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Certificates of Insurance DATE (MM/OOIYY) 7/2 5 /97 ------ ----..- THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE "OLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER T~E COVE~~E.AFFORQEO_BY THE POLICIES BElQW. COMPANIES AFFORDING COVERAGE , ACORD . Pf'OiJl/(i"R Sed g w i c k S. W. F lor i d a C S Box 4 1 300 3 Nap 1 e s, F L 3 4 1 0 1 - 300 3 COMPANY A St. Paul Mercury INSURED COMPANY B Health Management Assocs" Inc 581 1 Pel i can Bay B 1 v d, S t e 500 Nap 1 e s F L 3 4 1 0 8 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 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..J\ND_CONDtTIONS_ O=rF SUC~J.PLJ.CIES, . LIMITS .SHOW!t M.8.Y _H8.YLBEE11. B10UCEUY PA!!Jj'LAIHS> _ co TYPE OF INSURANCE POLICY NUMBER POLICY EFFEGTlVE POLICY EXPIRATION UMITS lTR DATE(MM/OOIYY) DATE(MMJIJO/YY) G~=:~N:RAlllABILlTY ,,_n ., - . n_ ---- - -- - -- . - . - ::~:;ci;~:;!~~~:EAGG T: - ~J ~'-:b~s [-.' , OCCUR ~ERSONAl_I!'A.ll.V.IN.J~~'( $ OWNER'S & CONT PROT EAC;H OCCURR.ENCE $ FIRE DAMAGE ( Anyone fire) $ MED EXP (Anyone person) $ A AUTOMOBILE lIABII1TY X ANY AUTO All OWNED AUTOS SCHEDULED AUTOS X HIRED AUTOS NON.OWNED AUTO H K 0 7 2 0 0 465 1 0 / 0 1 / 9 6 1 0 / 0 1 / 9 7 COMBINED SINGLE LIMIT BODilY INJURY (Per person) BODilY INJURY (Per accident) GARAGE UABlUTY ANY AUTO PROPERTY DAMAGE AUTO ONLY - EA ACCIDENT BY OTHER THAN AUTO ONLY: EACH ACCIDENT $ $ AGGREGATE EXCESS l.IABIUTY UMBRELLA FORM OTHER THAN UMBRELLA FORM ~-'---_.~--_._-------_.~-- WORKMAN's COMPENSATION AMJ EMPlOYER'S LIABA1TY THE PROPRIETOR! '-l'Ncl PARTN.ERS/EXECUTIVE ~ OFFICERS ARE: EXCl '~--'_.- ornER EACH OCCUBRE.t!CE .. AGGREGATE .------ .]~l{~~KI. ]~J~- ..,El EACH A,C;C;;DE,N"f $ I j ~~~II~::: ~Zl~~~l~~:E : ~~-~_ f~_ ~~- $ JO 00 (jJl 0 $ $ $ $ $ $ OESCRIPTION OF OPERAooNs.tLOCATlONSIVEHiCiESISPEClAlrrrMS--"---'-- ..----,--, BOA ROO F COM MIS S ION E R S 0 F M 0 N ROE C N T Y AND M 0 N ROE C N T Y S C H 0 0 LBO A R 0 ARE ADO I T ION A L INS U RED SON L Y A S RES P E C T S THE USE B Y F ISH E R MEN 'SH 0 S PIT A L , MAR A THO N, F L 0 F C N T Y S C H 0 0 L BUS E S FOR H U R R I CAN E E V A C U A T ION PUR P 0 S E S . MONROE COUNTY TRANSPORTATION PUB L I C S E R V ICE S B U I L 0 I N G WIN G 3, ROO M 304 5 100 C 0 L LEG E R 0 A 0 KEY W EST, F L 3 3 0 4 0 SHOULD ANY OF THE ABOVE OESCRIBED POlICIES BE CANCEUID BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILl. ENDEAVOR TO MAIL 1.0_ DAYS WRITTEN NOTICE TO THE CER1lFICATE HOLDER NAMED TO THE LEFT BUT FAIlURE TO MAIL SUCH NOTICE SHMLIMPOSE NO OBUGATION OR UABIUTY OF ANY KIND UPON THE COMPANY, ITS AGENTs OR REPRESENTATIVES. JI/ SENTATIVE ~ AOOM COftPORA.tlON 1993 ACORD CERTIFICATE OF LIABILITY INSURANC DATE (MMJDD/YY) 1 OJ 03j 9 7 TillS CERTIFICATE IS ISSUED AS A HATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON TilE CERTIFICATE 1l0LDER. TIllS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER TilE c:OVERJUiE,/:\ITQBOflLlJrTlIE POLICIES BELOW. COMPANIES AFFORDING COVERAGE PRODUCER Sed 9 w i c k S. W. F lor i d a C S BOX 4 1 3 003 NAP L E S F L 3 4 101 - 300 3 COMPANY A St. P a u I Fir e Ins . Co. INSURED COMPANY B H e a 1 t h Man age men t Ass 0 c s ., I n c 581 1 Pel i can Bay B I v d, S t e 500 Naples FL 34108 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 ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITIl RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL TilE TERMS, ~ r::=:;ION~~T POL:::~ITS SNON1i~~F=[:~~" ~;~ X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ ~ttb~s k.~ OCCUR PERSONAl & ADV INJURY... _$______ OWNER'S & CONT PROT EACH OCCURRENCE $ FIRE DAMAGE ( Anyone fire) L..n MED EXP (Anyone person) $ A AtJfOMOBlLE lIABlUTY X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS X HIRED AUTOS NON.OWNED AUTO H K 0 7 2 0 0 508 10/01/97 1 0/0 1 /98 COMBINED SINGLE LIMIT $ 1000000 BODILY INJURY (per person) $ BODILY INJURY (Per accident) $ GARAGE LIABIUTY ANY AUTO ~._.__----.--.-l2I'.cP 0''[ Co _W R! iL~~~f:l<1.fJ~Y.C:11L ~ -<', --.--_.l...-....L PROPERTY DAMAGE $ EXCESS lIABlUTY X UMBRELLA FORM OTHER THAN UMBRELLA FORM ~~ ------- -----..----- -- WORKMAN"S COMPENSATION AND EMPlOYER'S lIABILITY THE PROPRIETOR/ ~ j INCL PARTNERS/EXECUTIVE 'n .. n OFFICERS ARE: EXCL - -~---_.- ..-----...._______,__,_... ____." u___ '. .._~__.___ OlHER AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EACH OCCURRENCE AGGREGATE $ $ .__G"~~lw~sl~]~t~~ EL EACH ACCIDENT EL DISEASE. POLICY LIMIT $ $ EL DISEASE - EA EMPLOYEE $ ------ .~----_.._-------_.- DESCRIPTlON OF OPERATIONSIlOCAllONsNEiiiCiESISI'EClAi: ITEMS.-----. . BOA R D 0 F COM MIS S ION E R S 0 F M 0 N ROE C N T Y ARE ADD I T ION A L M 0 N ROE C 0 U N T Y T RAN S P 0 R TAT ION PUB Lie S E R V ICE S B U I L DIN G WIN G 3. ROO M 304 5 100 C 0 L LEG E R 0 A D KEY W EST. F L 3 3 0 4 0 SHOULD ANY OF THE ABOVE DESCRIBED POlICIES BE CANCEllED BEFORE mE EXPIRATION DATE lHEREOF, THE ISSUING COMPANY WlIJ. ENDEAVOR TO MAIL 1 0-- DAYS WRITTEN NOTICE m THE CERTIFICATE HOlDER NAMED TO THE LEn BUT FAILURE TO MAIL SUCI-I NOTICE SI-IAllIMPOSE NO OBlIGATION OR lIABIUTY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATNES. ,~.","nR~~^'P. ~ c ACORD CORPoRATION 1993 ACORQM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYY) 11/03/9f.l 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 SE'dqwick S. W. F 1 () F:i da ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, C S Bo:.: 41300:::i INSURERS AFFORDING COVERAGE NaDles. FL 34101-,3003 . -.. -...-- INSURED INSURER A: St. Paul NeFcury !;3rz- ..__n___________ n_ INSURER B: .. - -- Health f'o1anagement Assocs. , Inc ./ INSURER c: - __u_ . ..------- ~>811 Pelic;:\n Bay Blvd. Ste 500 INSURER D: - -------------------- N.::trrlles FL 34100 INSURER E: COVERAGES 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. INSR POLICY EFFECTiVE POLICYEXPIRATION T TYPE OF INSURANCE POLICY NUMBER DATE MM/DDIYY DATE MM/DDIYY LIMITS i. GE~ERAL LIABILITY ~MMERCIAL GENERAL LIABILITY Ii: CLAIMS MADE D OCCUR ~ EACH OCCURRENCE ~ I IFII'IE:o.~!-GE (A."Y one fire) f------ MED EXP (Anyone person) I $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS. COMP/OP AGG $ ~ GEN'L AGGREGATE LIMIT APPLIES PER: j~T LOC {.~ AUTOMOBILE LIABILITY HK07200569 :- X ~ ANY AUTO I I ALL OWNED AUTOS '--1 : I SCHEDULED AUTOS W HIRED AUTOS i X I NON.OWNED AUTOS ~ 10/01/98 10/01/99 COMBINED SINGLE LIMIT (Ea accident) $ 1000000 BODILY INJURY (Per person) BODILY INJURY (Per accident) 1$ H PROPERTY DAMAGE (Per accident) $ LiV AUTO ONLY. EA ACCIDENT $ : GARAGE LIABILITY ANY AUTO , EXCESS LIABILITY [J OCCUR D CLAIMS MADE DATE _\ .~ /t iIl.-,' ..~ _ ES EACH OCCURRENCE EA ACC $ $ $ $ $ $ $ OTHER THAN AUTO ONLY AGG AGGREGATE W~!VER: DEDUCTIBLE RETENTION $ I WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OTHER WC STATU. I 10TH. TORY L1MITS..l. _ ER EL EACH ACCIDENT $ EL DISEASE. EA EMPLOYE $ EL DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATlONS/LOCATIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS BOARD OF CONMISSIONERS OF MONROE COUNTY AND MONROE COUNTY SCHOOL BOARD ARE ADDITUIONAL INSUREDS ONLY AS RESPECTS THE USE BY FISHERNAN'S .~OSPITAL, MARATHON, FL OF CNTY SCHOOL BUSES FOR HURRICANE EVACUATION CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER: MONROE COUNTY TRANSPORTATION PUBLIC SERVICES BUILDING WING 3, ROOM 304 5100 COLLEGE ROAD KFY WEST FL 33040 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORI ESENTATIVE -Z:.- ~ ACORD 25-S (7/97) :~.... 16 @ACORD CORPORATION 1988 ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MMlDD/YYYV) 10/1/2010 1113/2009 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE . C RTIFICA TE DOES NOT AMEND, EXTEND OR THE COV RAGE AFFORDED BY THE POLICIES BELOW. PRODUCER Lockton Cornpanies, LLC-I Kansas City 444 \V. 47th Street, Suite 900 Kansas City \1064111-1906 (816) 960-9000 I,-'~ F' ("1, \', ~ t.,_ ) ING COVERAGE NAIC # INSURED HEALTH ~vlANAGE~1ENT ASSOCIATES. INC. 1312017 5811 PELIC/\.N BAY BLVD. SUITE 500 NAPLES FL 34108-2710 t ~ .'" \/ lal Insurance Company 23043 COVERAGES HE \~1 \03 HD THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING l j , !-.. INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. 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 SUB.JECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLlCY NUMBER P8l-+~~:~58;Q~F Pg~~J (~~gl~~I~N LIMITS LTR NSRO TYPE OF INSURANCE GENERAL LIABILITY EACH OCCURRENCE S XXXXXXX - DAMAGE TO RENTED COMMERCIAL. GENERAL LIABILITY NOT APPLICABLE PREMISES iEa occurence) $ XXXXXXX - U o OCCUR CLAIMS t...1ADE MED EXP (Anyone person) $ XXXXXXX - PERSONAl.. & ADV IN,JURY $ XXXXXXX i-- GENERAl.. AGGREGATE $ XXXXXXX i-- GENII.. AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ XXXXXXX n n PRO- n L.OC POLICY JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - $ 2,000,000 A X ANY AUTO AS2-651-004245-029 10/1/2009 10/1/2010 (Ea accident) - - ALL OWNED AUTOS BODIL Y INJURY $ XXXXXXX SCHEDULED AUTOS (Per person) - 51 HIRED AUTOS G)SOoL BODILY INJURY - $ XXXXXXX NON-OWNED AUTOS D (Per accident) - - PROPERTY DAMAGE Il~ /IJ (Per accident) $ XXXXXXX GARAGE LIABILITY \ \- ~ ' / AUTO ONLY - EA ACCIDENT $ XXXXXXX R ANY AUTO NOT APPLICABLE '( OTHER THAN EA ACC $ XXXXXXX I / 1"\ /1 AUTO ONL Y: AGG $ XXXXXXX EXCESS/UMBRELLA LIABILITY 6'f6- ~ EACH OCCURRENCE $ XXXXXXX U OCCUR [::::::::::J CLAIMS MADE NOT APPLICABLE AGGREGATE s XXXXXXX ,. s XXXXXXX o UMBRELLA ee' ~ DEDUCTIBLE FORM $ XXXXXXX RETENTION $ S XXXXXXX WORKERS COMPENSATION AND X I we STATU- I IOTH- A W A 7 -651-004245-019 10/] 12009 10/1/20 I 0 TORY LIMITS ER EMPLOYERS' LIABILITY ANY PROPRlET08JP ARTNERlEXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? NO El.. DISEASE - EA EMPLOYEE S 1,000,000 If yes, describe under SPECIAL PROVISIONS below EL. DISEASE. POLICY LIMIT S 1,000,000 OTHER DESCRIPTION OF OPERATIONS fLOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS MONROE COUNTY BOARD OFCOUNTY COMMISSIONERS ARE ADDITiONAL INSUREDS AS REQUIRED BY CONTRACT CERTIFICATE HOLDER 10602272 Nl0NROE COUNTY BOARD OF COUNTY COivll\-1ISSIONERS 11 00 SI~10NTON STREET KEY "VEST FL 33040 CANCELLATION 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 LEFT. BUT FAILUR~ TO 00 SO SHALL ~ ~ c.,-:~ ACORD 25 (2001/08) ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) `� 12/29/2016 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 CONTACT MCGRIFF,SEIBELS&WILLIAMS,INC. PHON , . P.O.Box 10265 A/C.No,Eat):E 800-476-2211 (A C,No): Birmingham,AL 35202 E-MAIL ..- ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Steadfast Insurance Company 26387 INSURED:------ Fishefineh's'Hospital INSURER B: 3301 Overseas Highway INSURER C: Marathon,FL 33050 INSURER D: INSURER E: INSURER F: COVERAGES . CERTIFICATE NUMBER:BSUFZ57U 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 ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY HPC017424002 01/01/2017 01/01/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED X CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ 50,000 MED EXP(Any one person) $ 5,000 - - PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: .. .. - -GENERAL AGGREGATE--'•- $ 3,000,000 RO- X 1 POLICY JECT LOC - PRODUCTS-COMP/OP.AGG .$ - • 3,000,000 OTHER: $ . AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT-_ (Ea accident) $ • ANY AUTO - -- - BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident $ AUTOS _ AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ — AUTOS (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 $ A Professional Liability HPC017424002 01/01/2017 01/01/2018 Each Incident $ 1,000,000 Aggregate $ 3,000,000 $ $ $ 'DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) • APPRO ED GEMENT BY WAIV R / Y S AC,- �+I • CERTIFIC/iTE HOLDER CANCELLATION L N• ,, ,Le _ 6 G.,: G SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County Board of County Commissioners AUTHORIZED REPRESENTATIVE �StreetSuite 408 Key West,FL 33040 Page 1 of 1 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD ACRD ® DATE (MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 04/18/2016 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 CONTACT NAME: MCGRIFF, SEIBELS & WILLIAMS, INC. P.O. Box 10265 (A/C, No. Ext): 800-476-2211 FAX No): Birmingham, AL 35202 E - MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :Steadfast Insurance Company 26387 INSURED INSURER B : Fishermen's Hospital 3301 Overseas Highway INSURER C : Marathon, FL 33050 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: H3K66PXS 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 W P OLICY NUMBER VD (MM /DD/YYYY) (MM /DD/YYYY) A X COMMERCIAL GENERAL LIABILITY HPC017424001 01/01/2016 01/01/2017 EACH OCCURRENCE $ 1,000,000 DAMAGE TO X CLAIMS - MADE OCCUR PREMISES (Ea occurrence) $ 50,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GE AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _ $ 3,000,000 X POLICY I I PRO ri LOC PRODUCTS7COMP /OP AGES � 3,000,000 ,78--r Li ate t -` OTHER: .� AUTOMOBILE LIABILITY EOM @tE LIMIT � $ Q - AN AUTO BODILY INJ19Ri' r person) - ALL OWNED SCHEDULED BODILY INJIJI3r accident�'y6 CD AUTOS AUTOS 70 - AT ED PROPERTY CATA HIRED AUTOS AUTOS OS (Per accident�sr Al �� r" r'f"i UMBRELLA LIAB OCCUR EACH OCCUNiENCE XI b EXCESS LIAB CLAIMS -MADE AGGREGATEr ,...1 ' ..J DED RETENTION $ WORKERS COMPENSATION I PER UTE I OT IER AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE Y / N 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 $ A Professional Liability HPC017424001 01/01/2016 01/01/2017 Each Incident $ 1,000,000 Aggregate $ 3,000,000 $ $ $ DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more spf• is r . uir( 4 N pe. FMENT Cwl - 1-frt 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. Monroe County Board of County Commissioners AUTHORIZED REPRESENTATIVE 1111 12th Street Suite 408 Key West, FL 33040 ;" ! Page 1 of 1 © 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD DATE (MM /DD/YYYY) A P © ® CERTIFICATE OF LIABILITY INSURA 03/12/2015 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). CONTACT PRODUCER NAME: FAX MCGRIFF, SEIBELS & WILLIAMS, INC. (n/ r o X , Extl: 600 476 - 2211 (A FA , No): P.O. Box 10265 (A/C. Birmingham, AL 35202 ADDRESS: 1 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :Zenith Insurance Company 13269 INSURED INSURER B : Fishermen's Hospital INSURER C 3301 Overseas Highway Marathon, FL 33050 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:FYES7D7U REVISION NUMBER: THIS IS TO THAT THE INDICATED. CERTIFY NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT TRACT OR OTHER DOCUMENT WITH RESPECT TOLIWHICH 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE W INSD VD POLICY NUMBER (MM /DD/YYYY) (MM /DD/YYYY) EACH OCCURRENCE I $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED CLAIMS -MADE I I OCCUR PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GE 'L AGGREGATE LIMIT APPLIES PER'. POLICY 1 1 JECT PRO- 1 I LOC PRODUCTS - COMP /OP AGG $ $ OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY (Ea accident) $ BODILY INJURY (Per person) $ ANY AUTO ALL OW _ NED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS — NON -OWNED —PROPERTY DAMAGE $ (Per accident) HIRED AUTOS AUTOS $ EACH OCCURRENCE $ UMBRELLA LIAB OCCUR EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTION $ I STATUTE I I A WORKERS COMPENSATION Z126569401 04/01/2015 04/01/2016 X AND EMPLOYERS' LIABILITY Y I N E.L. EACH ACCIDENT . $ 500,000 ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? E .L. DISEASE - EA EMPLOYEE $ and (Mandatory in If yes, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below $ $ $ $ $ DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) APP '• �: , �I • GEMENT DA "'AI[lraL! W " /A — C (. C bt r, s fir__.- ' • jI`) 'YZl CERTIFICATE HOLDER CANCELLATION 7 Z . ZI 11 t - a r'OZ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE L _ ] THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. i .J b ii 3'3 i d O J 031:j AUTHORIZED REPRESENTATIVE Monroe County Board of County Commissioners 1100 Simonton Street a Key West, FL 33040 Page 1 of 1 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD ` „.......,. 1 FISHERI OP ID: LD ACO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 06130/2014 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 pollcy(les) 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 Phone: 407 -513 -6365 CONT McNeary, Inc. Fax: 407. 423 -4648 PHONE 1 FAX 307 Park Lake Circle (pJC, No. Eat! (A/C, Not: Orlando, FL 32803 ADDRESS: McNeary, Inc. - Florida INSURER(S) AFFORDING COVERAGE NAIC V INSURER A : Zurich American Insurance INSURED Fishermen's Hospital INSURER 0: Hal Leftwich 3301 Overseas Hwy INSURER C : . • Marathon, FL 33050 -2329 INSURER D: 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 AWL SUBR' POLICY EFF POYYYI LICY EXP LIMITS LTR INSR INVD POLICY NUMBER IMMIDO/Y (MMIDDYYt /YY GENERALLIABIUTY EACH OCCURRENCE 5 1,000,000 EMSES Eace A X COMMERCIAL GENERAL LIABILITY X HPC017424000 07101 /2014 01/01/2016 pR $ 60,000 X CLAIMS -MADE I I OCCUR MED EXP (Any one person $ 6,000 PERSONAL & ADV INJURY 5 1,000,000 GENERAL AGGREGATE 5 3,000,000 GEN'L AGGREGATE UMIT APPLIES PER: PRODUCTS - COMP/OP AGG 5 3,000,000 — 1 POLICY n J R n LOC S AUTOMOBILE LIABILITY (Ea COMBINED SINGLE LIMIT i — ANY AUTO BODILY INJURY (Per person) 5 ALL OWNED SCHEDULED BODILY INJURY (Per accident) S AUTOS AUTOS NON -OWNED PROPERTY DAMAGE S HIRED AUTOS AUTOS (Per accident) S UMBRELLA LIAB OCCUR EACH OCCURRENCE S 5,000,000 — A EXCESSLIAB X CLAIMS -MADE HPC017423B00 07/01/2014 01/01/2016 AGGREGATE S 5,000,000 DED 1 1 RETENTIONS 5 WORKERS COMPENSATION l WCSTATU- 10TH- AND EMPLOYERS' LIABILITY Y1 N I TORY LIMITS I ER ANY PROPRIETOR/PARTNER /EXECUTIVE I I N/ A E.L. EACH ACCIDENT 5 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L DISEASE - EA EMPLOYEE 5 U YYen describe und er E.L. DISEASE - POLICY LIMIT 5 DESCRIPTION OF OPERATIONS below A Professional HPC017424000 07/01/2014 01/01/2016 Ealncid 1,000,000 Aggregate 3,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is requl : d) 4 0 . entail: diaz- christine @monroecounty- FL.gov D LIMO Wit -. GIeitC 'jj .{{ Cktv ;sfi�- WZ CERTIFICATE IYOLt] INHO3 34iN0w CANCELLATION �� s bra lilt SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN �� ,f � 1 � j (��/ ^ h(�}) ACCORDANCE WITH THE POLICY PROVISIONS. om o , t 4 s t lOG AUTHORIZED REPRESENTATIVE Diaz e(\ . 444 t IKev West, FL 33OZ0 ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD A CERTIFICATE OF LIABILITY INSURANCE DA"IMMI°DNY"' ,0/26/2012 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,ANDTHE 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 endorsament(s). PRODUCER COX MC MCGRIFF,SEIBELS&WILLIAMS,INC. PHONE IRAX P.O.Box 10265 INC.No Ext.BOOJI62211 (A/C No): _ . Birmingham,AL 35202 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIL* INSURER A:Evanston Insurance Company _ 35378 INSURED IX8uRE0.B: Fishermen's Hospital 3301 Overseas Highway INSURER C. Marathon,FL 33050 INSURER D'. INSURER INSURER F: COVERAGES CERTIFICATE NUMBER:4CFPEHZM 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 RAID CLAIMS. Mee- ADDL SUSS --- -- : POLICY EFF POLICY EXP LIMBS Lila TYPE OF INSURANCE INS ND/Y R WED POLICY NUMBER IMMODIYYYTI (MMYYYI A GENERAL MOBILITY SM087987 07I01/2012 07/01/2013 EACH OCCURRENCE 1000,000 UAMAbk TO RENTED _. 50.000 X COMMERCIAL GENERAL LIABILITY • PREMISES(Ea occurrence] ' X CLAIMS-MADE OCCUR MED EXP(Any one person) 5,000 X Retro Date:7/1/2011 PERSONAL BAW INJURY 1,IXq,030 GENERAL AGGREGATE 3.000,000 GENt AGGREGATE LIMIT APPLIES PER'. r PRODUCTS-COMP/OPAGG 1,000,000 POLCY7 PGR nLW _. -. AUTOMOBILEOABIIJTY ^/X y —COMBINED RY(PE LIMIT $ A Y AUTO TO V'\U Roll IBWILV INJUM(Perperwn) $ — ALL OWNED SCHEDULED AUTOS AUTOS BODL JURY(PerevlEani) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS �� - (Peraccident) _ _ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAMSMADE AGGREGATE $ _ DED RETENTION - �- - $ WORKERS COMPENSATION WC STATU- OTH. AND EMPLOYERS'LMBnrtY YIN TORY LIMITS. ER __...- ANY PROPRIETORPW ANENEXECUTIVE II NIA I EL.EACH ACCIDENT 1OFFICER/MEMBE . Mandatory In NH)EXCLUDED? E L.DISEASE-EA EMPLOYEE S It yes.describe under DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT A Hospital Preessional Liability SM887987 07/01/2012 07/01/2013 Aggregate 3,000,000 Claims Occurrence 1.000,000 Retro Date:7/1/2011 ecw-eialDN OF OPERA-GONE/LOCATIONS/VEHICLES (Attach ACORD I➢I,Addxmn.Remarks Schedule,H 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, Monroe County Board of County Commissioners 1100 Simonton St AUTMORMED REPRESENTATIVE Re 2-268 -daws.me Keyy West, est FL 33040 k 4'�Rh Page 1 of 1 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Rae, CERTIFICATE OF LIABILITY INSURANCE DATEMMoDIYYYYI 10/26/2012 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(les)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 cerilllcate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER ARTHUR J GALLAGHER RISK NAAMe T ROBIN THOMPSON,CSR 4904 EISENHOWER BLVD STE 250 PHONE Ear(TOT)]9T-41R0 INC.NRI: ADDDRESS,ROBIN THOMPSON®A Ni POM INSURER(8)AFFORAINO COVERAGE NAIL A TAMPA FL 3313345353 INSURER A!FWCJUA INSURED FISHERMEN'S HOSPITAL INC ORA FISHERMEN'S COMMUNITY HC INSURER B: 3301 OVERSEAS HIGHWAY INSURERct INSURER C: MARATHON FL 33050 INSURER E: FEIN:590914771 INSURER F: COVERAGES CERTIFICATE NUMBER:121026000 REVISION NUMBER: THIS I5 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. UMW TYPE OF INSURANCE IUR SLIER POLICY NUMUER IMMNpYV1YI IMMMTGWYYYYI LAM GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIALOENERAL JA IUTY PREMISES(EaONhMcel - $ CWMS.MADE u OCCUR MEDEXp(Any mL pnon $ PERSIXUL6ADV INJURY $ I ..... GENERMAGGREGATE 1 — GENLAGGREGATE LIMIT APPDE$PER: _ � PROn11CTS.CgBP/OPAOO $ I POLICY I I ii�r n �Lac Y `A� 5 AUTOMOBILEYABILM .� / COMDINEOSINGLE UMn(Es atelden1) S MIYAVSC 11//1 BODILY INJURY(PttArgo) 5 - ALL OWNED — SCHEDULED BODILY INJURY(Per ,&. ) 5 AUTOHIRED S AUTOS AVIOS NON:OOWt1ED PROPERTY DAMAbE $ _AUTOS IPeeWOMU 3 UMBRELLA LIAR —OCCUR EACHCCCURRENCE 5 EXCESS LIAAR CIAMSMAOE AGGREGATE 5 W MPEN TENTONS 5 OEO MINERSSATON • AND EMPLOYERS'UABILRYTORYNCSTAUMISTUI ER A ANY PA OPRIETORNARTIERIEXECUIVE Y ❑ 2849C187 8/R/2012 R/B/2013 E)(L.EACHACCIDEm $1 000 ODD 00 OMCEMEMBER EXCLUDED, N N/P IMeOtlebryln NN) FL DISEASE-EA EMPLOYEE I.1.000.000.00 Emanate. RioWNWe nFl EL.DISEASE-POLICY LIMIT Si,000,000,00 MN xnPFRgI0IL9 Wow DESCRIPTION OF OPEMPOASlLOCATIONSI VEHICLES IANsch ACORD 101,Additional Ramada UaAatula.a Mors space la n WIn[I 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 ACCORDANCE WITH THE POLICY PROVISIONS. Room 2-268 Key West FL 33040 AUTHORIZED REvnee¢xrATWS (y�/ Phontlumber 305292-4537 "tl' 1JPU, O 1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD A Rd CERTIFICATE OF LIABILITY INSURANCE oa rzovz� 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(es)must be endorsed. H SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A slalament on this certificate does not confer rights to the certificate holder In lieu of such endonement(s). PRoDucEn CORM( MCGRIFF SEIBELS&WILLIS,PIA INC. AaN' RD.Bw 10265 PLO ie e• 800476-2211 FAX WC Birmingham,AL 35202 L - Pc NM ADDRE00: INIUREWBI AFFORDING COVERAGE ANC, - NSURER A:Evanston Insane.Company 35378 INSURED mens Xwpllel xsURER a: 3301 Overseas H'phway SSUAER c: Marathon,FL 33050 xeuue 0: mama fi: ItlweR A: COVERAGES CERTIFICATE NUMBERABSTLX]S REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREO 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. ion INSURANCE p WBRSNYn Y NUMBER IMANY IF! `POLICYPM DnYYYY1 Lane GENERAL UAOIUTY W eR SMBOI9SIP0 0Imm1(2012 0701 Q013 EACH OCCURRENCE i W0,000 IRD X COMMERCIAL GENERAL LIABILITY PREMISES TUoco;yn•nul 50'000 X CLAIMS.MACE [ I OCCUR 1EO X Relro Date✓ll/2011 PEE(Arynne Pmnt 5,W0 PERSONAL B ARV INJURY 1,000.000 GENERAL AGGREGATE 3000.000 - GRNti AGGREGATE LIMIT APPLIES PER. DUCTS-COwRWAOG 1,000.000 ^ POLICY I IJFrt ^LOC PRO AUTOMOBILE UABILfTY COMBINL 05INGLELIMIT ANY AUTO L sand f — ALL OWNED —SCHEDULED BODILY INJURY IPorp•r•:n 5 HIIOD NUmS a a' BO lictiMe PxE•¢E•nn $ ON rvE0 fx RE00YTOSS P (Pr KNOPEU _- ( yamA{ IA - - f UMBRELLA LW OCCUR Ry V' EACH OCCURRENCE 5 — Excess HAD CLAMS-MADE \/ AGGREGATE 5 DED RETENTIONS II1 WORKERS f EMPLOYERS'LIABILITY nN OR LIMIT mR. R AI ER OTnWRNEMBER EXCLUDED? iNE I I MIA EL.EACH ACCIDENT $ IMYo�desmry halil EL.DISEASE-EA EMPLOYEE $ OESCRIPTION OF OPERATIONS teox EL.DISEASE-POLICY LIMIT DESCRIPTION OP OPERATIONS r LOCATINS;VENUES(Much ALONG W.ANWn•I Remark.Sch•Cul•,Pinion spice le •pulr•al 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. Monroe County Board of Ccunly Commissioners 1100 Simonton St A TNORBEB REPRESENTATIVE Room 2-268 �VJrI Q h Nay West,FL 33000 CJf 164..Q+➢:-Q Page 1 of 1 01998-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORO name and logo are registered marks of ACORD l L - ATECORD CERTIFICATE OF LIABILITY INSURANCE 10,IR010 "TW r00 PRODUCER LMI.IOn Companies,LLC-I Kansas CHU THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 1u W a-m SOeeL S le goo -MOWER. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE KansasND OR Cg MO/L 1'_-loU6 (( AO �HE OOV RAGE AFFORDED BOYTTHE POLICIES EBELOW. 816)ono 0000 �E�_I � IV �. INSURERS AFFOR ING COVERAGE NAIC N INSURED HEALTH MANAGEMENT ASSOC AIIS.INC RsURER A LlbinaM ul ialai I _uranceC Dpany 23043 13L'DC' 41411 PELICAN BAN RI-A IN IlllblallEfta 1 Sill F Soo INSURER N.PLES R.1.110R-2PI0 -- - - IIT INAJMEAIE. THIS HE ISSUING COVERAGES III,NNI A03 HD RENS)AUTHOHZED REPRESENTATIIVE OR PRODUCERP CONTRACT ND THE CERTFFICATE H 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 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. LTR NSR• TYPE OF INSURANCE POLICY NUMBER DATE(MWDNYY) POLICYFFECTIVE DATE IMWODIYIYI LIMITS GENERAL LIABILITY EACH OCCURRENCE XXXXXXX PREMISESORENTEO COMMERCIAL GENERAL LIABILITY NOT APPLICABLE DAMAGE Eattcurenael $ XXX XXXX CLAIMS MADE OCCUR EXP LAny one person) 5 XXXXXXX PERSONAL B ADV INJURY 5 XXXXXXX I. GENERAL AGGREGATE S XXXXXXX GENT AGGREGATE I MIT APPJPS PER PRODUCTS COMP/OP AGO S XXXXXXX POLICY E ] & FILM AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - oass A ® ANY AUTO AS2 o5 I-OLWN_0.5-029 IO/I/'_Lx19 IQI/2010 ,Ea accidanf) ' � . ALL OWNED AUTOS BODILY INJURY SCHEDULED AU COHS IPEI Pe'eon) S XXXXXXX gi gi NR OOND-OrvED AUTOSwNEDAUTOS (Pee Pe ea aenllINJU $ XXXXXXX JJJPROPERTY ident) RAGE $ XXXXXXX GARAGE LIABILITY AUG)ONLY-EAACGIDENE 5 XXXXXXX ANY AUTO NOT APPLICABLE X olnee THAN EA ACC S XXXXXXX (/�� ,wmONLY A O S XXXXXXX EXCESS/UMBRELLA LIABILITY 1//Ip�(i EACH OCCURRENCE $ XXXXXXX . OCCUR I CLAIMS MADE NOT APPLICABLE A'V-�"/�'� AGGREGATE $ XXXXXXY P '/ 1. 5 XXXXXXX UMBRELLA Clll\/T/1 t��� 1 ■ OEDUGTIDL£ (�FORM � � 5 XXXXXXX RETENTION S S XXXXXXX A WORKERS COMPENSATION AND WA?G51-0042_4 S-019 10/IR000 10/1/2010 X TORY( T RATS ER EMPLOYERS LIABILITY E.L.EACH ACCIDENT 5 I,OW,IXN) NY PROPPIETORP.ARTNEll SUEEXECU vE ANY EXCLUDED^ NO E.L.DISEASE.EA EMPLOYEE S I,INNI,(NNI If pm ys Snubsum« SPECIAL PROVISIONS bebry F I_DISEASE POLICY LIMIT S I,000OLH1 OTHER DESCH!PPON OF OPERAT!ONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS 40NRO (It IVNULt xlUSlpN .. >IIIO%SE!Gal ROG la Eg1.[RI LONIH3.1 CERTIFICATE HOLDER CANCELLATION 10602272 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION MONROE CIOINTY BOARD OF COUNTY COMMISSIONERS DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN I I1)0 SIMONTON STREET NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL KEY WEST FL 311140 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER.ITS AGENTS OR / REPRESENTATIVES. n AUTHOR PRESENTATIVE ACORD 25(2001/0B) Ts.,q, stbns,eem^u ms cemfi.t.lulluauss slot,"Fiala,'lull"PAt„m'says^loss.And S.ty is dls o NAm. 0 ACORD CORPORATION 1988