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Certificates of Insurance EASTMAN INSURANCE AGENCY, INC 4201 N FEDERAL HWY, SUITE E LIGHTHOUSE POINT, FL 33064 954 941-5090 FAX: 941-0442 INSURED .. n.___ ......._ ..... .. .. .. ,.... ::::::)':}:)}/{:: DATE (MM/DDIVY) .... ....H H" ....' H...... .. .,...())))))( 10 21 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 .:.:..:. At~..ltl."..J.:\,I,:.:.i,..,...I&..'....:,:'.::.II.:i'lj11111:11:11\1.'11_.1.....'..1...,:.:,..1,1..,1.:1.1.1.....1.11111&1 ;.;.:.:.:-:.:.;.:.:.;.:.:.;.:.:.;.:-:-.............. PRODUCER COMPANY A PARADIGM INSURANCE COMPANY HYATT & HYATT INC DBA BENIHANA RESTAURANT AND MARTHA'S RESTAURANT 3591 SOUTH ROOSEVELT BOULEVARD EY WEST FL 33040 COMPANY B COMPANY C 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 EXPIRA Tim: DATE (MM/DDIVY) DATE (MM/DDIVY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $2 000 000 COMMERCIAL GENERAL LIABILITY PRODUCTS. COMP/OP AGG $1 000 000 CLAIMS MADE [R] OCCUR PERSONAL & ADV INJURY $1 000 000 A OWNER'S & CONTRACTOR'S PROT CMP968510 7/6/96 7/6/97 EACH OCCURRENCE $1 000 000 FIRE DAMAGE (Anyone fire) $50 000 MED EXP (Anyone person) $-0- AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS BODILY INJURY ~ ,J~. (Per person) $ SCHEDULED AUTOS HIRED AUTOS BODILY INJURY 'ir'\"f\' $ NON-OWNED AUTOS (Per accident) 'r.:I'1,'!/- PROPERTY DAMAGE $ THE PROPRIETOR! PARTNERS/EXECUTIVE OFFICERS ARE: OTHER _."'" /" vcr: AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ ()~ 1(; EACH OCCURRENCE $ 8E/lG7rE AGGREGATE $ JUt'tJtf. If $ STATUTORY LIMITS EACH ACCIDENT $ DISEASE - POLICY LIMIT $ DISEASE - EACH EMPLOYEE $ GARAGE LIABILITY ANY AUTO OTHER THI\N UMBRELLA FORM EXCESS LIABILITY UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ;' .~; F INCL EXCL DESCRIPTION OF OPERA TlONS/LOCA TIONSNEHICLES/SPECIAL ITEMS THE CERTIFICATE HOLDER BELOW IS NAMED AS AN ADDITIONAL INSURED. PARKING LOT LEASE AGREEMENT--PREMISES AT SOUTH ROOSEVELT BLVD, KEY WEST, FL COUNTY OF MONROE 5100 COLLEGE ROAD KEY WEST, FLORIDA 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 FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY ATT: ,FAX: AgQ.I!lP~$~$O(~/~.@{ cc ~ KAY MILLER ~ O.~....?~, 2:,:::~..?,41! OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATI ~B~H"""""""""""" ::::::\::::::~A(;~RP:'QPRP9RA,..gNJ~i;i$ .:.:.:.;...........:.:.:.:.............:.:.:.:...............:.;....................................... ............................................................ . ...... ....... ....... ...... . ........................................... .................................. ....................... HHH H..H"""'H " 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 EASTMAN INSURANCE AGENCY, INC 4201 N FEDERAL HWY, SUITE E LIGHTHOUSE POINT, FL 33064 954 941-5090 FAX: 941-0442 COMPANY A PARADIGM INSURANCE COMPANY HYATT & HYATT INC DBA BENIHANA RESTAURANT AND MARTHA'S RESTAURANT 3591 SOUTH ROOSEVELT BOULEVARD EY WEST FL 33040 COMPANY B COMPANY C 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 EXPIRATION DATE (MM/DDIYV) DATE (MM/DDIYV) LIMITS GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 00 OCCUR A OWNER'S & CONTRACTOR'S PROT CMP 9 68510 GENERAL AGGREGATE $2 000 000 PRODUCTS - COMP/OP AGG $1 000 000 PERSONAL & ADV INJURY $1 000 000 7/6/96 7/6/97 EACH OCCURRENCE $1 000 000 FIRE DAMAGE (Anyone fire) $50 000 MED EXP (Anyone person) $-0- PFf r,'~' .,.... '.:"r\' In COMBINED SINGLE LIMIT $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS (),e/~ c~k.... BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ \"!,"TR: PROPERTY DAMAGE $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' LIABILITY AGGREGATE EACH OCCURRENCE EACH ACCIDENT $ $ $ $ $ THE PROPRIETOR! PARTNERS/EXECUTIVE OFFICERS ARE: OTHER AGGREGATE INCL EXCL STATUTORY LIMITS EACH ACCIDENT $ DISEASE. POLICY LIMIT $ DISEASE - EACH EMPLOYEE $ DESCRIPTION OF OPERATlONS/LOCATIONS/VEHICLES/SPECIAL ITEMS THE CERTIFICATE HOLDER BELOW IS NAMED AS AN ADDITIONAL INSURED. g~RI!E'QA!gff9bq~R::::::':::::f:::::::::::: ':::::t:t:::tm::tt::t:t:ttt:::tt::t::::::J;ANpgbMrlpN:: ., .. ................... .................... ................... ................... ;.;.::::::::::::::::::::::::::: ...................... .......................... . ......................... ...................... .................. . COUNTY OF MONROE ATTENTION: KAY MILLER KEY WEST, FLORIDA 33~40 FAX: 305 ].,J92 454...\, (C'.'--13~W~ A*QfO?::g$fk(:J~(':' 'iii/:;& '. . . 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 FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE AUTHORIZED REPRESENTATIVE ................. ." ;:::;::=::::::::;:::::;:::::;:::::;: ITS AGENTS OR REPRESENTATIVES. ~ t::::::{'lA*9fO:t@QRP9RAnQNjijQ~. ACORD 1M 01(013(1999 PRODUCER (305)743-0494 eys Insurance Agency P.O. Box 500280 Marathon, FL 33050-0280 FAX (305)743-0582 of Monroe County, Inc. 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 General Accident Attn: Gail Cain INSURED Ext: COMPANY A Hyatt & Hyatt, Inc. DBA Martha's & Benihana Restaurant 3591 South Roosevelt Blvd. Key West, FL 33040 COMPANY B Fl Hospitality Mutual Ins Co 3D") ,/, COMPANY C COMPANY D 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 (MM/DDIYY) LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X OCCUR 0045795016772 OWNER'S & CONTRACTOR'S PROT X Liquor Liability GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 1,000,000 07/06/1998 07/01/1999 PERSONAL & ADV INJURY $ 1,000,000 EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Anyone fire) $ 50,000 MED EXP (Anyone person) $ 5,000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' LIABILITY COMBINED SINGLE LIMIT $ BODILY INJURY $ (Per person) BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH $ AGGREGATE $ EACH OCCURRENCE $ AGGREGATE $ a1Q. $ "Y Jll:U(Ji';r of UME__ ~_qq ~ if? /;,,' ,eYES -. GARAGE LIABILITY ANY AUTO B THE PROPRIETORI PARTNERS/EXECUTIVE OFFICERS ARE: OTHER INCL EXCL BINDER 01/01/1999 01/01/2000 TORY LIMITS ER EL EACH ACCIDENT EL DISEASE - POLICY LIMIT $ $ 500,000 500,000 500,000 EL DISEASE - EA EMPLOYEE $ DESCRIPTION OF OPERATlONS/LOCATIONSNEHICLES/SPECIAL ITEMS Certificateholder listed as additional insured......... Liquor Liability limits are: each common cause $l,OOO,OOO-Aggregate $1,000,000 Employee Benefits-Claims Made form-Limits are: $l,OOO,OOO-Aggregate $l,OOO,OOD County of Monroe ATT: Kay Miller 5100 Junior College Road DATE 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 FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE N NTATIVES. ACORD 25-5 (1195) @ACORD CORPORATION 198 ACORD TM FAX (305)743-0582 of Monroe County, Inc. 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 General Accident Ins. Co. of America PRODUCER (305)743-0494 eys Insurance Agency P.O. Box 500280 Marathon, FL 33050-0280 Attn: Gail Cain INSURED Ext: COMPANY A Hyatt & Hyatt, Inc. DBA Martha's & Benihana Restaurant 3591 South Roosevelt Blvd. Key West, FL 33040 COMPANY B F=A .x-F!?~ 1 1998 q~ :tJ3Ii'1 / COMPANY C THIS IS TO CERTIFY THAT THE POLICIES OF IN URANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUR D NAMED ABOV 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 (MM/DDIYY) DATE (MM/DDIYY) LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X OCCUR 0045795016772 OWNER'S & CONTRACTOR'S PROT X Liquor Liability A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS X HIRED AUTOS X NON-OWNED AUTOS 0045795016772 GARAGE LIABILITY ANY AUTO EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' LIABILITY THE PROPRIETOR! PARTNERS/EXECUTIVE OFFICERS ARE OTHER INCL EXCL DESCRIPTION OF OPERA TlONS/LOCA TIONSNEHICLESlSPECIAL ITEMS Certificateholder listed as additional insured... ...... Liquor Liability limits are: each common cause $l,OOO,OOO-Aggregate $1,000,000 Employee Benefits-Claims Made form-Limits are: $l,OOO,OOO-Aggregate $1,000,000 County of Monroe INn1AL ATT: Ke.) P1; 11 er- fYJMllq ""J)f_L /C/o 5100 Junior College Road Key West, FL 33040 DAtE 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 FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE AUTHORIZED REPRESEN ACORD _TM DATE (MM/DDIYY) 08/03/1999 PRODUCER (305)743-0494 eys Insurance Agency P.O. Box 500280 Marathon, FL 33050-0280 FAX (305)743-0582 of Monroe County, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR AL rER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE General Accident Attn: INSURED Ext: COMPANY A Hyatt & Hyatt, Inc. Martha's Restaurant & Benihana Restaurant 3591 South Roosevelt Blvd. Key West, FL 33040 COMPANY B Fl Hospitality Mutual Ins Co COMPANY C COMPANY D IS 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 EXPIRATION DATE (MM/DDIYY) DATE (MM/DDIYY) LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X OCCUR 0045795016772 OWNER'S & CONTRACTOR'S PROT XLi quor L i abi 1 i ty GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ $ $ $ 2,000,000 1,000,000 1,000,000 1,000,000 50,000 5,000 07/06/1999 07/06/2000 PERSONAL & ADV INJURY EACH OCCURRENCE FIRE DAMAGE (,A,ny one fire) MED EXP (Anyone person) AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS COMBINED SINGLE LIMIT $ ...y BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ NTE PROPERTY DAMAGE $ GARAGE LIABILITY ANY AUTO EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EACH OCCURRENCE $ AGGREGATE $ $ B THE PROPRIETORI PARTNERS/EXECUTIVE OFFICERS ARE OTHER INCL 30606011 01/01/1999 01/01/2000 - TORY LIMITS ER EL EACH ACCIDENT EL DISEASE - POLICY LIMIT $ $ 500,000 500,000 500,000 EXCL EL DISEASE - EA EMPLOYEE $ DESCRIPTION OF OPERA TlONS/LOCA TlONSNEHICLES/SPECIAL ITEMS '**Additional Insured County of Monroe ATTN: Maria DelRio 5100 Junior College Road Key West, FL 33040 INITIAL 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, AlLURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED ACORDTM CERTI ICATE OF LIABILITY INSURANCE DATE (MMlDDIYY) 01/03/2000 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 Fl Hospitality Mutual Ins Co PRODUCER (05)743-0494 eys Insurance Agency P.O. Box 500280 Marathon, FL 33050-0280 FAX (305)743-0582 of Monroe County, Inc. Attn: Ext: COMPANY A INSURED Hyatt & Hyatt, Inc. Martha's & Benihana Restaurants 3591 South Roosevelt Blvd. Key West, FL 33040 301 COMPANY B 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 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 l'/''!.TR: POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE (MMlDDIYY) DATE (MMlDDIYYI GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ PERSONAL & ADV INJURY $ EACH OCCURRENCE $ FIRE DAMAGE (Anyone fire) $ MED EXP (Anyone person) $ COMBINED SINGLE LIMIT $ BODILY INJURY $ (Per person) BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ ~ EACH OCCURRENCE $ AGGREGATE $ 0l/01/2000 01/01/2001 $ 500,000 EL DISEASE - POLICY LIMIT $ 500,000 EL DISEASE - EA EMPLOYEE $ 500 000 TYPE OF INSURANCE POLICY NUMBER GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR OWNER'S & CONTRACTOR'S PROT AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS '"~',,,,!w_r':,""''-' ~ l I \ \' ". ... L'Y__.: _ f1tl'f - -- ---- f'i. ,,~ GARAGE LIABILITY ANY AUTO EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' LIABILITY A THE PROPRIETOR/ PARTNERS/EXECUTIVE OFFICERS ARE: OTHER 30606041 INCL EXCL DESCRIPTION Of OPERATIONSlLOCATIONSNEHICLESlSPECIAL ITEMS -~tt Countyof Monroe Monroe County Risk Management 5100 College Road Key West, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY \/\/ILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ederick Aiken ACORQM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYY) 01/11/2001 PRODUCER (305)743-0494 FAX (305)743-0582 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Keys Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 500280 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Marathon, FL 33050-0280 INSURERS AFFORDING COVERAGE INSURED Hyatt & Hyatt, Inc. INSURER A: Burlington Ins Co Martha's Restaurant & Benihana Restaurant INSURER B Restaurant Owners PC Inc 3591 South Roosevelt Blvd. INSURER c: Fl Hospitality Mutual Ins Co Key West, FL 33040 INSURER D: I 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, I~TR TYPE OF INSURANCE POLICY NUMBER P~}+~Y ~~~5DmE GENERAL LIABILITY INDER 01/04/2001 A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 0 OCCUR XLi quor L i abi 1 i ty EACH OCCURRENCE LIMITS FIRE DAMAGE (Anyone fire) MED EXP (Anyone person) PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS '''-1). COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY $ (Per person) BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ (Per accident) AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY AGG $ 01/04/2002 EACH OCCURRENCE $ AGGREGATE $ $ $ $ GARAGE LIABILITY ANY AUTO EXCESS LIABILITY INDER X OCCUR D CLAIMS MADE B DEDUCTIBLE RETENTION $ WOR,KERS COMPENSATION AND EMPLOYERS' LIABILITY 01/01/2001 01/01/2002 30606041 C $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATlONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ertificateholder is additional insured as their interest may appear (not applicable to work comp) CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Monroe County Board of County Commissioners Monroe County Risk Management 5100 College Road Key West, FL 33040 $ $ $ 1,000,00 50,00 5,00 1,000,00 2,000,00 1,000,00 1,000,000 500,00 500,00 500,00 C TIFICATE HOLDER NAMED TO THE LEFT, ALL IMPOSE NO OBLIGATION OR LIABILITY ACORD 25-S (7/97) @AcORDcORPORATION 1988 ACORQM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYY) 04/17/2002 PRODUCER (305) 743-0494 FAX (305)743-0582 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Keys Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 500280 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Marathon, FL 33050-0280 INSURERS AFFORDING COVERAGE INSURED Hyatt & Hyatt, Inc. INSURER A: Northfield Ins Co. 3591 South Roosevelt Blvd. INSURER B: Great American Alliance Ins Co Key West, FL 33040 INSURER c: Fl Hospitality Mutual Ins CO INSURER D: I 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 TYPE OF INSURANCE POLICY NUMBER P~l-+~~~~~gg;W~ Pg~!fll~~~~N LIMITS LTR ~NERAL LIABILITY ICP424760 01/04/2002 01/04/2003 EACH OCCURRENCE $ I,OOO,OO(J COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ 100,OO(J I CLAIMS MADE [K] OCCUR MED EXP (Anyone person) $ 5,OO(J ,"- X Liquor Liability PERSONAL & ADV INJURY $ I,OOO,OOCJ ",-,- GENERAL AGGREGATE $ 2 ,000 , OOCJ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ include~ II ,nPRO- n POLICY JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT f-- $ ANY AUTO /"'" \ ^ ) E~':'I,l (Ea accident) - AP'J\~!V B~ R"v J 1/ L J - ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS - (Per person) - BY , \ -1~ 11X - HIRED AUTOS BODILY INJURY DATE ~ $ NON-OWNED AUTOS (Per accident) - N/A_YE - WAIVER . PROPERTY DAMAGE $ (Per accident) ~RAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY ~MB5525467076 01/04/2002 01/04/200,i EACH OCCURRENCE $ I,OOO,OOC ~ OCCUR D CLAIMS MADE AGGREGATE $ B $ =l DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND 30606041 01/01/2002 01/01/2003 I TORY'LIMITS I IU~R- EMPLOYERS' LIABILITY 500,000 C E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONSlLOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Certificateholder is listed as an additional insured in the GL policy. CERTIFICATE HOLDER I X I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION 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, Monroe County Board of Commissioners BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 1100 Simonton Street OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. Key West , FL 33040 AUTHORIZED REPRESENTATIVE t'Y, II rw 'llIK ~ i.... j . I/~ YI"'\ ACORD 25-5 (7/97) FAX: 295-4342 @ACORD l:ORPORA TION 1988 ACORQM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYY) 04/17/2002 PRODUCER (305) 743-0494 FAX (305)743-0582 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Keys Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 500280 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Marathon, FL 33050-0280 INSURERS AFFORDING COVERAGE INSURED Hyatt 8r Hyatt, Inc. INSURER A: Northfield Ins Co. 3591 South Roosevelt Blvd. INSURER B: Great American Alliance Ins Co Key West, FL 33040 INSURER c: Fl Hospitality Mutual Ins CO INSURER D: I 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 TYPE OF INSURANCE POLICY NUMBER p~.k+~~i~~8gmr Pg~!flr~';~~N LIMITS LTR GENERAL LIABILITY P424760 01/04/2002 01/04/2003 EACH OCCURRENCE $ I,OOO,OO(J - 100,OO(J COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ I CLAIMS MADE [K] OCCUR MED EXP (Anyone person) $ 5,OO(J A X Liquor Liability PERSONAL & ADV INJURY $ 1,000,OO(J - GENERAL AGGREGATE $ 2,OOO,OO(J f-- GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COM~OPAGG $ includecl n .nPRO- n POLICY JECT LOC ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ~n (Ea accident) f-- ALL OWNED AUTOS ~ppm ED~~IBj~ DODlL Y INJURY '-- ~EMENT $ SCHEDULED AUTOS (Per person) f-- HIRED AUTOS (tk: BODILY INJURY '-- $ ~ /~ (Per accident) NON-OWNED AUTOS " l oi.T' f-- DATE ~ - .' ,~- ~ Pp~~:W?AMAGE $ lA/II IIIL:O r..1/11 V :c: (Pe 'e) GARAGE LIABILITY AUTO ONL)-: EA ACCIDENT $ =J ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY UMB5525467076 01/04/2002 01/04/2002 EACH OCCURRENCE $ 1,000,OO(J o OCCUR 0 CLAIMS MADE AGGREGATE $ B $ R DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND 30606041 01/01/2002 01/01/2003 I TORY LIMITS I IOJ~- EMPLOYERS' LIABILITY E,L. EACH ACCIDENT $ 500,OO(J C E.L. DISEASE - EA EMPLOYEE $ 500,OO(J E.L. DISEASE - POLICY LIMIT $ 500,OO(J OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS AD,QED BY ENDORSEMENT/SPECIAL PROVISIONS Certificateholder is listed as an additional insured in the GL policy. CERTIFICATE HOLDER I X I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION 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, Monroe County Board of Commissioners BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 1100 Simonton Street OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. Key West , FL 33040 AUTHORIZED REPRESENTATIVE y\'J)P k nl'~ Ii; 1,fA 0 /I -vv"'" ACORD 25-5 7/97 . - @ACORDCf)RPORATION 1988 FAX. 295 4342 ~CORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYY) 03/06/2003 PRODUCER (305) 743-0494 FAX (305)743-0582 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Keys Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 500280 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Marathon, Fl 33050-0280 INSURERS AFFORDING COVERAGE INSURED Hyatt & Hyatt, Inc. INSURER A: Northfield Ins Co. 3591 South Roosevelt Blvd. INSURER B: Great American Alliance Ins Co Key West, Fl 33040 INSURER c: Fl Hospitality Mutual Ins CO INSURER D: I INSURER E: 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~~: TYPE OF INSURANCE POLICY NUMBER Pg.k+~~~~~g8;W~ GENERAIL LIABILITY fc\PPLICATION 01/23/2003 f--- COMMERCIAL GENERAL LIABILITY I CLAIMS MADE [!] OCCUR A X liquor liability - COVERAGES Pg~!fl/~J;bRif'~N 01/23/2004 LIMITS $ $ $ $ $ PRODUCTS - COMP/OP AGG $ EACH OCCURRENCE FIRE DAMAGE (Anyone fire) MED EXP (Anyone person) PERSONAL & ADV INJURY GENERAL AGGREGATE - GEN'L AGGREGATE LIMIT APPLIES PER: I POLlCy-n j~8T n LaC AUTOMOBILE LIABILITY - ANY AUTO - "ro..../' """""'" ...., BY lye ... 'CD.AAA P " DATE -~?':1Q::0- ---- ~E((1/:~_YEL- ~p -U"r / . Yt 127 h;,ln ~tbrm5le ..... '-' OTHER THAN AUTO ONLY: AGG COMBINED SINGLE LIMIT (Ea accident) - _ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) HIRED AUTOS BODILY INJURY (Per accident) - _ NON-OWNED AUTOS PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT $ $ $ $ $ $ $ $ B GARAGE LIABILITY =J ANY AUTO EXCESS LIABILITY UMB5525467076 :J OCCUR D CLAIMS MADE I DEDUCTIBLE ~ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 01/01/2003 01/01/2004 I VVlo <>.", u- I IOTH- TORY LIMITS I I ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.l. DISEASE - POLICY LIMIT $ EA ACC 01/23/2004 01/23/2003 EACH OCCURRENCE AGGREGATE 30606041 C OTHER 1,000,000 100,000 5,000 1,000,000 2,000,000 included $ $ $ $ 1,000,000 500,000 500,000 500,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS c 0 p~: V\ v-,. ~ '" t<..- on the ~onroe County Board of County Commissioners is the Additional Insured (A) General liability Policy & (B) Excess liability Policy. ~onroe County Board of County Commissioners is the Certificate Holder on the (C) Workers Compensation Policy. CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION Monroe County Board of County Monroe County Risk Management attn: Maria Slavik 1100 Simonton Street Key West, Fl 33040 SHOULD ANY OF TH" 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 FAILURE TO MAIL SUCH NOTICE SHALL IMPOS~ OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPAtfI', ITS AGENTS_ 8EPRESENTATIVES. AUTHORIZED REPRESENTATIVE / .. /_ /' U Frederick Aiken lu~ ~ , v (0 @ACORDCORPORATION 1988 Commissioners ACORD 2S-S (7/97) FAX. (305)292-4564 ij?)7 ACORD.. CERTIFICATE OF LIABILITY INSURANCE 1 DATE (MMlDDIYY) 07/25/2000 PRODUCER (305) 743-0494 (305)743-0582 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Keys Insurance Agency of Monroe County, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 500280 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Marathon, FL 33050-0280 INSURERS AFFORDING COVERAGE INSURED Hyatt & Hyatt, Inc. INSURER A: Frontier Pacific Insurance Co Martha's Restaurant & Benihana Restaurant INSURER B: Fl Hospitality Mutual Ins Co 3591 South Roosevelt Blvd. INSURER c: Key West, FL 33040 INSURER D: I 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. I~;: TYPE OF INSURANCE POLICY NUMBER P~H~Y :~~8T1VE GENERAL LIABILITY 0000020 01/04/2000 X COMMERCIAl GENERAL LIABILITY CLAIMS MADE 00 OCCUR A X Liquor Liability LIMITS EACH OCCURRENCE $ $ $ $ $ PRODUCTS - COMP/OP AGG $ FIRE DAMAGE (Anyone fire) MED EXP (Anyone person) PERSONAL & ADV INJURY GENERAL AGGREGATE ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY $ (Per person) BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ (Per accident) AUTO ONLY - EA ACCIDENT $ OTHER THAN EAACC $ AUTO ONLY: AOO $ EACH OCCURRENCE $ AGGREGATE $ $ $ $ GARAGE LIABILITY ANY AUTO EXCESS LIABILITY OCCUR D CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 30606041 01/01/2000 01/01/2001 $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ B OTHER A DESCRIPTION OF OPERATlONSlLOCATlONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS dditional Insured CERTIFICATE HOLDER CANCELLATION ADDITIONAL INSURED; INSURER LETTER: 1,000,00 50,00 1,00 1,000,00 2,000,00 1,000,00 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 FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR lIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ~ Frederick Aiken County of Monroe Attention: Maria DelRio 5100 Junior College Raod Key West, FL 33040 ACORD 25-8 (7/97) PRODUCER INSURED ACORQM CERTIFICATE OF LIABILITY INSURANCE KEYS INSURANCE ASSOCIA'IES, P. O. BOX 500280 MARATHON, FL 33050 INC. 1 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. I I _I'NSUR"",E",R, S AFFORDH',jG COVERAGE ,." U_..! "N,A, IC~, . _.. JI'I~UHERA.QBE INSURANCE mRP. F._n~ INSURER B: FEDERAL INSURANCE m. ,~NSURER~ Fi,-EfOSPI'!'!iliITY MUTUALiNS.(~ .n '__ , INSURER D: I HYA'IT & HYA'IT, INC. 3591 S. R(X)SEVELT BLVD. KEY WEST, FL 33040 , 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. INSA ADD'C--- - -- POLICY EFFECTIVE LTR POLICY NUMBER DATE MM/DD Y Al I i I I GENERAL LIABILITY l IXCQMMERCIAL GENE~!,L LIABILITY i --l, ..J CLAIMS MADE IX] OCCUR 'I X_LIQOOR_LIABILI'I'Y.. ,GEN'L AGGREGA.~E LIMIT APPLIES PER: i 1 POLICY PRO-i LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS LIMITS SIM104583-04 1/23/04 EACH OCCURRENCE + $ 1,000,000 ! DAMAGE TO RENTED - I ~PFlEMI~ES.(ga occurence) I $...._lOQ,...O...QQ_ , I I MED EXP (Anyone person)_ $ 5 , 000. ..F'~.Fl..SONAL & ADV INJUF1Y .J~J , 000-,.000._ GENE~L!\GGREGATE !$...2&00, 000 PRODUCTS - COMP/OP AGG $ 2..,..0..00,000_ COMBINED SINGLE LIMIT $ (Ea accident) I ---------- ---- BODILY INJURY $ (Per person) _______________ _..._n BODILY INJURY (Per accident) $ AP BY DATE WAIVER PROPERTY DAMAGE (Per accident) $ ~UTO_ONLY-EAACCIDENT 1$--- , OTHER THAN EA ACC I $.___._.. AUTO ONLY: AGG 1$ EACH OCCURRENCE $ .1~OJlO._ l~:::EGA:_..-__~.=--=_ ~- 1;-- I W, C STATU- I OTH- I TORY LIMITS, ER n__.... E.L. EACH ACCIDENT $ ,J'.~.' ;ISEASE - E~ ~-;J:..OYE~~. . E.L. DISEASE - POLICY LIMIT ' $ ANY AUTO EXCESs/UMBRELLA LIABILITY 79535732-02 B .~ OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY C ANY PROPRIETOR/PARTNER/EXECUTIVE I OFFICER/MEMBER EXCLUDED? If yes, describe under I SPECIAL PROVISIONS below OTHER 1/1/05 1/1/04 30606041 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS MJNROE mUNTY BOAD OF mUNI'Y mMMISSIONERS IS LISTED AS AN ADDITIONAL INSURED: LESSOR ON THE (A) GENERAL LIABILTY POLICY. C'()~" ~~ cO--/~<-{ ..uY CERTIFICATE HOLDER CANCELLATION MJNROE mUNTY BOARD OF <X>UNI'Y mMMISSIONERS MJNROE mUNI'Y RISK MANAGEMENT ATl'N: MARIA SLAVIK 11 00 SIM:>N'IDN S'I'REID' KEY WEST, FL 33040 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 ACORD 25 (2001/08) @ ACORD CORPORATION 1988 ACORQM CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDD/YYYY) 03/11/2005 PRODUCER (305)743-0494 FAX (305) 743-0582 THIS CERTIFICATE IS ISSUED AS A MAnER OF INFORMATION Keys Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 500280 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Marathon, FL 33050-0280 INSURERS AFFORDING COVERAGE NAIC# INSURED Hyatt & Hyatt, Inc. INSURER A: Lloyds of London DBA: Martha's & Benihana Restaurants INSURER B: Mt. Hawley Insurance Co 3591 South Roosevelt Blvd. INSURER c: Fl Hospitality Mutual Ins Co Key West, FL 33040 INSURER D: Hudson Specialty Ins. CO 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 DO" TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE PR~!f: EXPIRATION LIMITS GENERAL LIABILITY BINDER 01/23/2005 01/23/2006 EACH OCCURRENCE $ 1,000,000 ~ X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,000 ~ CLAIMS MADE [K] OCCUR MED EXP (Anyone person) $ 5,00(J -- A PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000 I 'nPRO- n POLICY JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - (Ea accident) $ ANY AUTO - ALL OWNED AUTOS ~~ttNAGEME BODILY INJURY - A~~E~DD~I NT $ SCHEDULED AUTOS (Per person) - BY - HIRED AUTOS - ~ \' ,~ BODILY INJURY $ NON-OWNED AUTOS DATE ltJ--C:M (Per accident) - - N/~ PROPERTY DAMAGE $ WAIVER _YES (Per accident) GARAGE LIABILITY o/i a~L1 } AUTO ONLY - EA ACCIDENT $ =1 ANY AUTO :E1 -0;; OTHER THAN EA ACC $ LC" """" AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY BINDER 01/23/2005 01/23/2006 EACH OCCURRENCE $ 1,000,OOC Xl OCCUR 0 CLAIMS MADE (Jy,u I1k.VhWQ AGGREGATE $ B $ l,OOO,OO(J IC~ =1 DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND 30606041 01/01/2005 01/01/2006 I WCSTATU-.I IOJbl- EMPLOYERS' LIABILITY $ 500,000 C ANY PROPRIETOR!PARTNER!EXECUTIVE E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under E.L. DISEASE - POLICY LIMIT $ 500.000 SPECIAL PROVISIONS below O]HER . b'l' BINDER 01/23/2005 01/23/2006 $1,000,000 D Llquor Lla 1 lty DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ertificateholder is additional insured as their interest may appear (not applicable to work comp) Monroe County Board of County Commissioners Risk Management PO Box 1026 Key West, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTI TO TH TIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH OTlCE HAL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSU AUTHORIZED REPRESENTATIVE NTS OR REPRESENTATIVES. ACORD 25 ~2~01/0~ . . CL'~ @ACORD CORPORATION 1988 ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDIYYYY) TM 03/11/2005 PRODUCER (305)743-0494 FAX (305)743-0582 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Keys Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 500280 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Marathon, FL 33050-0280 INSURERS AFFORDING COVERAGE NAIC# INSURED Hyatt & Hyatt, Inc. INSURER A: Lloyds of London DBA: Martha's & Benihana Restaurants INSURER B: Mt. Hawley Insurance Co 3591 South Roosevelt Blvd. INSURER c: Fl Hospitality Mutual Ins Co Key West, FL 33040 INSURER D: Hudson Specialty Ins. CO 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, I~~: ~~?;~ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY AL40161 01/23/2005 01/23/2006 EACH OCCURRENCE $ l,OOO,OO( ~ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,00e t-- ~ CLAIMS MADE 00 OCCUR 5,OOe MED EXP (Anyone person) $ I-- I,OOO,OO(] A PERSONAL & ADV INJURY $ I-- 2,000,00(] GENERAL AGGREGATE $ - 1,000,00(] GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COM~OPAGG $ 11 nPRO- n POLICY JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT I-- APPR~ (Ea accident) $ ANY AUTO ~D~KM I-- ~AGtMEN"r ALL OWNED AUTOS BODILY INJURY - ay_ ..... 'Jj~ J (Per person) $ SCHEDULED AUTOS I-- DATE _ ~y - ..---- HIRED AUTOS :=0 BODILY INJURY I-- --~ (Per accident) $ NON-OWNED AUTOS WAIVER NIA_~; - - .( l\ S_ PROPERTY DAMAGE $ ,"""A' ( hi J -""'...~ (Per accident) GARAGE LIABILITY V'l[ ~ AUTO ONLY - EA ACCIDENT $ =1 ANY AUTO \.. C' -l C'Y\oU~ OTHER THAN EA ACC $ Q;~ ~ ~-j AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EMU0301185 01/23/2005 01/23/2006 EACH OCCURRENCE $ 1,000,00(J ::KJ OCCUR D CLAIMS MADE AGGREGATE $ B $ 1,000,OO(J =1 DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND 30606041 01/01/2005 01/01/2006 I T"X~~T ~J,~:c, I. IOJ,ti- EMPLOYERS' liABiLITY 500,00(J C ANY PROPRIETOR!PARTNER!EXECUTIVE E.L. EACH ACCIDENT $ OFFICER!MEMBER EXCLUDED? E,L. DISEASE - EA EMPLOYEE $ 500,00(J If yes, describe under E.L. DISEASE - POLICY LIMIT $ 500 ,OO(J SPECIAL PROVISIONS below O]HER HSLL00399 01/23/2005 01/23/2006 $1,000,000 D Llquor Liability DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ertificateholder is additional insured as their interest may appear (not applicable to work comp) ATE H LDER Monroe County Board Risk Management PO Box 1026 Key West, FL 33040 of County Commissioners EXPIRATION DATE THEREOF, THE ISSUING I ~ DAYS WRITTEN NO BUT FAILURE TO MAIL SU OF ANY KIND UPON THE IN AUTHORIZED REPRESENTATIVE BE CANCELLED BEFORE THE R R WILL ENDEAVOR TO MAIL CATE HOLDER NAMED TO THE LEFT, IMPOSE NO OBLIGATION OR LIABILITY ACORD 25 (2001/08V c:.C ,~~ @ACORD CORPORATION 1988