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Certificates of Insurance
Client#: 720292 AMIERIEMPIR DATE MMIDDIYYYYJ ACORD,, CERTIFICATE OF LIABILITY INSURANCE 01/0512024 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 have ADDITIONAL INSURED provisions or 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 any rights to,the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Certificate Specialists NAME;_ Marsh &McLennan Agency PHONE 727 447-6481 FAX (Nq,,No, E?ct)� " FAx No): Bouchard Region E-MAIL A s$, certificates@bouchardinsurance.com 101 N.Starcrest Drive — INSURER(S)AFFORDING COVERAGE NAIC 4 Clearwater, FL 33765 INSURER A:Landmark American insurance Company 33138"rrr . ................................... . ........ ............ INSURED INSURER B:Landmark American insurance Company 33138 American Empire Builders, Inc. 13775 SW 145th CT INSURER C:StarNet Insurance Company 40045 INSURER D:Allied World Assurance Company(U.S.)1 19489 Suite B __............. Miami, FL 33186 INSURER E:Van:tapro Specialty insurance Company 44768 lNSURER F; Travelers Property Casualty Co.of America 25658 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 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 LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR Abinisubm POLICY.E..FF...-_POLICY-EX,P, TYPE OF INSURANCE WVD! POLICY NUM LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y LHA 1114319 1210812023 1210812024 EACHOCCURRENCE S1,000,000 L DAMfiEj1,),RENTED CLAIMS-MADE X�OCCUR PREMISES E a currence) $100,000 VIED EXP(Any-one 55,0001 11 PERSONAL&ACV I NJURY S1,000,000 GEN AGGRECATE LIMIT APPLIES PER GENERAL AGGREGA rE 52,000,000 - POL.ICY PRO LOC PRODUCTS-COMNOP AGG s2,000,000 ..................1 2THFR MBIN SINGLE LIMIT E AUTOMOBILE LIABILITY Y Y �5087027305 12108/2023 1210812024(CE) ED cl.r,� $1,000,000 X. ANY AUTO BODILY INJURY iPer person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS x HIRED x NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per acaldant� ..................... ........................ ....... B UMBRELLA DAB OCCUR y Y LHA105583 12108/2023 12/0812112J EACH OCCURRENCE S5,000,000 X� EXCESS LIAB CLAIMS-MADE ,IM S-MADE1 AGGREGATE 55,006,000 DED RETENTION S $ c WORKERS COMPENSAPON IOTH- I Y KRM626582001 12/08/2023 121081202�,X.I... AND EMPLOYERS'LIABILITY YfN ANY PROPRIETOF?IPARTNER/EXECUTIVE[l,�-I EL EACHACC9DENT 51 0000,00 OFFICERIMEMBER EXCLUDED? NIA� _1= . 7 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERAT DNS below E.L DISEASE-POLICY LIMIT 51,000,000 D Pollution Liab. I Y Y 03128724 12/0812023 12108/2024 $2M/$2M Professional Liab Y Y F Rent/Leased Equip QT6608$92240ATIL23 112108/2023112/08/2024 $1,000,000 per item DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES ACORD 101,Additional Remarks Schedule,may The attached if more space is required) PROJECT: Seaview Drive Bridge(904606) Replacement COMPLETE CERTIFICATE HOLDER(S)&ADDITIONAL INSURED(S), Monroe County Board of County Commissioners and any other entity as required by written contract or agreement and subject to the terms, conditions and AP"7 SK') T exclusions of the policies. (See Attached Descriptions) eY 4.24 DATE-- CERTIFICATE HOLDER CANCELLATION WANN KA yft— SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 11100 Simonton St Key West,FL 33040-0000 AUTHORIZED REPRESENTATIVE 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) 1 of The ACORD name and logo are registered marks of ACORD #S120947681M12092801 RCGAD DESCRIPTIONS (Continued from Page 1) If required by written contract, Certificate Holder is an additional insured with respect to General Liability, Auto Liability, and Excess Liability,subject to the terms, conditions and exclusions of the policies.Additional insured with respect to General Liability includes ongoing and completed operations. Coverage with respect to General Liability is primary and noncontributory. When required by written contract,waiver of subrogation applies in favor of Certificate Holder with respect to General Liability, Auto Liability,Workers Comp, Professional Liability, Pollution Liability, and Excess Liability subject to the terms,conditions and exclusions of the policy. There,are no exclusions for Jib, Boom and/or Overload on the Rented/Leased Equipment policy. SAGITTA 25.3(2016103) 2 of 2 #S12094772/M12092801 Client#: 720292 AMIERIEMPIR DATE MMIDDIYYYYJ ACORD,, CERTIFICATE OF LIABILITY INSURANCE 01/0512024 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 have ADDITIONAL INSURED provisions or 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 any rights to,the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Certificate Specialists NAME;_ Marsh &McLennan Agency PHONE 727 447-6481 FAX (Nq,,No, E?ct)� " FAx No): Bouchard Region E-MAIL A s$, certificates@bouchardinsurance.com 101 N.Starcrest Drive — INSURER(S)AFFORDING COVERAGE NAIC 4 Clearwater, FL 33765 INSURER A:Landmark American insurance Company 33138"rrr . ................................... . ........ ............ INSURED INSURER B:Landmark American insurance Company 33138 American Empire Builders, Inc. 13775 SW 145th CT INSURER C:StarNet Insurance Company 40045 INSURER D:Allied World Assurance Company(U.S.)1 19489 Suite B __............. Miami, FL 33186 INSURER E:Van:tapro Specialty insurance Company 44768 lNSURER F; Travelers Property Casualty Co.of America 25658 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 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 LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR Abinisubm POLICY.E..FF...-_POLICY-EX,P, TYPE OF INSURANCE WVD! POLICY NUM LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y LHA 1114319 1210812023 1210812024 EACHOCCURRENCE S1,000,000 L DAMfiEj1,),RENTED CLAIMS-MADE X�OCCUR PREMISES E a currence) $100,000 VIED EXP(Any-one 55,0001 11 PERSONAL&ACV I NJURY S1,000,000 GEN AGGRECATE LIMIT APPLIES PER GENERAL AGGREGA rE 52,000,000 - POL.ICY PRO LOC PRODUCTS-COMNOP AGG s2,000,000 ..................1 2THFR MBIN SINGLE LIMIT E AUTOMOBILE LIABILITY Y Y �5087027305 12108/2023 1210812024(CE) ED cl.r,� $1,000,000 X. ANY AUTO BODILY INJURY iPer person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS x HIRED x NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per acaldant� ..................... ........................ ....... B UMBRELLA DAB OCCUR y Y LHA105583 12108/2023 12/0812112J EACH OCCURRENCE S5,000,000 X� EXCESS LIAB CLAIMS-MADE ,IM S-MADE1 AGGREGATE 55,006,000 DED RETENTION S $ c WORKERS COMPENSAPON IOTH- I Y KRM626582001 12/08/2023 121081202�,X.I... AND EMPLOYERS'LIABILITY YfN ANY PROPRIETOF?IPARTNER/EXECUTIVE[l,�-I EL EACHACC9DENT 51 0000,00 OFFICERIMEMBER EXCLUDED? NIA� _1= . 7 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERAT DNS below E.L DISEASE-POLICY LIMIT 51,000,000 D Pollution Liab. I Y Y 03128724 12/0812023 12108/2024 $2M/$2M Professional Liab Y Y F Rent/Leased Equip QT6608$92240ATIL23 112108/2023112/08/2024 $1,000,000 per item DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES ACORD 101,Additional Remarks Schedule,may The attached if more space is required) PROJECT: Seaview Drive Bridge(904606) Replacement COMPLETE CERTIFICATE HOLDER(S)&ADDITIONAL INSURED(S), Monroe County Board of County Commissioners and any other entity as required by written contract or agreement and subject to the terms, conditions and AP"7 SK') T exclusions of the policies. (See Attached Descriptions) eY 4.24 DATE-- CERTIFICATE HOLDER CANCELLATION WANN KA yft— SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 11100 Simonton St Key West,FL 33040-0000 AUTHORIZED REPRESENTATIVE 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) 1 of The ACORD name and logo are registered marks of ACORD #S120947681M12092801 RCGAD DESCRIPTIONS (Continued from Page 1) If required by written contract, Certificate Holder is an additional insured with respect to General Liability, Auto Liability, and Excess Liability,subject to the terms, conditions and exclusions of the policies.Additional insured with respect to General Liability includes ongoing and completed operations. Coverage with respect to General Liability is primary and noncontributory. When required by written contract,waiver of subrogation applies in favor of Certificate Holder with respect to General Liability, Auto Liability,Workers Comp, Professional Liability, Pollution Liability, and Excess Liability subject to the terms,conditions and exclusions of the policy. There,are no exclusions for Jib, Boom and/or Overload on the Rented/Leased Equipment policy. SAGITTA 25.3(2016103) 2 of 2 #S12094772/M12092801 Client#:720292 AMERIEMPIR ACOR& CERTIFICATE OF LIABILITY( INSURANCE DATE(MMIDONYYY) 1 0/2412 0 2 2 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 have ADDITIONAL INSURED provisions or 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 any rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT Marsh&McLennan Agency ?A c°NNu Ext,727 447.6481 we No; Bouchard Region ADDRESS:101 N.Starcrest Drive certificates@bouchardinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# Clearwater,FL 33765 INSURERA;Landmark American Insurance Company 12833 INSURED American Empire Builders, Inc. INSURER B:StarStone Specialty Insurance Company 44776 13775 SW 145th CT INSURER C:StarNet Insurance Company 40045 INSURER D:Allied World Assurance Company(U.S.)1 19489 Suite B Miami,FL 33186 INSURER S:Vanta ro Specialty Insurance Company 44768 INSURER F: Charter Oak Fire Insurance CO 25615 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 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLLICYy EXP LTR WVD POLICY NUMBER MMIDDIYYYY MMlDDlYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y LHA113163 12108/2021 1210812022 EACH OCCURRENCE $1 000 000 CLAIMS-MADE X OCCUR ppMq T ENTED PREMI9a occurrence $100 000 X B11PD Ded:$5,000 MED EXP(Any one parson) $5,000 PERSONAL&ADV INJURY $1,000,000 OFN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X PRO- JECT LOC PRODUCTS-COMPIOPAGG s2,000,000 OTHFR: $ E AUTOMOBILE LIABILITY Y Y 5087027303 12/08/2021 12/08/2022 �aaBINFI]SINGLELIMIT 1,000,000 X ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY Per accident $ AUTOS ONLY AUTOS { ) X HIRED X NON-OWNED PROPFRTYDAMAGE $ AUTOS ONLY AUTOS ONLY Per accident B UMBRELLA LIAR I X I OCCUR Y Y 89186A21 I AALI 12108/2021 12/0812022 EACH OCCURRENCE $5 000 000 X1 EXCESS LIAR ri CLAIMS-MADE AGGREGATE $5 000 000 DED RETENTION$ $ C WORKERS COMPENSATION Y KEY0145742 1210812021 12108/202 X PER U IER OTH- ANo EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNERlEXECUTIVE E.L.EACH ACCIDENT $1 000 000 OFFICERIMEMBER EXCLUDED? N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1 000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E,L.DISEASE-POLICY LIMIT $1 000,000 D Pollution Liab. Y 03128724 12/08/2021 12108/202 $2mi11$2mil$15k Rot Professional Liab Y 03128724 $2m1$2m$25k Retention F Rent/Leased Equip QT8S92240ATIL21 12/08/2021 12/0812022 $1mil Per Item$5k Ded DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schadule,may be attached II'more space Is required) PROJECT: Seaview Drive Ridge(904606)Replacement COMPLETE CERTIFICATE HOLDER(S)Sr ADDITIONAL INSURED(S): Monroe County Board of County Commissioners and any other entity as required by written contract or agreement and subject to the terms,conditions and exclusions of the policies. 1 T (See Attached Descriptions) 153y, � CERTIFICATE HOLDER CANCELLATION WAN" A Monroe County Board of County Commissioners THE EXPIR I OF' 1100 Simonton St ACCORDANCE WITH THE POLICY PROVISIONSn�r oc vniwr fccrr uv Key West, FL 33040 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) 1 of 2 The ACORD name and logo are registered marks of ACORD #S119295331M11924864 RCJTF DESCRIPTIONS (G,bnined from Page 1) If required by written contract,Certificate Holder Is an additional Insured with respect to General Liability,Auto Liability,and Excess Liability,subject to the terms,conditions and exclusions of the policies.Additional insured with respect to General Liability includes ongoing and completed operations. Coverage with respect to General Liability is primary and noncontributory. When required by written contract,waiver of subrogation applies in favor of Certificate Holder with respect to General Liability,Auto Liability,Workers Comp, Professional Liability,Pollution Liability, and Excess Liability subject to the terms,conditions and exclusions of the policy. There are no exclusions for Jib, Boom and/or Overload on the Rented/Leased Equipment policy. I i SAGITTA 25.3(2016103) 2 Of 2 #S119295331M11924864