Certificate of Insurance
A CORaM CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDNY)
10/09/2002
PRODUCER (904)448-9777 FAX (904)448-9788 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Insurance Office of America, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
2700 University Blvd.West OCT 1 5 2002 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Building B
Jacksonville, FL 32217 INSURERS AFFORDING COVERAGE
INSURED Hi - Tech Envi ronmenta 1 INSURER A: American Int't. Specialty
1541 Sunset Dr., Ste 204 INSURER B:
Coral Gables" FL 33143 INSURER c:
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 P81+~~~~gg~IE Pg~!fll~r.I:~~N LIMITS
LTR
~NERAL LIABILITY 19352356 08/16/2002 08/16/2003 EACH OCCURRENCE $ 1,000,000
X COMMF.RCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ 100,000
I CLAIMS MADE [!] OCCUR MED EXP (Anyone person) $ 25 ,000
A ~ CPL * PERSONAL & ADV INJURY $ 1,000,000
X Professional Liab GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000
h .nPRO-.n
POLICY JECT LOC
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)
-
- ALL OWNED AUTOS APPR6 :er V ~ K~ NAG~r!J BODILY INJURY
$
SCHEDULED AUTOS (Per person)
- ~ ,
HIRED AUTOS BV ~ u
- ~q Tlff BODILY INJURY $
NON-OWNED AUTOS DATE 1 hI. (Per accident)
-
- N/A-L JES PROPERTY DAMAGE $
., ._~ (Per accident)
~GE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $
=:J OCCUR 0 CLAIMS MADE AGGREGATE $
$
~ DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND I T"6~~ LtrvWs I IOJ~-
EMPLOYERS' LIABILITY
- E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $
EL DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CPL - Contractors Pollution Liability.
ertificate Holder is Additional Insured regarding General Liability
REVISED AND REPLACES PREVIOUSLY ISSUED CERTIFICATE
CERTIFICATE HOLDER I X I ADDITIONAL INSURED; INSURER LETTER: A CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
County of Monroe EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Solid Waste Management 2!L- DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Attn: Carol Cobb BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
1100 Simonton St Room 2-284 OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES,
Key West, Fl 33040 AUTHORIZED REPRESENTATIVE ~$~~
David Nauahton/KATHY
ACORD 25-5 (7/97)
FAX: (305)292-4555
@ACORDCORPORATION 1988
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s),
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25-5 (7/97)
6300 Wilson Mills Road
Mayfield Village, OH 44143
1-800-444-4487
OCT 2 8 2002
PROGRESSIVE
COMMERCIAL VEHICLE INSURANCE
HI- TECH ENVIRONMENTAL
1541 SUNSET DR
CORAL GABLES FL 33143
USAA GENERAL
9800 FREDRICKSBRG B1E
SAN ANTONIO, TX 78288
CERTIFICATE OF INSURANCE
TIllS DOCUMENT CERTIFIES THAT INSURANCE POLICIES IDENTIFIED BELOW HAVE BEEN ISSUED BY THE DESIGNATED INSURER TO THE
INSURED NAMED ABOVE FOR THE PERIOD(S) INDICATED, TIllS CERTIFICATE IS ISSUED FOR INFORMATION PURPOSES ONLY, IT CONFERS NO
RIGHTS UPON THE CERTIFICATE HOLDER AND DOES NOT CHANGE, ALTER, MODIFY, OR EXTEND THE COVERAGES AFFORDED BY THE POLICIES
LISTED BELOW, THE COVERAGES AFFORDED BY THE POLICIES LISTED BELOW ARE SUBJECT TO ALL THE TERMS, EXCLUSIONS, LIMITATIONS,
ENDORSEMENTS, AND CONDmONS OF THESE POLICIES,
BODIL Y INJURY/ PROP DAMAGE
04099484-1
10/12/02
10/12/03
1,000,000 CSL
A
BY
DATE
WAIVER
N/4~YES
i
i
SPECIAL CONDITIONS ADD ADDITIONAL.lNSUREDEFF:IO/18/02
SCHEDULED AUTOS ONLY
ADnITJONALlNSUREln:
COUNTY OF MONROE SOLID WASTE MNG
1100 SIMONTON ST, RM 2-284
KEY WEST, FL 33040
I
I FAX NUMBER:
305-292-4555
I Please be advised we will not notify certificate holders in
Ithe event of mid-term cancellation.
. -d~ 1~
PROGRESSIVE
COMMERCIAL VEHICLIii: IN8UAANCII
ADDITIONAL INSURED
The person or organization named below is a person insured with respect to such liability coverage as is
affected by the policy but this insurance applies to said insured only as a person liable for the conduct of
another insured and then only to the extent of that liability. We also agree with you that insurance
provided by this agreement will be excess insurance over any other valid and collectible insurance.
NAME OF PERSON OR ORGANIZATION:
COUNTY OF MONROE SOLID WASTE MANAGEMENT
1100 SIMONTON STREET, RM 2-284
KEY WEST, FL 33040
All other parts of this policy remain unchanged,
This endorsement changes Policy No.: CA:04099484-1
Issued to (Name of Insured): HI-TECH ENVIRONMENTAL
Endorsement Effective: 10/18/02
Expiration: 10/12/03
Form No. 1198 (7-96)
FROM
SOLI D WRSTE MR~~RGEr1ENT D I V
PHONE NO.
305 292 4432
Oct. 29 2002 03:29PM Pi
1',';(; LJili,)11
NOV 2 0 2002
MONROE COUNTY, FlJORIDA
Request For Waiver
uf
Insuran~c Requirements
It is r ~(pl~s;l'd t~Ui ti1e :I1Sdl ~n ;-oe lee lIirements, as specifioild in the County's Scnedule oflnsuraDce Requirements,
be waiv..\l vi lli.:xlili"J ".. ,~e :o.Ucw..i"g eontr8Ct.
Contractor.
Hi-Tech Envi;~nmental Cortsul~~nts, Inc.
Contract for:
Ground Water and Surface Water Sampling artd_..~palysis
Address of ,:;"'\~trlld,,,:
~....l5:~'l S\in5~?t D:r{~"'&, S,..ite ~O!J
~-~~~,------,"-,-- -,--_.,'--
Coral Gables FL 33L43
Phone:
(3.:1.5.) 665-u883
Scope of Work:
. Ground Water and ."Sut'fac~ Water S amp 1 ing,_ and Analysis
______.__....~~M______~_.______.....___..... ...,.w____ --.------- ---..------..---- --~
PoiiC:Jes Waiver
wHi ailp!, tQ;
C:e r-f 1;; cc...J.e- oJ!.. 2 xe /VI p+in -r1 rD rr. FL..l4J..clLkU_~~<n._._-
-~m-~-',,~~~~;T:J-:;~~B~fc~ :t:: /';;'wo<a<- .
Reason for Waiver:
VJ ' ' d.. ' .
o r ~_~_ 0....... pt".n$..A-:t_L.a~----_._-----.._,---_....
~ / r ~
'------;- //Jq'c-- .~._-?;- ~--., --.-"
/'
/'
Signature of Contractor:
1"'\...+"...
Ri:l\ Midl,il~eme\)t
~.._--------~_.._--_._--_...._.__....------_.
County Adoinistr'.!w~ a?I-'~I:
.....pproved:
Not Approved:
Date:
Board of County Commission~rs appeal:
A'!lproved: __"
Not Approve.J:
Meeting Date:
AOmimst:n1tlQl'l In!W'UCllon
UJ.""C;: l
102
07-08-2002
ST A TE OF FLORIDA
DEPARTMENT OF INSURANCE
DIVISION OF WORKERS' COMPENSATION
CERTIFICA TE OF EXEMPTION FROM FLORIDA WORKERS' COMPENSATION LAW
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from
Florida Workers' Compensation Law.
EFFECTIVE
07/09/2002
EXPIRATION DATE 07/08/2004
PERSON
SSN
FEIN
BUSINESS
SEIPP
274-46-6727
650519547
HI TECH 8tlVIRONMBNTAL CONSULTANTS INC
1541 SUNSET DRIVE
# 204
CORAL GABLES FL 33143
JOAN
p
NOTE: Pursuant to Chapter 440 . 1 O( 1} , (g) I 2 IF. S. I a sole prQprietor I partner, or an
officer of a corporation who elects exemption from the Florida Workers'
Compensation Law may not recover benefits or compensation under Chapter 440.
PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE
STATE OF FLORIDA
DEPARTMENT OF INSURANCE
DIVISION OF WORKERS' COMPENSA lION
.~
L
o
CONSTRUCTION HlUSTRY
CERTIFICATE OF EXEMPTION FROM FLORIDA
WORKERS' COMPENSATION LAW
EFFECTIVE: 07/09/2002
EXPIRATION: 07/08/2004
PERSON: SEIPP JOAN
SSN: 274-46-6727
FEIN: 650519547
BUSINESS: HI TECH ENVIRONMENTAL CONSUlT A
1541 SUNSET DRIVE
# 204
H
E
R
E
NOTE: Pursuant to chapter 440.10{1l.(g),2, F,S..
a sole proprietor, partner, or officer of an corporation
wIlo elects exemption from the Florida Workers' Compensation
Law may not recover benefits or compensation under Chapter 440 .
CUT HERE
* Carry bottom portion on the job I keep upper portion for your records.
ACOBQ.. CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY)
07/29/2004
PRODUCER (904)448-9777 FAX (904)448-9788 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Insurance Office of America, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
2700 University Blvd.West ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
West Building B
Jacksonville, FL 32217 INSURERS AFFORDING COVERAGE NAIC#
INSURED Hi-Tech Environmental Consultants,Inc INSURER A: Gulf Insurance Co
1451 Sunset Dr., Ste 204 INSURER B:
Coral Gables" FL 33143 INSURER c:
INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDINI
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 DD'L TYPE OF INSURANCE POLICY NUMBER P!,.L!<:'Y EFFECTIVE POLICY EXPIRATION LIMITS
GENERAL LIABILITY GU7121273 10/30/2003 10/30/2004 EACH OCCURRENCE $ 1,000,000
~
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,OO(
>- h CLAIMS MADE [!] OCCUR 2 5 ,O()(j
MED EXP (Anyone person) $
A X Contr.Prof.Liab.* PERSONAL & ADV INJURY $ I,OOO,OO(
I-- 2,OOO,O()(j
GENERAL AGGREGATE $
- 2 ,000 , OO(
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS.COM~OPAGG $
Xl .n PRO. nLOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $
ANY AUTO (Ea accident)
-
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS (Per person)
-
HIRED AUTOS BODILY INJURY
,-- $
NON-OWNED AUTOS (Per accident)
- '. MMA~EMEt'lT
AP ,,~p ~{M'~ PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY BY I ft ',~ AUTO ONLY - EA ACCIDENT $
R ANY AUTO ,L . 6-0/. -fJ--lp OTHER THAN EA ACC $
DATE __'___, ~--~' AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY WA~~~Ac I.- yES EACH OCCURRENCE $
~ OCCUR D CLAIMS MADE b( lJ, AGGREGATE $
$
1 DEDUCTIBLE (,<-r -~r() $
'-/ -'~
RETENTION $ '-t' $
WORKERS COMPENSATION AND G ~(E rfj I TVX~~T ~T,~~ I IOJ~-
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $
--
OFFICER/MEMBER EXCLUDED? EL. DISEASE - EA EMPLOYEE $
If yes, describe under EL. DISEASE. POLICY LIMIT $
SPECIAL PROVISIONS below
OTHER
~ESCRlPTlON OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVllilONS for work performed by the
~ertificate Holder is Additional Insured regarding General Liab,lity
~amed Insured.
~e: Ground Water & Surface Water Sampling
~EVISED.AND REPLACES CERTIFICATE ISSUED 7/28/04
Monroe County Board of County
COIlIIIissioners
Att'n: Maria Slavik
1100 Simonton St.
Key West, FL 33040
N
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 MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES,
AUTHORIZED REPRESENTATIVE / $ ~
@ACORDCORPORATION 1988
ACORD 25 (2001/08),IFAX: (305)295-4342
c.c. :~
ACOBLt CERTIFICATE OF LIABILITY INSURANCE \ DATE (MM/DDNYYY)
10/28/2004
PRODUCER (904)448-9777 FAX (904)448-9788 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Insurance Off;ce of Amer;ca, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
2700 Un;vers;ty Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
West BuHd;ng B
Jacksonv;lle, FL 32217 INSURERS AFFORDING COVERAGE NAIC#
INSURED H1-Tech Envlronmental Consultants, Inc. INSURER A: Hudson Insurance Group
1541 Sunset Dr., Ste 204 INSURER B:
Coral Gables, FL 33143 INSURER c:
INSURER D:
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~~: ~~~1 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
GENERAL LIABILITY GU7121273 10/30/2004 10/30/2005 EACH OCCURRENCE $ 1,000,00(1
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 50,00(1
I CLAIMS MADE [!] OCCUR MED EXP (Anyone person) $ 5,OOe
A ,X Contractors PERSONAL & ADV INJURY $ 1,000,000
X Profess;onal Uab. GENERAL AGGREGATE $ 1,000,00(1
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ l,OOO,OOiJ
iXl POLICY n ~~8T n LOC
~OMOBILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)
I---
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS (Per person)
- ~:~~'.i '. ,""'~'1~ 1
HIRED AUTOS BODILY INJURY
- l" "1"- . \ $
NON-OWNED AUTOS ' #I A J) '-'-' .. (Per accident)
-
- ." )~ PROPERTY DAMAGE $
.o---1Q~-1- (Per accident)
GARAGE LIABILITY Oi\iE .- ~' b AUTO ONLY - EA ACCIDENT $
==1 ANY AUTO \N!\,\n::,q Nli\ rC OTHER THAN EA ACC $
L""\ A , AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY U~. '-' 1 Q"lM1 EACH OCCURRENCE $
tJ OCCUR 0 CLAIMS MADE ('\.) AGGREGATE $
l, \J uJ $
R DEDUCTIBLE C"n. $
RETENTION $ $
WORKERS COMPENSATION AND I :X~~TflT,~-..1 10J~-
EMPLOYER.')' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $
OTHER
~ESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPE,IAL PROVISIONS for work performed by the
~ert;f;cate Holder ;s Add;t;onal Insured regard;ng Genera L;ab;l;ty
'4amed Insured.
lie: Ground Water . Surface Water SaqJH ng
C.t>~5 '. t=\ y..,.,a,V\. C e-
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Monroe County Board of County
Comnbs;oners
Att'n: Mar;a Slav;k
1100 S;monton St.
Key West, FL 33040
EXPIRATION DATE THEREOF, THE ISSUING INSURER 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 INSURER,ITS AGENTS OR REPRESENTATIVES,
AUTHORIZED REPRESENTATIVE
~p~
@ACORDCORPORATION 1988
ACORD 25 (2001/08) FAX: (305)295-4342
ACORQM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY)
01/12/2005
PRODUCER (904)448-9777 FAX (904)448-9788 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Insurance Office of America, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
2700 University Blvd. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
West Building B
Jacksonville, FL 32217 INSURERS AFFORDING COVERAGE NAIC#
INSURED Hi-Tech Environmental Consultants, Inc. INSURER A: Hudson Specialty Insurance Compa y
1541 Sunset Dr., Ste 204 INSURER B:
Coral Gables, FL 33143 INSURER c:
INSURER D:
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 DD'! TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
GENERAL LIABILITY GU7121273 10/30/2004 10/30/2005 EACH OCCURRENCE $ 1.000.00~
- 50.00Cl
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $
I "
I CLAIMS MADE [!] OCCUR MED EXP (AnV one person) $ 5.00Cl
A PERSONAL & ADV INJURY $ 1.000.00Cl
- 1.000.00Cl
GENERAL AGGREGATE $
- 1.000.00Cl
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $
Xl POLICY n ~r8i n LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- (Ea accident) $
ANY AUTO
-
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS (Per person)
- Ar.~ ~~'6. ;~~AO(b"~~
HIRED AUTOS BODILY INJURY
- $
NON-OWNED AUTOS (Per accident)
I-- BY - - .=-jt1 ~1J~
I-- PROPERTY DAMAGE $
DATE -- -- (Per accident)
GARAGE LIABILITY Wt>.I\I'";P' It;~ ,-YES-- AUTO ONLY - EA ACCIDENT $
R ANY AUTO L,), CfJOJ Da.
7)lJi OTHER THAN EA ACC $
~/\ AUTO ONLY: AGG $
OESS/UMBRELLA LIABILITY ~CC, \f.L !UP EACH OCCURRENCE $
OCCUR 0 CLAIMS MADE AGGREGATE $
~r h lP1 ~c~ $
R DEDUCTIBLE $
RETENTION $ - "'-" $
WORKERS COMPENSATION AND I TVX~~T~~~!:: I 10Jbl-
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE EL. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? EL. DISEASE - EA EMPLOYEE $
If yes. describe under EL. DISEASE - POLICY LIMIT $
SPECIAL PROVISIONS below
p~TH'f: . Liability GU7121273 10/30/2004 10/30/2005 $1.000.000 Occurance
A ro ess10nal $1.000.000 Aggregate
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY INDORSEMENT I SPECIAL PROVISIONS
ncluded as Additional Insured is the Board 0 County Commissioner regarding General Liability
REVISED AND REPLACES CERTIFICATE ISSUED 11/01/04
Monroe County
Risk Management
Att'n: Maria Slavik
1100 Simonton St.
Key West, FL 33040
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2~1/0~) FAX: (305)292-4342
cG.:~
THY
~$~
@ACORD CORPORATION 1988
ACORQM
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDIYYVY)
11/02/2005
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
PRODUCER (904)448-9777 FAX (904)448-9788
Insurance Office of America, Inc.
2700 University Blvd.
West Building B
Jacksonville, FL 32217
INSURED Hi - Tech Envi ronmental Consul tants, Inc.
1541 Sunset Dr., Ste 204
Coral Gables, FL 33143
INSURERS AFFORDING COVERAGE
INSURER A Hudson Speci a 1 ty Insurane Compan
INSURER B:
INSURER C:
INSURER D:
INSURER E:
NAIC#
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~~~ ~~I?:~ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
GENERAL LIABILITY FEC6104314 10/30/2005 10/30/2006 EACH OCCURRENCE $ 1,000,000
I-- DAMAGE TO RENTED
X COMMERCIAL GENERAL LIABILITY $ 50,000
o CLAIMS MADE 00 OCCUR MED EXP (Anyone person) $ 5,000
!--
A PERSONAL & ADV INJURY $ 1,000,000
I--
GENERAL AGGREGATE $ 1,000,000
e-- l,OOO,OO(]
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS. COMP/OP AGG $
-xl . n PRO. nLOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $
ANY AUTO (Ea accident)
-
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS (Per person)
-
HIRED AUTOS BODILY INJURY
- $
NON-OWNED AUTOS 1\_Pf~L l~n~MA~ (Per accident)
I-- GEMENl
!-- t:l Y.,..,. .' ... . ~ PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY DATE ... '.. _.U=:--L~' f) AUTO ONLY. EA ACCIDENT $
R ANY AUTO WAIVEH ;\1 I A, ,.-4--- y ~ OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY PIt: Q1 ~ EACH OCCURRENCE $
=:J OCCUR o CLAIMS MADE AGGREGATE $
C r L -I~' 00 $
=1 DEDUCTIBLE (~ " $
RETENTION $ $
WORKERS COMPENSATION AND Ck* C0W6 I T"Xg~T~J,~S I IOJ~-
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE E:L EACH ACCIDENT $
OFFICER/MEMBER EXCLUIJED? E.L. DiSEASE - EA EMPLOYEE $
If yes, describe under
SPECIAL PROVISIONS below EL DISEASE. POLICY LIMIT $
OTH'f: . Liabil ity FEC6104314 10/30/2005 10/30/2006 $1,000,000 Occurance
Pro esslonal
A $1,000,000 Aggregate
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
ertificate Holder is Additional Insured regarding General Liability for work performed by the
Ilamed Insured.
~e: Ground Water & Surface Water Sampling
CC', 0n.~n(~
COVERAGES
Monroe County Board of County
CORl11issioners
Att'n: Maria Slavik
1100 Simonton St.
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 MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES,
AUTHORIZED REPRESENTATIVE
~(fi1z;;;r
John Davis (IOA)/KATHY
ACORD 25 (2001/08) FAX: (305)295-4342
@ACORDCORPORATION 1988
ACDBQM CERTIFICATE OF LIABILITY INSURANCE i,C\' DATE (MM/DDIYYYY)
, "'.;-:;\ 11/02/2005
~ I ,.,
PRODUCER (904)448-9777 FAX (904)448-9788 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Insurance Office of America, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
2700 University Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
West Building B
Jacksonville, FL 32217 INSURERS AFFORDING COVERAGE NAIC#
INSURED Hi-Tech Environmental Consultants, Inc. INSURER A: Hudson Specialty Insurane Compan
1541 Sunset Dr., Ste 204 INSURER B:
Coral Gables, FL 33143 INSURER c:
INSURER D:
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~;: t1'?~~ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
GENERAL LIABILITY FEC6104314 10/30/2005 10/30/2006 EACH OCCURRENCE $ 1,000,000
-
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 50,000
I CLAIMS MADE 00 OCCUR MED EXP (Anyone person) $ 5,000
A X PERSONAL & ADV INJURY $ 1,000,000
-
GENERAL AGGREGATE $ 1,000,000
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000
Xl n PRO- nLOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $
ANY AUTO (Ea accident)
-
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS (Per person)
-
HIRED AUTOS M~~EME.Nl BODILY INJURY
- APP~o!t\~I~~ $
NON-OWNED AUTOS (Per accident)
- .1 _
- ~O---:{)C; PROPERTY DAMAGE $
tW _--. .. .....~Il 0.-- (Per accident)
GARAGE LIABILITY T
OJ\\C_-'--".'-'V~ .- AUTO ONLY - EA ACCIDENT $
R ANY AUTO >j1J\ ___ ~- YES -frr: 11L. OTHER THAN EA ACC $
Wf'.,IVEP, '. ~~ ^ AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY u~- ~~ EACH OCCURRENCE $
~ OCCUR o CLAIMS MADE ,~ AGGREGATE $
, $
~ DEDUCTIBLE (CQJ $
RETENTION $ $
WORKERS COMPENSATION AND I TVXg~T~Jg:c: I IOJ,tl-
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $
If yes, describe under
SPECIAL PROVISIONS below EL DISEASE - POLICY LIMIT $
OTH'f: FEC6104314 10/30/2005 10/30/2006 $1,000,000 Occurance
Pro essional L iabil ity
A $1,000,000 Aggregate
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
k CPL - Contractors Pollution Liability.
ertificate Holder is Additional Insured regarding General Liabil ity
CC- 0 ~ 'V'\.Q. V\ c.. ~
CERTIFICATE HOLDER CANCEll ATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
County of Monroe EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
Solid Waste Management ..l:.L DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Attn: Carol Cobb BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
1100 Simonton St Room 2-284 OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES,
Key West, FL 33040 AUTHORIZED REPRESENTATIVE ~~
John Davis (IOA)/KATHY
ACORD 25 (2001/08) FAX: (305)292-4555
@ACORDCORPORATION 1988
COVERAGES
Progressive Express Ins, Company
PO Box 94739
Cleveland, OH 44101
800-444-4487
....riuow
IN_.NCI"o.\l~
SEP
>;
Policy number: 04099484-5
Underwritten by:
Progressive Express Ins. Company
August 25, 2006
Page 1 of 1
'....,
Certificate of Insurance
Certificate Holder
!\ddit,onal,nsured
MONROE lOUM" BOARD OF COUNTY
COMMI)SIO~IER,
110l SIMONTON ST
KEY WEST, FL 33040
Insured
HI-TECH ENVIRONMENTAL
1541 SUNSET DR
CORAL GABLES, FL 33143
Agont
,,',"'" "',"""" " US!\!\INS!\GCYINC
9800 FRDRCKSBRG HSVCW
SAN ANTONIO, TX 78288
This document certifies that insurance policies identified below have been issued by the designated insurer to the
insured named above for the period(s) indicated, This Certificate is issued for information purposes only, It confers no
rights upon the certificate holder and does not change, alter, modify, or extend the coverages afforded by the policies
listed below, The coverages afforded by the policies listed below are subject to all the terms, exclusions, limitations,
endorsements, and conditions of these policies,
PoliCY Effective Date: Nov 21, 2005
Poircy Expiration Date: Nov 21,2006
Insurance coverage(s) Limits
Bodily Inju~iProp~rtyDal1lage $1,000,000 Combined Single Limit
Uninsured Motorist $300,0001$300,000 Non-Stacked
PersonallnJuryProtectlon " """"", " .. " ,,$10,OOOw/Workers CornP-Namedlnsd&Relallve
Employers Non-Owned Auto 81PD $1,000,000 Combined Single Limit
Description of LocationNehicles/Specialltems
Schedul,ed autos only
1997 FORD PICKUP lFTCR10A3VUC00825
Certificate number
2370621X484
Please be advised that additional insureds and lienholders will be notified in the event of a mid-term
cancellation.
,~
;".
.'
0-&r\J
'M~~
\L\ ',"- <1t~Co-9b
'f:-
0Ilb : ~
CC"~
Form 5241 (10i02)
/ .
~~
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