLETTING AND ASSIGNMENT
THE DISTRICT shall sublet the premises to MARINERS but
solely and exclusively for the purpose of operating a
not -for -profit hospital and for the furnishing of indigent health
2
care services in accordance with an agreement between MARINERS
and THE DISTRICT. MARINERS shall not assign or transfer this
sublease or any interest therein without the prior written
consent of THE DISTRICT and the consent to such assignment shall
not be deemed to be a consent to any subsequent assignment. Any
such assignment without consent of THE DISTRICT shall be void and
shall, at the option of THE DISTRICT, constitute a breach of its
agreements with MARINERS. Any interest of estate created by
sublease to MARINERS shall not be subject to involuntary
assignment, transfer or sale by operation of law or otherwise,
and any such attempted involuntary assignment, transfer or sale
shall be void and of no effect and shall, at the option of THE
DISTRICT, constitute a breach of its primary agreement with
MARINERS concerning the use and occupation of the premises to be
constructed hereon.
All notices, demands or other writings in this lease
provided to be given or made or sent by either party hereto to
the other shall be deemed to have been fully given or made or
sent when delivered to:
Chairman, Board of Trustees
Keys Hospital Foundation, Inc.
d/b/a Mariners Hospital
50 High Point Road
Tavernier, FL 330470
and for THE DISTRICT
Honorable Jack London
Mayor of Monroe County
Alamo Building, Suite B
Route 2, Box 674B
Summerland Key, FL 33042
or his successors in office.
3
THE DISTRICT shall endeavor to secure tax exemptions for the
subject property; however, any taxes that may be levied upon the
real estate, which is the subject of this lease, or any
improvements thereon, shall be paid or reimbursed by MARINERS.
VII. ASSESSMENTS AFFECTING IMPROVEMENTS
Specifically and without any way limiting the generality of
the foregoing, MARINERS shall further pay all special
assessments, levies and charges made by any governmental or
political entity for local improvements and shall pay the same as
they shall fall due and before they shall become delinquent and
as required by the act and proceedings under which any such
assignments or levies or charges are made by any such
subdivision.
VIII. CONSTRUCTION OF NEW BUILDING
On or before the day of , THE DISTRICT
shall at THE DISTRICT's expense subject to contingent
requirements for MARINERS to pay any overrun, prepare plans and
specifications for a new building to be erected on the premises
which shall provide for a 42-bed hospital as well as accessory
and auxiliary services as may be needed. Such plans and
specifications shall be approved by MARINERS prior to contracting
for the construction of said improvement. MARINERS shall not
unreasonably withhold such approval. THE DISTRICT shall secure a
design/built contractor pursuant to the requirements of Florida
Statutes Section 287.055, which contractor shall design the
facility subject to the approval of both MARINERS and THE
DISTRICT. Upon such approvals being furnished, construction
4
shall thereupon commence in accordance with the contract between
the design/builder and THE DISTRICT.
After MARINERS is in possession of the hospital pursuant to
the agreement between MARINERS and THE DISTRICT, it shall have
the right of Sublessee to make alterations, improvements and
changes to the building which may from time to time be deemed
necessary or to replace any such building with a new one at least
equal in value to the one which will be built by THE DISTRICT.
All such improvements shall be made at MARINERS expense.
THE DISTRICT shall be the owner of the hospital building,
and it shall be regarded as personal property regardless of its
degree of attachment to the real estate. THE DISTRICT shall also
be the owner of any identified equipment purchased by THE
DISTRICT for incorporation of installation in the hospital.
MARINERS shall remain the fee simple owner of the real property
subject to this ground lease.
IX. INSURANCE
During the period from the date of this lease until the
effective date of the operational sublease from THE DISTRICT to
MARINERS, THE DISTRICT agrees that it shall require the
following:
A. Maintain all insurances required for the construction
of public facilities including, but not limited to, builders risk
policy, public liability, full hazard insurance including, but
not limited to, fire, windstorm and flood.
B. THE DISTRICT shall require the design/build contractor,
its agents, subcontractors, and materialmen to maintain workmen's
compensation insurance coverage as required by law.
C. THE DISTRICT shall not sell, encumber or hypothecate
its interest in the land, which is the subject of this lease,
without the prior written consent and approval of MARINERS.
D. The new Mariners Hospital shall be constructed by THE
DISTRICT in accordance with plans and specifications approved by
THE DISTRICT, MARINERS and the Department of Health and
Rehabilitative Services of the State of Florida.
E. THE DISTRICT shall not be required to commence
construction of the new hospital facilities until it is assured,
in the sole discretion of the District, that MARINERS has the
confirmed availability of funds to make necessary contributions
to complete the hospital facilities over and above the funds
generated by the special taxing district and specifically
sufficient to cover any overrun in the cost of construction as
against the budget as aforesaid.
X. OTHER PROVISIONS
It is agreed between the parties that this document shall be
recorded upon its execution and shall constitute a conveyance of
the said property to THE DISTRICT for the 99-year term as
aforesaid.
C.
The parties of this Agreement have hereunto set their hands
and seals the a 8'fh day of _ 7v1993.
BOARD OF COUNTY COMMISSIONERS
OF MONRSCOUNTY, FLORIDA
�-ii/
(Seal)
Attest: DANNY L. KOLHAGE, CLERK
By: a.-J� C.
Deputy ClArk
KEYS HOSPITAL FOUNDATION, INC.
By
Chairm n
(Seal)
Attest:
Secretary
STATE OF FLORIDA
COUNTY OF MONROE
Before me personally appeared Christian A. Fleisher
and Charlen C. Regan , as Chairman and Secretary of
the Keys Hospital Foundation, Inc., personally known to me to be
the persons described in and who executed the foregoing
instrument and acknowledged to and before me that they executed
said instrument in the capacity and for the purpose therein
expressed.
WA
WITNESS my hand and and official seal, this -/ 2 day of
4
A.D. 1993.
Notary Public
State of Florida at Large
My Commission Expires:
N" 5=1 P TITTLE
22 : MIY OOMIMISSgq CC 2�i%4
EXIIiS: MWOh 11, INT
' d ; $ ` lMn U n.0 NMY nae Ui+rOWOM
A parcel of land lying in Sections 33 and 34, Township 82 South, Rangc 38 East in Key largo,
Monroe County, Florida, said parcel also consisting of a portion of Lot 15, Plat of AMOS LOWE
HOMESTEAD, according to the Plat thereof as recorded in Plat Book 1, at Page 80 of the
Public Records of Monroe County, Florida, said parcel also consisting of a JK)rtion of
Government Lot 2, Section 33, Township 62 South, Range 38 East, Monroe County, Florida and
being more particularly described as fullOws.
,Commenec at the intersection of the most Easterly corner of said Lot 15 and the Northwesterly
Right -of -Way line of U.S. Highway No. 1 (State Road No. 5);
thence N 47 3'28" W along the said Easterly line of Lot 15 for 246.41 feet to the Point of
2
Beginning;
thence S 42 35'04" W a distant of 210.01 feet;
thence S 47 23'28" E a disitancc of 246.41 feet to the Northwesterly Right -of Way line of U.S.
Highway No. 1;
thence 6 42 35'04" W along the said Northwesterly Right -of -Way line of U.S. Highway No. 1 a
distance of 50.00 feet;
thcncc N 47 23'28" W a distance of 246.41 feet;
thence S 42 35'04" W a distance of 114.71 feet;
thence S 47 24'56" E a distance of 46.41 feet;
thcncc S 42 35'04" W a distance of 180.00 feet;
thence S 02 12'04" E a distance of 68.35 feet;
thence S 87 46'49" W a distance of 177.35 feet;
thence N 02 13'52" W a distance of 647.74 foot;
thence N 87 46'49" E a distance of 61.13 fu;t;
thence N 02 13'11" W a distance of 145.18 feet;
thence N 87 50'34" E a distant of 174.46 feet to the said Easterly line of Lot 15;
thcncc S 47 23'28" E along the said Easterly line of Lot 15 a distance of 422.83 feet to the Point
of Beginning;
LESS AND EXCLUDING M.O.B PARCEL 1 AND M.O.B. PARCEL 2 DESCRIBED IN
EXHIBIT A-2 ATTACHED HERETO.
EXHIBIT A
M.O.B. Parcel 1
A parcel of land lying in Sections 33 and 34, Township 62 South,
Range 38 East in Keys Largo, Monroe County, Florida, said parcel
also consisting of a portion of Lot 151 Plat of AMOS LOWE
HOMESTEAD, according to the Plat thereof as recorded in Plat Book
2 at Page 80, of the Public Records of Monroe County, Florida, said
parcel also consisting of a portion of Government Lot 2, Section
33, Township 62iSouth# Range 38 cularl described as Monroe
County,
Florida and
being more particularly
Commence at the intersection of tho most Easterly corner of said
Lot 15 and the Northwesterly Right -of -Way line of U.S. Highway No.
1 (State Road No. 5); thence N 47'23128' W along the said Easterly
line of Lot 15 for 246.41 feet; thence S 42*35104" W for 5.53 feet
to the Point of Beginning; thence S 42*350040 M a distance of
215.98 feet; thence N 47.241561 W a distance of 39.09 feet to the
point of curvature of a curve to the right, having a radius of 9.56
feet, a central angle of 83`381251 a tangent length of 8.55 feet,
a chord bearing of N 05035143N W and a chord length of 12.75 feet;
thence along the arc of said curve, an arc length of 13.95 feet to
the end
henceaSd47•23128 9 aedistance," Of48.59 dn ce of feetto the20 Poin
tt
feet;
of Beginning.
M.O.B Parcel 2
A parcel of land lying in Sections 33 and 34, Township 62 South,
Range 38 East in Key Largo, Monroe County, Florida, said parcel
also consisting of a portion of Lot 15, Plat of AMOS LOWE HOMESTEAD
according to the Plat thereof as recorded in Plat Book 1 at Page
80, of the Public Records of Monroe County, Florida, said parcel
also consisting of a portion of Government Lot 2, Section 33,
Township 62 South, Range 38 East, Monroe County, Florida and being
more particularly described as follows:
Commence at the intersection of the most Easterly corner of said
Lot 15 and the Northwesterly Right -of -Way line of U.S. Highway No.
1 (State Road No. 5); thence N 47'23'28" W along the said Easterly
line of Lot 15 for 246.41 feet; thence S 42*35104' W for 248.52
feet to the Point of Beginning; thence S 42.35104" W a distance of
126.20 feet; thence S 47"24156" E a distance of 46.41 feet; thence
S 42*35104' W a distance of 191.75 feet; thence N 47*241560 W a
distance of 23.00 feet; thence S 42*35104" W a distance of 59.00
feet; thence S 47*24156" E a distance of 27.37 feet; thence S
87.46"49" W a distance of 85.73 feet; thence N 02'13152" W a
distance of 54.69 feet; thence N 42635104" E a distance of 390.07
feet to a point on a curve to the right having a radius of 9.56
feet, a central angle of 83*38125" a tangent length of 8.55 feet,
a chord bearing of S 89*14109' E and a chord length of 12.75 feet;
thence along the arc of said curve, an arc length of 13.95 feet to
the point of tangency of said curve; thence S 476241560 E a
distance of 39.09 feet to the Point of Beginning.
Exhibit A-2
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S 947.24'56'E 39.09'
ANARIIK63 NA8LD ON SUIVEt DII PO20,AR111O1N?Z*0S
-
i H&SUC7,INCVAN
1ARINERS HOSPITAL
Tavernier, Florida
FREDERICK H. HILDEBRANDT
SketcR to Accrimpany
Doe, No.
93-296
ENGINEER SURVEYOR PLANNER
re cn
1^=200'
8if Flood ►eirtNo.
FHN
3150 Northside Oriv•
at«
Suite 10i
w• 7/13/93
fil.ee Fie" Zem
INd E1ert
Key West. Ft. 33040
REVI IONS AND/OR ADDITIONS t3051 293-0466
Fax. 113061 293-0237
MOBILE 1305t 951-8146
13
FI(V � SUR•R��V\ TE OF I ANI ISSUE DATE (MM/DD/YY)
fQ`
8 / 31 / 9 3
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
REGAN INSURANCE AGCY
COMPANIES AFFORDING COVERAGE
901-11 OVFRSF.AS HWY
TAVERNIER FL 33070
COMPANY
LETTER A ST PAUL FL _,FRV CFN I FR
INSURED
i
COMPANY B
LETTER A 0 gy RISK MANAGEME
n I
COMPANY G, �
KEYS HOSPITAL FOUNDATION
LETTER vy
50 HTGH PT ROAD
TAVERNIER FL 33070
COMPANY
LETTER D DATE��p
�c
NY NIA --YES
LETTERE WAIVER:
COVERAGES
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.
CO TYPE OF INSURANCE POLICY NUMBER
ILTR
POLICY EFFECTIVE POLICY EXPIRATION LIMITS
DATE (MM/DD/YY) DATE (MM/DD/YY)
GENERAL LIABILITY i ti 6000601
I Zt J 31 Y3GENERAL AGGREGATE $ z ! i,. o o
X COMMERCIAL GENERAL LIABILITY
PRODUCTS-COMP/OP AGG. $ L! 0 0 0! 0 0 +
CLAIMS MADE X OCCUR.
PERSONAL & ADV. INJURY $ 1 ! 000000
OWNER'S & CONTRACTOR'S PROT.
EACH OCCURRENCE $ 1 ! 000000
FIRE DAMAGE (Any one fire) $ 1007000
MED. EXPENSE (Any one person) $ 5000
AUTOMOBILE LIABILITY
COMBINED SINGLE
$
ANY AUTO
LIMIT
ALL OWNED AUTOS
BODILY INJURY
$
SCHEDULED AUTOS
(Per person)
HIRED AUTOS
BODILY INJURY
$
NON -OWNED AUTOS
(Per accident)
GARAGE LIABILITY
PROPERTY DAMAGE $
EXCESS LIABILITY
EACH OCCURRENCE $
UMBRELLA FORM
AGGREGATE $
OTHER THAN UMBRELLA FORM
STATUTORY LIMITS
WORKER'S COMPENSATION
EACH ACCIDENT $
AND
DISEASE —POLICY LIMIT $
EMPLOYERS' LIABILITY
DISEASE —EACH EMPLOYEE $
OTHER
Received
Risk Mgmt. & Loss Control
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
DATE
HOSPITAL
NnfIAL __ or--_
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATIQN DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
MARINER'S HOSPITAL SPECIAL
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
TAXING DISTRICT E: O A R D /ADD I. N S O
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
5100 COLLEGE RD
K F Y WEST FL 330,90
AUTHORIZED REPRESENTATIVE
ROBERT ,t, wFGAm :. � B
ACORD 25-8 (7/90)
' t '� " "' CACORD CORPORATION 19901
A0,401s10® CERTIFICATE OF INSURANCE ISSUE DATE
31 / 9 3'
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
PRODUCER
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
REGAN INSURANCE AGCY
COMPANIES AFFORDING COVERAGE
901,111 OVERE. EAS FIWY
T A V E R N I E R FL 33070
COMPAN
LETTER -�.Y A APPROVED BY RISK MANAGEMENT
COMPANY BY
B
INSURED
LETTER
KEYS HOSPITAL. FOUNDATION
COMPANY DATE
C'
MARINERS HOSPITAL
LETTER
5 0 H T G I i P T ROAD
COMPANY WAIVER- N/A YES -•----
D
T AVERNIER FL 33070
LETTER
COMPANY E
LETTER FL_ MFD MALPRACTICE
COVERAGES
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.
CO TYPE OF INSURANCE POLICY NUMBER
�LTR
POLICY EFFECTIVE POLICY EXPIRATION LIMITS
DATE (MM/DD/YY) DATE (MM/DD/YY)
GENERAL LIABILITY
GENERAL AGGREGATE $
COMMERCIAL GENERAL LIABILITY
PRODUCTS-COMP/OP AGG. $ - -
CLAIMS MADE OCCUR.
PERSONAL & ADV. INJURY $
OWNER'S & CONTRACTOR'S PROT.
EACH OCCURRENCE $
FIRE DAMAGE (Any one fire) $ '.
MED. EXPENSE (Any one person) $
AUTOMOBILE LIABILITY
COMBINED SINGLE $
ANY AUTO
LIMIT
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS
(Per person) i
I
HIRED AUTOS
BODILY INJURY $
NON -OWNED AUTOS
(Per accident)
GARAGE LIABILITY
PROPERTY DAMAGE $
EXCESS LIABILITY
EACH OCCURRENCE $
UMBRELLA FORM
AGGREGATE $
OTHER THAN UMBRELLA FORM
STATUTORY LIMITS
WORKER'S COMPENSATION
EACH ACCIDENT $
AND
DISEASE —POLICY LIMIT $
EMPLOYERS' LIABILITY
DISEASE —EACH EMPLOYEE $
OTHER
71011YT - z f b
Received
MEDICAL MALPRAC
Risk Mgmt. & LOSS Control
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
DATE
HOSPITAL
IIVW£!ALJ
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATIQI� DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL JJ AYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
MARINER'S HOSPITAL SPECIAL
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
TAXING DISTRICT
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
5100 COLLEGE RD
KEY WEST FL 330�i0
T AUTHORIZED REPRESPNArIVE
�
,
RODER1� Af GAN F.
ACORD 25-S (7/90)
b ' CACORD CORPORATION 1990
ISSUE DATE (MM/DD/YY) i
CERTIFICATE OF INSURANCE 8 / 31 / 9 3
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
PRODUCER
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
REGAN INSURANCE AGCY
COMPANIES AFFORDIM kAN &QAr-E
9019'I OVERSEAS HWY
APPROVED BY
TAVERNIER FL 33070
COMPANY A
LETTER —
�
NY B �f
LETTERDATE
INSURED
KEYS HOSPITAL FOUNDATION
COMPANY YES —
C WAIVER: N/A �.-
MARINEHOSPITAL
LETTER
L )�
.�0 HIGH PT ROAD
COMPANY D
TAVERNTFR FL_ 33070
LETTER ASSOCIATED INDUSTRIES 1.
COMPANY E
LETTER
COVERAGES
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.
(CO TYPE OF INSURANCE POLICY NUMBER
LTR
POLICY EFFECTIVE POLICY EXPIRATION LIMITS
DATE (MM/DD/YY) DATE (MM/DD/YY)
GENERAL LIABILITY
GENERAL AGGREGATE $
COMMERCIAL GENERAL LIABILITY
PRODUCTS-COMP/OP AGG. $
CLAIMS MADE OCCUR.
PERSONAL & ADV. INJURY $
OWNER'S & CONTRACTOR'S PROT,
EACH OCCURRENCE $
FIRE DAMAGE (Any one fire) $
MED. EXPENSE (Any one person) $
AUTOMOBILE LIABILITY
COMBINED SINGLE
$
ANY AUTO
LIMIT
ALL OWNED AUTOS
BODILY INJURY
$
SCHEDULED AUTOS
(Per person)
HIRED AUTOS
BODILY INJURY $
NON -OWNED AUTOS
(Per accident)
GARAGE LIABILITY
PROPERTY DAMAGE $
EXCESS LIABILITY
EACH OCCURRENCE $
UMBRELLA FORM
AGGREGATE $
OTHER THAN UMBRELLA FORM
932307802
D
3 / 01 / 9 3 3 / 01 / 91 X STATUTORY LIMITS
ATON
WORKER'S COMPENSI
EACH ACCIDENT $ 1! 0 0 0! C 0 0
AND
DISEASE —POLICY LIMIT $ 1 f 000 f 000
EMPLOYERS' LIABILITY
DISEASE —EACH EMPLOYEE $ 1! 0 0 0 Y 0 0 0
OTHER
Received
Risk Mgmt. & Loss Control
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
DATE —o2 ' 3
FLORIDA OPERATIONS
INITIAL _ -,-Ze C
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
y
3{'DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
MARINER'S HOSPITAL SPECIAL
MAIL
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
TAXING DISTRICT BOARD
LIABILITY OF ANY D UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
5100 COLLEGE RD
KEY WEST FL- 33094
AUTHORIZED REP SE ATIVE
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ROE E ' (F-"f FGAN E
ACORD 25-S (7/90)
CACORD CORPORATION 1990