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Certificate of Insurance .., CERTIFICATE OF INSURANCE ISSUE DATE (MM/DDIYY) 6/06/96 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. PRODUCER PCA SOLUTIONS INC POBOX 166007 ALTAMONTE SPRINGS, FL 32716 COMPANIES AFFORDING COVERAGE COMPANY A LETTER PCA PROPERTY & CASUALTY INSURANCE COMPANY COMPANY B LETTER Rece iVeC1 INSURED KEYS MICROCABLE CORPORATION 3229 FLAGLER AVE #107 KEY WEST, FL 33040 COMPANY C 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 POLICY EFFECTIVE POLICY EXPIRATION DATE (MM/DDIYY) DATE (MM/DDIYY) LIMITS COMMERCIAL GENERAL CLAIMS MADE OCCUR OWNER'S & CONTRACTOR'S PROT, GENERAL AGGREGATE $ PRODUCTS-COM PlOP AGG, $ PERSONAL & ADV, INJURY $ EACH OCCURRENCE $ $ $ FIRE DAMAGE (Anyone fire) MED, EXPENSE (Anyone person) GENERAL LIABILITY AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY BODILY INJURY (Per person) $ {)/C/G ~"" :~ BODILY INJURY (Per accident) $ EXCESS LIABILITY 'r-f) il,,' .~ \J~ r EACH OCCURRENCE AGGREGATE $ $ $ PROPERTY DAMAGE UMBRELLA FORM OTHER THAN UMBRELLA FORM A WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY 62624039095 6/15/95 6/15/96 STATIONARY LIMITS EACH ACCIDENT DISEASE-POLICY LIMIT DISEASE-EACH EMPLOYEE OTHER .t,$ ;~' ~. !, . ':" DESCRIPTION OF OPERATIONSlLOCATIONSNEHICLESlSPECIAL ITEMS .f: FAX: 305-292-4564 ... -ri; 'r.' ~ Yir'" ~,_'1, t' r'. , , MONROE COUNTY RISK MANAGEMENT ATTN: KAY MILLER 5100 COLLEGE ROAD KEY WEST, FL 33040 CANCE.LLATION SHOULD ANY OF THE"tBOVE DESCRIBED POLICIES BE CANCEllED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ..l.Q... DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAIWRE TO MAil SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE CO ANY, ITS AGENTS OR REPRESENTATIVES, CERTIFICATE HOLDER AUTHORIZED REPRESENTATIVE ~ CC'. PIL.t:r ISSUE DATE (MM/DDIYY) CERTIFICATE OF INSURANCE PCA SOLUTIONS INC POBOX 166007 ALTAMONTE SPRINGS, FL 32716 6 06 96 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. COMPANIES AFFORDING COVERAGE PRODUCER ~~~~NYA PCA PROPERTY & CASUALTY INSURANCE COMPANY COMPANY B LETTER INSURED COMPANY D LETTER KEYS MICROCABLE CORPORATION 3229 FLAGLER AVE #107 KEY WEST, FL 33040 COMPANY C LETTER 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY DATE (MM/DDIYY) DATE (MM/DDIYY) LIMITS COMMERCIAL GENERAL CLAIMS MADE OCCUR OWNER'S & CONTRACTOR'S PROT, GENERAL AGGREGATE $ PRODUCTS-COMP/OP AGG, $ PERSONAL & ADV, INJURY $ EACH OCCURRENCE $ $ $ FIRE DAMAGE (Anyone fire) MED, EXPENSE (Anyone GENERAL LIABILITY ANY AUTO OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY APPROVED BY RISK ~ANflGEMENT BY ~ - /~-, 'l? ::~f,,~v~;~~: COMBINED SINGLE $ LIMIT BODILY INJURY $ (Per person) BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ EACH OCCURRENCE $ AGGREGATE $ AUTOMOBILE LIABILITY EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM A WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY 09047145096 6/15/96 6/15/97 STATIONARY LIMITS EACH ACCIDENT DISEASE-POLICY LIMIT DISEASE-EACH EMP~Qm $100,000 $ 500,000 $ 100,000 OTHER DESCRIPTION OF OPERATIONSlLOCATIONSNEHICLESlSPECIAL ITEMS FAX: 305-292-4564 OliN1'" ~1Tl ... CERnFICATE HOLDER CANCELLATION ~...,,' ,,~ MONROE COUNTY RISK MANAGEMENT ATTN: KAY MILLER 5100 COLLEGE ROAD KEY WEST, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAIWRE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE CO ANY, ITS AGENTS OR REPRESENTATIVES, ~ AUTHORIZED REPRESENTATIVE Cc. : ,:::/(.. E r TO: 0~a~- ~/~ SUBJECT, ~ ~ 4~~ ~~ ~,C;#~~;Y {7~~ i=RO,Y: MONROE COUNTY RISK MANAGEMENT & LOSS CONTROL Wing II, Room 207, P.S B. STOCK ISLAND, KEY WEST, FLORIDA 33040 (305) 292-4454 Fax (305) 292-4401 DATE /,,2.-/~ -?~ ~-~ /.2--/~ --~ DATE BY ~ 7$-~ BY RMCC-847-3 PRINTED IN U.SA .-\priI22.1993 1 st Printing 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: K~s Microcable Corp. Contract for: County Translator ~sTPm Address of Contractor: 3229 Flagler Avenue. #107 Kev West, FL 33040 305-296-8112 Phone: ~ Scope of Work: Operation and maintenance of translator sysTPm Signature of Contractor: I-z.....q ~ i.,P Reason for Waiver: ~ .A A ^-'" ~^-<- ~ Date tv' A roved ~ ~ot Approved ~ rqf;}. . \&--~-t'-- i~ -. - p~ /[)-/; tc / 9 ~ Risk Management County Administrator appeal: Approved: Not Approved: Dale: Board of County Commissioners appeal: Approved: Not Approved: Meeting Dale: WAIVER ~ KEI'S MICIIOCRSLE Wireless Cable Television for the Florida Keys December 9, 1996 via Facsimile: 305-292-4564 Donna J. Perez, ARM Risk Manager Monroe County Risk Management 5100 College Road Key West, FL 33040 Re: Insurance for Translator System [~~~" ~>\'Ci_ ~-~<~'I ~"t. Dear Donna: Pursuant to our meeting on December 5, 1996 with Norm Leggett (Monroe County) and Lawton Swan of Interisk Corporation, we are pleased with the County's plan for moving forward respecting insurance coverage requirements on the translator system. Following thorough discussion of the County translator system's history to date, including our current Agreement with Monroe County and plans to upgrade the system, we were directed to file a Request for Waiver of Insurance Requirement form with your office, which is attached. The basis for this insurance waiver request is as follows: The translator system delivering Miami television networks fails to meet the criteria as an essential need for Monroe County. On two different occasions, the electorate has voted against ad valorem taxes to support the translator system. KMC is the only enti ty which responded to Monroe County's RFP to operate and maintain the system; were it not for KMC, the translator would have gone "dark" earlier this year. Current translator equipment is of little monetary value and therefore has no real insurable value. Electronics, feed lines and antennas are in unsatisfactory condition, or simply obsolete. (This explains the marginal quality and reliability of reception in many areas. A comprehensive upgrade plan by KMC is currently underway. We estimate replacing approximately 60% of the system by the second Keys Microcable Corporation, 3229 Flagler Avenue, Suite 107, Key West, FL 33040 (305) 296-8112 Fax (305) 296-1076 , Donna J. Perez December 9, 1996 Page 2 quarter of 1997. This will include new translator electronics, un-interruptable power supplies, and other equipment. KMC relies on the translator system to transport Miami networks for its wireless cable system in Key West. Despite whether or not the translator system is insured by KMC, the Miami signals are essential to our company. Therefore, KMC will take all necessary steps to preserve these signals at all times. We appreciate your time and consideration in this matter and will look forward to hearing from you. Please contact us without hesitation should you require any further information or assistance. Sincerely, KEYS MICROCABLE CORPORATION ~~ J. Kell Bloomer President attachment file"moncty.1296.kmc Keys Microcable Corporation, 3229 Flagler Avenue, Suite 107, Key West, FL 33040 (305) 296-8112 Fax (305) 296-1076 ~~QRA_;;ii~;.. 'PRODUCER" '(iO'S') 294::"44'94" "" """""'''iAi''(josji94:::oi7i''''''. "",,"" THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE eys Insu rance Agency of Mon roe County, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 805 Peacock Pl aza ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Key West, FL 33040 : COMPANIES AFFORDING COVERAGE :. "~~~~~~"""" 'i3'li'r"" ii'9'1:"0.ii..' f nsi.i' rari ce'. 'tom'pariy."'. ...,..,...."..," , ~: ~ 'A ~?f1 ~ ~~~~~"""'''piH)G'jfESSfVE "toMPANtts" "".."" " " B ...................... .......................... INSURED Keys Microcable Corporation PO Box 5528 Key West, FL 33045-5528 .............................. ......................... ................... ................... : COMPANY : C : COMPANY : D 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 AN"f 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE (MMlDDIYY) DATE (MMlDDIYY) LIMITS A COMMERCIAL GENERAL LIABILITY : CLAIMS MADE :X OCCUR B0274G410162 OWNER'S & CONTRACTOR'S PROT : : GENERAL AGGREGATE : $ ._ ....__...... ..d._ .__..__....__.. . PRODUCTS. COM PlOP AGG : $ ..............,.................... ..................... : PERSONAL & ADV INJURY . $ 02/02/1998 02/02/1999 ........................................ : EACH OCCURRENCE $ ......................... ..................... ~ FIRE DAMAGE (Anyone fire) : $ . d........_........._...................... : MED EXP (Anyone person) : $ . .1, 000, ()OO "~,.<:)<:)<>.,,.()()g .1, ()()(), 000 ,..:t., ,(),(),()", <:)<:)<>. H50,()()0 1 000 B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS X SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS Comp/ $500 Oed colljHssooDed :CA040160350 COMBINED SINGLE LIMIT $ BODtL Y INJURY $ (per person) 12/11/1997 12/11/1998 BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ 500 000 BY : AUTO ONLY. EA ACCIDENT : $ :' ?T.H.~~. ~~~, ~,u.T.~,?~~~: ". ,,:tt\::~::\:\:::::::::::::::::::::::::~~::\:::::::::t:::::::::::::::::~:' EACH ACCIDENT ~ $ AGGREGATE ~ $ EACH OCCURRENCE $ AGGREGATE $ $ GARAGE LIABILITY ANY AUTO EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM DATE ~lWVfR: NIA .L YES ........................................ . . ......,................................. . ......................................... " : :r()~Y.,~I~,rr.~,:"",..:. .101<, ,ttt~\\t\tt:ttttttt:t:t:} . EL EACH ACCIDENT · $ . EL DISEASE. POLICY LIMIT : $ .........................................................n THE PROPRIETOR! PARTNERSJEXECUTIVE OFFICERS ARE: OTHER INCL EXCL ~ EL DISEASE - EA EMPLOYEE: $ DESCRIPTION OF OPERATIONSlLOCATIONSlVEHICLESlSPECIAL ITEMS ertificate holder is named as an additional insured on liability policy and auto policy iability policy has $500 deductible per occurrence SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Mon roe County BOCC BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 5100 Co 1 1 ege Road OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. ..~ Certificate of Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFICATE HOLDER THIS CERTIFICATE IS NOT AN INSURANCE POLICY AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. STAFF LEASING, LP" BY STAFF ACQUISITION, INC., THE GENERAL PARTNER, AND THE AFFILIATED LIMITED PARTNERSHIPS OF WHICH STAFF ACQUISITION, INC. IS THE GENERAL PARTNER AND THEIR SUCCESSOR CORPORATIONS 600 301 BOULEVARD WEST, SUITE 202 BRADENTON, FLORIDA 34205 is, at the issue date of this certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(ies) is subject to all their terms, exclusions and conditions and is not altered by any requirement, term or condition of an contract or other document with res ect to which this certificate ma be issued. CERTIFICATE EXP. DATE * 0 CONTINUOUS o EXTENDED 00 POLICY TERM Name and address of Insured ./ LIBERlY_ MUTUAL@ , This is to Certify that TYPE OF POLICY POLICY NUMBER LIMIT OF LIABILITY Coverage Afforded Under WC EMPLOYERS LIABILITY Law of the Following States: WORKERS COMPENSATION 1-1-99 W A 1-65D-00411 0-298 WC1-651-004110-018 Bodily Injury By Accident Each $1,000,000. Accident GENERAL LIABILITY All States Endorsement Bodily Injury By Disease Policy $1,000,000. Limit Bodily Injury By Disease Each $1,000,000. Person General Aggregate-Other than Prod/Completed Operations o CLAIMS MADE I RETRO DATE I Products/Completed Operations Aggregate ~prROVED Bodily Injury and Property Damage Liability o OCCURRENCE BY Personal and Advertising Injury Per Occurrence Per Person/ Organization D~TE Other: Other: AUTOMOBILE LIABILITY DOWNED o NON-OWNED o HIRED \S~:\jER: N. A Vf:~._ Each Accident - Single Limit - B,L and P,D, Combined Each Person CG'. Each Accident or Occurrence Each Accident or Occurrence OTHER EMPLOYEES LEASED TO: F767 EFFECTIVE DATE: 01/01/9B KEYS MICROCABLE The above referenced Workers' Compensation policy provides statutory benefits only to employees of the Named Insured(s) on the policy, not to employees of any other employer. 'IF THE CERTIFICATE EXPIRATION DATE IS CONTINUOUS OR EXTENDED TERM, YOU WILL BE NOTIFIED IF COVERAGE IS TERMINATED OR REDUCED BEFORE THE CERTIFICATE EXPIRATION DATE SPECIAL NOTICE. OHIO: ANY PERSON WHO, WITH INTENT TO DEFRAUD OR KNOWING THAT HE IS FACILITATING A FRAUD AGAINST AN INSURER, SUBMITS AN APPLICATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT IS GUILTY OF INSURANCE FRAUD, IMPORTANT NOnCE TO FLORIDA POLICY HOLDERS AND CERTIFICATE HOLDERS: IN THE EVENT YOU HAVE ANY QUESTIONS OR NEED INFORMATION ABOUT THIS CERTIFICATE FOR ANY REASON, PLEASE CONTACT YOUR LOCAL SALES PRODUCER, WHOSE NAME AND TELEPHONE NUMBER APPEARS IN THE LOWER RIGHT HAND CORNER OF THIS CERTIFICATE, THE APPROPRIATE LOCAL SALES OFFICE MAILING ADDRESS MAY ALSO BE OBTAINED BY CALLING THIS NUMBER NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW,) BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST 30 DAYS NOTICE OF SUCH CANCELLATION HAS BEEN MAILED TO: MONROE COUNTY/BOARD OF COUNTY ATTN:MARIA DEL RIO 5100 COLLEGE RD STOCK ISLAND KEY WEST, FL 33040 Liberty Mutual Group CERTIFICATE HOLDER OMMIS. DONAL AUTHORIZE P^TE 800-475-4430 PHONE 03/13/9B DATE ISSUED This certificate is executed by LIBERTY MUTUAL GROUP as respects sJN~n ies BS 772L R2