Certificates of Insurance
PRODUCER
DATE (MMIDDIYY)
11/02/00
MATTER OF INFORMATION
.....................,.......................................'...........
...... ACORD..
FL
FCC I INSURANCE CO
INSURED
LAUMAR ROOFING SOUTH INC.
PO BOX 1006
FORT LAUDERDALE
COMPANY
C
FL 33302
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOlWlTHSTANDING 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 EXPIRATION
DATE (MMIDDIYY) DATE (MMIDDIYY)
LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE D OCCUR
OWNER'S & CONTRACTOR'S PROT
GENERAL AGGREGATE $
PRODUCTS. COMPIOP AGG S
PERSONAL & ADV INJURY i-!----.-
EACH OCCURRENCE I $
FIRE DAMAGE (Any one filP.) I S
MED EXP (Any one person) S
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
COMBINED SINGLE LIMIT S
API'POVEO BY RISK MANAGEME H
flY C\. . eJ CJ.~ '~c/'<--
flATE I (
BODILY INJURY L:'
(Per person)
.~-----
BODILY INJURY I $
(Per accident)
r--
WMVF!t:
N,^
PROPERTY DAMAGE
$
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND
EMPLOYERS' UASIUTY
27138-001
AUTO ONLY - EA ACCIDENT $
OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE $
EACH OCCURRENCE $
AGGREGATE $
$
1/01/00 1/01/01
EL EACH ACCIDENT $ .SO C Cc::t::
EL DISEASE.POLlCY LIMIT $ SUi cc e
EL DISEASE.EA EMPLOYEE $ sC;C tee
GARAGE LIABILITY
ANY AUTO
THE PROPRIETOR!
PARTNERs/EXECUTIVE
OFFICERS ARE:
OTHER
INCL
EXCL
DESCRIPTION OF OPERATlONSILOCATlONSNEHICLESISPECIAL ITEMS
MONROE COUNTY BOARD OF
COUNTY COMMISSIONERS
5100 COLLEGE ROAD STOCK ISLAND
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
J.L DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR UABILITY
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
NC A
CQijiQM'tltm'tI"iJ
FRANK H. FURMAN INC.
A CORD_
CERTIFICATE OF LIABI~ITY INSURANC~~~~4 DA~t:~~~}o
~~-0TH S CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
~ -;O~Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE
~'8:.... DER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
.:::: A.t . ER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
PRODUCER
Insurance solutions & Services
720 King Georges Post Road
Fords NJ 08863
Phone: 732-738-6080 Fax:732-738-6081
INSURED
united States Fire Ins. Co.
American International Group
Laumar Roofing South, Inc.
800 SW 21 Terr, PO Box 1006
Ft. Lauderdale FL 33302
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I~f~ ~91g EFE~GT~\E P.9L1QY EXPlf3A T~9N
TYPE OF INSURANCE POLICY NUMBER DATE MM/DDIYY DATE '(MM/DDIYY LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
-
A ~ COMMERCIAL GENERAL LIABILITY 503-186781-6 04/01/00 04/01/01 FIRE DAMAGE (Anyone fire) $300,000
h CLAIMS MADE [!J OCCUR MED EXP (Anyone person) $15,000
PERSONAL & ADV INJURY $1,000,000
\--
GENERAL AGGREGATE $2,000,000
-
GEN'L AGG~ETxE LIMIT APnS PER: PRODUCTS - COMP/OP AGG $1,000,000
iI PRO.
POLICY X JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $1,000,000
A ~ ANY AUTO 133-6641444 04/01/00 04/01/01 (Ea accident)
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS (Per person)
\-- APPROVED BY RISK MAl ACfMfNl
HIRED AUTOS BODILY INJURY
I-- BY Cl.., WC'--vt ~ ~,l),-".:t~, . .
NON.OWNED AUTOS (Per accident) . ._J
- ,--.
- nm~ l \ \ ( ::3 f 0 PROPERTY DAMAGE $
:) (Per accident)
GARAGE LIABILITY , AUTO ONLY - EA ACCIDENT $
rl ANY AUTO WA!Vf=R: "". \..""---; ,1: EA ACe $
,.. OTHER THAN
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $4,000,000
B tJ OCCUR o CLAIMS MADE BE7395307 04/01/00 04/01/01 AGGREGATE $8,000,000
UMBRELLA $
rl DEDUCTIBLE FORM $
RETENTION $ $
WORKERS COMPENSATION AND I TORY L1MrrS I IUJr-
EMPLOYER<. LIABILITY ER --.-.-----"
E.L. EACH ACCIDENT $
E.L. DISEASE. EA EMPLOYEE $
E.L. DISEASE. POLICY LIMIT $
OTHER
A Inst Floater 503-186781-6 04/01/00 04/01/01 On Site $150,000
In Trans. $25,000
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Monroe County Board of County Commissioners are included as additional
insured and loss payee as respects to work performed by the insured
regarding Marathon Park Marina. Additional insured status subject to
written contract.
CERTIFICATE HOLDER I y I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
LAUS240 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
Monroe County -
Board of County Commissioners LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF
5100 College Road, Stock Is. ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENrAf.IVES, "
Key West FL 33040 I/~.'/'{".~, ~.".,At
I -
Frank G. Jacobs
COVERAGES
.. ACORD CORPORATION 1988
ACORD 25-S (7/97)