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Certificates of Insurance
DATE(MM/DD/YYYY) ACCOR" CERTIFICATE OF LIABILITY INSURANCE 6/14/2023 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Insurance by Ken Brown, Inc. PHONE FAX 707 Pennsylvania Ave Ste 1300 A/C No Ext: 321-397-3870 vc,No:321-397-3888 E-MAltamonte Springs FL 32701 ADDRESS: certificates@insbykenbrown.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Amerisure Mutual Insurance Company 23396 INSURED REEFTRO-01 INSURERB:Amerisure Partners Insurance Company 11050 GAUTIER TREE &LANDSCAPE INC. 100 N. Krome Ave INsuRERc:Amerisure Insurance Company 19488 Florida City FL 33034 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1201082445 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 WVD POLICY NUMBER MM/DD MM/DD A X COMMERCIAL GENERAL LIABILITY Y CPP20128232202 6/1/2023 6/1/2024 EACH OCCURRENCE $1,000,000 CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $1,000,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY� PE� LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY Y CA20128242205 6/1/2023 6/1/2024 COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident A X UMBRELLALIAB X OCCUR CU20128212102 6/1/2023 6/1/2024 EACH OCCURRENCE $5,000,000 EXCESS LAB CLAIMS-MADE AGGREGATE $5,000,000 DED X RETENTION$n $ C WORKERS COMPENSATION WC210548606 6/1/2023 6/1/2024 PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICE R/M EMBER EXCLUDED? ❑ N/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 $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Monroe County BOCC is additional insured on the general liability and auto liability policies as required per executed written contract. 1� ' BY 7/ 152 3"! CERTIFICATE HOLDER CANCELLATION WAMP SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County BOCC 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West FL 33040 W w " P4"' @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD REEF TROPICAL COMPANIES CA20128242205 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADVANTAGE COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement,the provisions of the Coverage Form apply unless modified by the endorsement. The premium for this endorsement is$ INCLUDED 1. EXTENDED CANCELLATION CONDITION COMMON POLICY CONDITIONS- CANCELLATION, Paragraph A.2.is replaced by the following: 2. We may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation at least: a. 10 days before the effective date of cancellation if we cancel for nonpayment of premium; or b. 60 days before the effective date of cancellation if we cancel for any other reason. 2. BROAD FORM INSURED SECTION II- LIABILITY COVERAGE A.1.WHO IS AN INSURED is amended by the addition of the following: d. Any organization you newly acquire or form, other than a partnership,joint venture or limited liability company, and over which you maintain ownership or a majority interest,will qualify as a Named Insured. However, (1) Coverage under this provision is afforded only until the end of the policy period; (2) Coverage does not apply to"accidents"or"loss"that occurred before you acquired or formed the organization;and (3) Coverage does not apply to an organization that is an"insured"under any other policy or would be an"insured"but for its termination or the exhausting of its limit of insurance. e. Any"employee"of yours using: (1) A covered"auto"you do not own, hire or borrow, or a covered"auto"not owned by the"employee" or a member of his or her household,while performing duties related to the conduct of your business or your personal affairs; or (2) An"auto" hired or rented under a contract or agreement in that"employee's"name, with your permission, while performing duties related to the conduct of your business. However,your "employee"does not qualify as an insured under this paragraph (2) while using a covered"auto" rented from you or from any member of the"employee's"household. f. Your members, if you are a limited liability company,while using a covered"auto"you do not own, hire, or borrow,while performing duties related to the conduct of your business or your personal affairs. g. Any person or organization with whom you agree in a written contract, written agreement or permit, to provide insurance such as is afforded under this policy, but only with respect to your covered"autos". This provision does not apply: (1) Unless the written contractor agreement is executed or the permit is issued prior to the"bodily injury"or"property damage"; Includes copyrighted material of Insurance Services Office, Inc. CA 71 15 11 09 Page 1 of 5 (2) To any person or organization included as an insured by an endorsement or in the Declarations; or (3) To any lessor of"autos" unless: (a) The lease agreement requires you to provide direct primary insurance for the lessor; (b) The"auto"is leased without a driver; and (c) The lease had not expired. Leased"autos"covered under this provision will be considered covered"autos"you own and not covered "autos"you hire. h. Any legally incorporated organization or subsidiary in which you own more than 50% of the voting stock on the effective date of this endorsement. This provision does not apply to"bodily injury"or"property damage"for which an "insured"is also an insured under any other automobile policy or would be an insured under such a policy, but for its termination or the exhaustion of its limits of insurance, unless such policy was written to apply specifically in excess of this policy. 3. COVERAGE EXTENSIONS-SUPPLEMENTARY PAYMENTS Under SECTION II - LIABILITY COVERAGE,A.2.a.Supplementary Payments, paragraphs (2) and (4) are deleted and replaced with the following: (2) Up to$2500 for the cost of bail bonds (including bonds for related traffic law violations) required because of an"accident"we cover. We do not have to furnish these bonds. (4) All reasonable expenses incurred by the"insured"at our request, including actual loss of earnings up to $500 a day because of time off from work. 4. AMENDED FELLOW EMPLOYEE EXCLUSION SECTION II - LIABILITY COVERAGE,B. EXCLUSIONS, paragraph S. Fellow Employee is deleted and replaced by the following: S. Fellow Employee "Bodily injury"to: a. Any fellow"employee"of the"insured"arising out of and in the course of the fellow"employee's" employment or while performing duties related to the conduct of your business. However,this exclusion does not apply to your"employees"that are officers, managers, supervisors or above. Coverage is excess over any other collectible insurance. b. The spouse, child, parent, brother or sister of that fellow"employee"as a consequence of paragraph a. above. S. HIRED AUTO PHYSICAL DAMAGE COVERAGE AND LOSS OF USE EXPENSE A. Under SECTION III -PHYSICAL DAMAGE COVERAGE,A.COVERAGE,the following is added: If any of your owned covered"autos"are covered for Physical Damage,we will provide Physical Damage coverage to"autos"that you or your"employees"hire or borrow, under your name or the"employee's" name, for the purpose of doing your work. We will provide coverage equal to the broadest physical damage coverage applicable to any covered"auto"shown in the Declarations, Item Three, Schedule of Covered Autos You Own, or on any endorsements amending this schedule. B. Under SECTION III - PHYSICAL DAMAGE COVERAGE,A.4.COVERAGE EXTENSIONS, paragraph b. Loss of Use Expenses is deleted and replaced with the following: b. Loss Of Use Expenses For Hired Auto Physical Damage, we will pay expenses for which an"insured" becomes legally responsible to pay for loss of use of a vehicle rented or hired without a driver, under a written rental contract or agreement. We will pay for loss of use expenses if caused by: Includes copyrighted material of Insurance Services Office, Inc. Page 2 of 5 CA 71 15 11 09 (1) Other than collision, only if the Declarations indicate that Comprehensive Coverage is provided for any covered"auto"; (2) Specified Causes of Loss, only if the Declarations indicate that Specified Causes Of Loss Coverage is provided for any covered"auto"; or (3) Collision, only if the Declarations indicate that Collision Coverage is provided for any covered "auto". However,the most we will pay for any expenses for loss of use is $30 per day,to a maximum of $2,000. C. Under SECTION IV—BUSINESS AUTO CONDITIONS, paragraph 5.b. Other Insurance is deleted and replaced by the following: b. For Hired Auto Physical Damage Coverage,the following are deemed to be covered "autos"you own: 1. Any covered"auto"you lease, hire, rent or borrow;and 2. Any covered"auto" hired or rented by your"employee"under a contract in that individual "employee's"name, with your permission, while performing duties related to the conduct of your business. However,any"auto"that is leased, hired, rented or borrowed with a driver is not a covered"auto", nor is any"auto"you hire from any of your"employees", partners (if you are a partnership), members (if you are a limited liability company), or members of their households. 6. LOAN OR LEASE GAP COVERAGE Under SECTION III - PHYSICAL DAMAGE COVERAGE,A. COVERAGE, the following is added: If a covered"auto"is owned or leased and if we provide Physical Damage Coverage on it, we will pay, in the event of a covered total"loss", any unpaid amount due on the lease or loan for a covered"auto", less: (a) The amount paid under the Physical Damage Coverage Section of the policy;and (b) Any: (1) Overdue lease or loan payments including penalties, interest or other charges resulting from overdue payments at the time of the"loss' (2) Financial penalties imposed under a lease for excessive use, abnormal wear and tear or high mileage; (3) Costs for extended warranties, Credit Life Insurance, Health,Accident or Disability Insurance purchased with the loan or lease; (4) Security deposits not refunded by a lessor; and (5) Carry-over balances from previous loans or leases. 7. RENTAL REIMBURSEMENT SECTION III - PHYSICAL DAMAGE COVERAGE,A.COVERAGE, paragraph 4. Coverage Extensions is deleted and replaced by the following: 4. Coverage Extensions (a) We will pay up to $75 per day to a maximum of$2000 for transportation expense incurred by you because of covered "loss". We will pay only for those covered "autos"for which you carry Collision Coverage or either Comprehensive Coverage or Specified Causes of Loss Coverage. We will pay for transportation expenses incurred during the period beginning 24 hours after the covered "loss" and ending, regardless of the policy's expiration,when the covered "auto"is returned to use or we pay for its "loss". This coverage is in addition to the otherwise applicable coverage you have on a covered "auto". No deductibles apply to this coverage. (b) This coverage does not apply while there is a spare or reserve "auto"available to you for your operation. Includes copyrighted material of Insurance Services Office, Inc. CA 71 15 1109 Page 3 of 5 8. AIRBAG COVERAGE SECTION III - PHYSICAL DAMAGE,B. EXCLUSIONS, Paragraph 3. is deleted and replaced by the following: We will not pay for"loss"caused by or resulting from any of the following unless caused by other"loss"that is covered by this insurance: a. Wear and tear, freezing, mechanical or electrical breakdown. However,this exclusion does not include the discharge of an airbag. b. Blowouts, punctures or other road damage to tires. 9. GLASS REPAIR-WAIVER OF DEDUCTIBLE SECTION III - PHYSICAL DAMAGE COVERAGE,D. DEDUCTIBLE is amended to add the following: No deductible applies to glass damage if the glass is repaired rather than replaced. 10. COLLISION COVERAGE—WAIVER OF DEDUCTIBLE SECTION III - PHYSICAL DAMAGE COVERAGE,D. DEDUCTIBLE is amended to add the following: When there is a "loss"to your covered"auto"insured for Collision Coverage, no deductible will apply if the "loss"was caused by a collision with another"auto"insured by us. 11. KNOWLEDGE OF ACCIDENT SECTION IV- BUSINESS AUTO CONDITIONS,A. LOSS CONDITIONS, 2. DUTIES IN THE EVENT OF ACCIDENT,CLAIM,SUIT OR LOSS, paragraph a. is deleted and replaced by the following: a. You must see to it that we are notified as soon as practicable of an"accident", claim, "suit"or"loss". Knowledge of an"accident', claim, "suit"or"loss" by your"employees"shall not, in itself, constitute knowledge to you unless one of your partners, executive officers, directors, managers, or members (if you are a limited liability company) has knowledge of the"accident", claim, "suit"or"loss". Notice should include: (1) How,when and where the"accident"or"loss"occurred; (2) The"insured's"name and address; and (3) To the extent possible,the names and addresses of any injured persons and witnesses. 12. TRANSFER OF RIGHTS(BLANKET WAIVER OF SUBROGATION) SECTION IV- BUSINESS AUTO CONDITIONS A.S.TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US is deleted and replaced by the following: If any person or organization to or for whom we make payment under this Coverage Form has rights to recover damages from another,those rights are transferred to us. That person or organization must do everything necessary to secure our rights and must do nothing after"accident"or"loss"to impair them. However, if the insured has waived rights to recover through a written contract, or if your work was commenced under a letter of intent or work order, subject to a subsequent reduction in writing with customers whose customary contracts require a waiver,we waive any right of recovery we may have under this Coverage Form. 13. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS SECTION IV- BUSINESS AUTO CONDITIONS, B. GENERAL CONDITIONS, 2. CONCEALMENT, MISREPRESENTATION OR FRAUD is amended by the addition of the following: We will not deny coverage under this Coverage Form if you unintentionally fail to disclose all hazards existing as of the inception date of this policy. You must report to us any knowledge of an error or omission in your representations as soon as practicable after its discovery. This provision does not affect our right to collect additional premium or exercise our right of cancellation or non-renewal. Includes copyrighted material of Insurance Services Office, Inc. Page 4 of S CA 71 1 S 11 09 14. BLANKET COVERAGE FOR CERTAIN OPERATIONS IN CONNECTION WITH RAILROADS When required by written contract or written agreement,the definition of"insured contract' is amended as follows: — The exception contained in paragraph H.3. relating to construction or demolition operations on or within 50 feet of a railroad; and — Paragraph H.a. are deleted with respect to the use of a covered "auto"in operations for, or affecting, a railroad. Includes copyrighted material of Insurance Services Office, Inc. CA 71 15 11 09 Page 5 of 5 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTOR'S BLANKET FLEX ADDITIONAL INSURED ENDORSEMENT - FORM A This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Policy Number Agency Number Policy Effective Date CPP20128232202 0845060 6-1-23 Policy Expiration Date Date Account Number 6-1-24 6-17-23 20008808 Named Insured Agency INSURANCE BY Issuing Company AMERISURE REEF TROPICAL COMPANIES KEN BROWN INC. MUTUAL INS. CO. A. SECTION II -WHO IS AN INSURED is amended to add as an additional insured: 1. Any person ororganization with whom you have agreed in a "written agreement"that such person or organization be added as an additional insured on this policy, and any other person or organization you are required to add as an additional insured under such "written agreement". 2. If"your work" began under a written letter of intent or written work order, any person or organization who issued the written letter of intent or written work order, but: a. such coverage will apply only for 30 calendar days following the date the written letter of intent or written work order was issued; and b. the person or organization is an additional insured only for, and to the extent of, liability arising out of"bodily injury", "property damage", or"personal and advertising injury" caused, in whole or in part, by your negligent acts or omissions, or the negligent acts or omissions of others working on your behalf, in the performance of your work as specified in the written letter of intent or written work order. This coverage does not apply to liability arising out of the independent acts or omissions of the additional insured. For the purposes of the coverage provided by this endorsement, a "written agreement" means a written contract or written agreement that: 1. requires you to include a person or organization as an additional insured for a period of time during the policy period; and 2. is executed prior to the occurrence of"bodily injury", "property damage", or"personal and advertising injury"that forms the basis for a claim under this policy. The insurance provided by this endorsement does not apply to any person or organization that is specifically listed as an additional insured on another endorsement attached to this policy. CG 73 24 03 23 Includes copyrighted material of the Insurance Services Office, Inc.,with its permission Page 1 of 3 B. The coverage provided to any person or organization added as an additional insured pursuant to Paragraph A.1 is limited as follows: 1. If the"written agreement"specifically and exclusively requires you to name the person or organization as an additional insured using the ISO CG 20 10 endorsement with edition dates of 11 85 or 10 01, or the ISO CG 20 37 10 01 endorsement, that person or organization is an additional insured, but only with respect to liability for"bodily injury", "property damage", or"personal and advertising injury" arising out of"your work" for that insured by or for you. 2. If the "written agreement" requires you to name the person or organization as an additional insured using the ISO CG 20 10 and or CG 20 37 endorsements without specifically and exclusively requiring the 11 85 or 10 01 edition dates, that person or organization is an additional insured, but only with respect to liability for"bodily injury", "property damage", or"personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf. 3. If the "written agreement" requires you to name the person or organization as an additional insured for operations arising out of your work and does not specify an ISO additional insured endorsement, that person or organization is an additional insured, but only with respect to liability for"bodily injury", "property damage", or"personal and advertising injury" arising out of your acts or omissions, or the acts or omissions of others working on your behalf, in the performance of your work as specified in the"written agreement". This coverage does not apply to liability arising out of the sole negligence of the additional insured unless specifically required in the "written agreement". 4. If none of the above paragraphs apply, then the person or organization is an additional insured only for, and to the extent of, liability arising out of "bodily injury", "property damage", or "personal and advertising injury" caused, in whole or in part, by your negligent acts or omissions, or the negligent acts or omissions of others working on your behalf, in the performance of your work as specified in the "written agreement". This coverage does not apply to liability arising out of the independent acts or omissions of the additional insured. However,the insurance afforded to such additional insured only applies to the extent permitted by law. C. The insurance provided to an additional insured under this endorsement does not apply to: 1. "Bodily injury" or"property damage" included in the "products-completed operations hazard" unless the "written agreement" specifically requires such coverage (including by specifically requiring the CG 20 10 11 85). To the extent the "written agreement" requires such coverage for a specified amount of time,the coverage provided by this endorsement is limited to the amount of time required for such coverage by the "written agreement". 2. "Bodily injury", "property damage", or"personal and advertising injury" arising out of an architect's, engineer's, or surveyor's rendering of, or failure to render, any professional services, including but not limited to: a. The preparing, approving, or failing to prepare or approve: (1) Maps; (2) Drawings; (3) Opinions; (4) Reports; (5) Surveys; (6) Change orders; CG 73 24 03 23 Includes copyrighted material of the Insurance Services Office, Inc.,with its permission Page 2 of 3 (7) Design specifications; and b. Supervisory, inspection, or engineering services. D. The limits of insurance that apply to the additional insured are the least of those specified in the "written agreement" or declarations of this policy. Coverage provided by this endorsement for any additional insured shall not increase the applicable Limits of Insurance shown in the Declarations. The limits of insurance that apply to the additional insured are inclusive of, and not in addition to,the Limits of Insurance shown in the Declarations. E. With respect to the coverage provided by this endorsement, SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 4. Other Insurance is deleted and replaced with the following: 4. Other Insurance. a. Coverage provided by this endorsement is excess over any other valid and collectible insurance available to the additional insured whether: (1) Primary; (2) Excess; (3) Contingent; or (4) On any other basis. In addition, this insurance is excess over any self-insured retentions, deductibles, or captive retentions payable by the additional insured or payable by any person or organization whose coverage is available to the additional insured. However, if the "written agreement" requires primary and non-contributory coverage,this insurance will be primary and non-contributory relative only to the other insurance available to the additional insured which covers that person or organization as a Named Insured, and we will not share with that other insurance. For any other insurance available to the additional insured where that person or organization is not a Named Insured, this policy will share coverage with that other insurance based on the terms specified in Paragraph b. Method of Sharing below. b. Method of Sharing If all the other insurance permits contribution by equal shares,we will follow this method also. Under this method, each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. CG 73 24 03 23 Includes copyrighted material of the Insurance Services Office, Inc.,with its permission Page 3 of 3 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 07/14/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NCT 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(!as)must have ADDITIONAL INSURED provisions or be endorsed.If SUBROGATION IS WAIVED,subject to the terns 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: PHONE(A/C,No,Ext): (800)277-1620 X 4600 FAX(A/C NO): (727)Z27 0704 FrankCrum Insurance Agency,Inc. E-MAIL ADDRESS: 100 South Missouri AvenuB INSURER(S)AFFORDING COVERAGE NAICq INSURER A: Frank Winston Crum Insurance Company Clearwater,FL 33756 _ 1600 INSURED INSURER... ... ......... B: FrankCrum L/C/F Tyler Gautier Landscaping Inc.dba Gautier Tree SURER C: &Landscape INSURER D: 100 South Missouri Avenu3 INSURER E: Clearwater FL 33756 INSURER F' COVERAGES CERWICATE NUMBER: 911588 REVISION NUMBER: THIS IS TO CERTIFY THAT TIME 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 A FFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED 3Y PAID CLAIMS. _—..m,.a..P. ILTR INSRD ADDL SUER POLICY EFF POLICY ERP _...- TYPE OF INSURANCE WVD POLICY NUMBER LIMITS ..,.,,,..y .,,.,....... (MMIDDIYYYY) (MM/DDM'YY) COMMERCIAL GENERALLIABILITY EACH OCCURRENCE $ _ N CLAIMS-MADE OCCUR DAMAGE TO RENTED $ PRE,MBSE:F.E a,.ermr wince ..................................�.,.,,.,�.,..,...,. MEN EXP(Any one person) $ _ ..,„,,. ,,,„_ PERSONAL&ADV INJURY $ OF.iN'l AGGREGATE LIMIT APF_IES PER: GI.?.M PAL AGGREGATES $ ... _.,...... ... m ....� ... CfJMI t01 AGG $ POLICY ��I'It(7,.:.:CT �.. �I_OC I ItODUCT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ -eccMe,nt ANY AUTO par,".)Per t;1t'4RJG.D AUTOS :i&%H$f]Jl.fi,^,1 BODILY INJURY( $ r:.JNL'✓ AUTOS BODILY INJURY(Per aocident} .. HIRED AUTOS „NON-OWNED PROPERTY' DAMAGE ONLY T c dent $ UMBRELLA LIAR OCCUR EACH OCURRENCE $ EXCESS LIAR CLAIMS MADE::. AGGREGATE $ DED R'F:TL-rJ'I'NI)&• WORKERS WMPFNSATI� ...... ....m , ON FUD WC202200000 0 1I01I2022 01/0112023 X R STATUTE OTH-' ER A EMPLOYERS LIABILITY Y/N ANY PROPRIETOR/PARTNEFB/EXE--ME OFFICER/MEMBER EXCLUDED N/A E L EACH ACCIDFNT $9 RRR.000 (Mandatory In NH) If yes,describe under I,I. ILO�rI'rg,R f fl�L 111P..G ff E $t 000 0 0 DESCRIPTION OF OPERATION below �........�................. E.L..DISEASE-POLICY I,IMIT $tdRQ 229 DESCRIPTION OF OPERATIONS rM-OCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Effective 12/29/2021,cove age is for 100%of the employees of FrankCrum leased to Tyler Gautier Landscaping Inc.dba Gautier Tree&Landscape(Client)for whom the client is reportinc hours to FrankCrum.Coverage is not extended to statutory employees. APPROVED BY RISK MANAGEMENT DATE WAIVER N/A YES CERTWICATE HOLDER CANCELLATION S;t'IOt,IW.D ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLCY PROVISIONS Monroe County BOCC AUTHORIZED REPRESENTATIVE 1100 Simonton Street Key West,FL 33)40 ©1988-2016 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID:91D1EB33-D9E4-462D-A5DD-5D59C8D96499 Cl CW A021011 CERTIFICATE OF INSURANCE This certificate is issued for informational purposes only. It certifies that the policies listed in this document have been issued to the Named Insured. It does not grant any rights to any party nor can it be used, in any way, to modify coverage provided by such policies.Alteration of this certificate does not change the terms,exclusions or conditions of such policies. Coverage is subject to the provisions of the policies, including any exclusions or conditions, regardless of the provisions of any other contract, such 3s between the certificate holder and the Named Insured. The limits shown below are the limits provided at the policy inception. Subsequent paid claims may reduce these limits. Certificate Holder Named Insured: THE MOONRCE COUNTY BOARD OF COUNTY GAUTIER TREE & LANDSCAPE INC. COMMISSIONERS & TYLER GAUTIER LANDSCAPING INC. 1100 SIMON'TON ST 89100 OVERSEAS HWY KEY WEST, FL USA 330403110 TAVERNIER FL 33070 Automobile Liabili Insurer Name:A113tate Insurance Company PolicyNumber C48929360 1--Any Aub 2-Owned Autos Only 3-Owned Priv.Pass.Autos Only 4--Owned Autos Other Than Priv. 5-Owned Autos Subject to 6-Owned Autos Subject to a Compulsory UM Law Pass.AUtoE OnlyX No Fault X 7--Specifically Described Autos X 8-Hired Autos Only X 9-Nonowned Autos Only Policy Effective Date: 05-03-2022 1 Policy Expiration Date: 05-03-2023 Limits of $1,000,000 Combined Single Limit(each accident) Insurance: BI Per Person BI Per Accident PD Per Accident Description of 0pe rations/Locations/Vehicles/Endorsements/Special Provisions APPROVED BY RISK MANAGEMENT DATE 10�4�2C� 2 WAIVER NIA- YES-Interested Pa : Additional Insured - All Other THIS CERTIFICATE DOES NOT GRANT ANY COVERAGE OR RIGHTS TO THE CERTIFICATE HOLDER. IF THIS CERTIF CATE INDICATES THAT THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED, THE POLICY(IES)MUST EITHER BE ENEORSED OR CONTAIN SPECIFIC LANGUAGE PROVIDING THE CERTIFICATE HOLDER WITH ADDITIONAL INSURED STATJS. THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED ONLY TO THE EXTENT INDICATED IN SUCH POLICY LANGUAGE OR ENDORSEMENT. Producer 7/14/2022 SUAREZ INSULANCE GROUP LLC Authorized Representative: Docusl9nea by: Date: 07-14-22 nsss�4rr�t��ar�sn,�,c;. Includes copyrighted material of Insurance Services Office, Inc.,with its permission Cl CW A021011 Allstate Insurance Company Page 1 of 1 Insured Full Copy DocuSign Envelope ID:91 D1 3B33-D9E4-462D-A5DD-5D59C8D9B499 POLICY NUMBER: 6 4 8 9 2 9 3 6 0 COMMERCIAL AUTO CA20481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are'insureds"for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Namedhsured: GAUTIER TREE & LANDSCAPE INC. Endorse rient Effective Date: 0 7-14-2 0 2 2 SCHEDULE Name Cf Person(s) Or Organization(s) THE MDONROE COUNTY BOARD OF COUNTY COMMISSIONERS 1100 SIMONTON ST KEY WEST, FL USA 330403110 Informa-ion r2quired to com fete this Schedule, if not shown above, will be shown in the Declarations. Each peron or organization shown in the Schedule is an 'insured"for Covered Autos Liability Coverage, but only to tl-e extent that person or organization qualifies as an insured" under the Who Is An Insured provision contained in Paragraph Al. of Section II - Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I - Covered Autos D Signed by: 7/14/2022 Coverages of the Auto Dealers Coverage Form, IVaN s0arf- 0556FOurs R54Ac CA 20 48 10 13 ©Insurance Services Office, Inc., 2011 Page 1 of 1 Insured Full Copy CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 11/21/2022 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Lilliam Reyes NAME: Regan Insurance Agency PHONE (305)852-3234 11 (305)852-3703 WC No..E.nfl E-MAIL AdC.No ...�.._...�..._...._ m 90144 Overseas Hwy. ADDRESSt ure'yEs( rtbgaalitasl.Irafh(ewns,cam INSURER(S)AFFORDING COVERAGE NAIC N Tavernier FL INSURERA:33070 Maxum tY Company Indemni Com an -._... .. INSURED IN INSURER B• _ _.. Tyler Gautier Landscaping Inc.DBA:Gautier Tree&Landscape INSURER C P.O Box 800 INSURER D r. INSURER E r w. Tavernier FL 33070 INSURER F COVERAGES CERTIFICATE NUMBER: GL 22/23 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 r 1uva LTR TYPE OF INSURANCE IN3D wUD POLICY NUMBER MM/DD/YYYY MM/DDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �OCCUR D J NT ED 100,000 PR EMISE$�(Ea.ar..curre�nr„el $ MED EXP(Any one person) $ 5,000 A Y BDG-3060193-01 11/22/2022 11/22/2023 PERSONAL&ADVINJURY $ 1,000,000 GENERALAGGREGATE $ 2,000,000 GE.NLAGGRrGAT�'LIMIT APPLIES PER: .. POLICY 17 PLO- LOC PRODUCTS-COMP/OPAGG $ 2,000,000 ILCT OTHER: Herbicides Or Pesticides $ AUTOMOBILE LIABILITY GOMMI NN4 E 9JMI"I' $ �:u5<iCCdien9. ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED F+'WOP'FRTY OAMAGE $ AUTOS ONLY AUTOS ONLY /,,,,Perm?ccadant UM EACH OCCURRENCE $ UMBRELLA LIAR OCCUR /s5 EXCESS LIAB CLAIMS-MADE � I tl AGGREGATE $ DED RETENTION$ $ WORKERS AND EMPLO ERS'L ABILITY YIN I � 11, 23 2.2 GL �- STTH ATUTE EE ._....�. ANY PROPRIETOR/PARTNER/EXECUTIVE N/A q, E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? II """""""'� (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES ACORD 1( 01,Additional Remarks Schedule,may be attached if more space is required) landscaping and lawn service and Tree Trimming/Prunning Certifiacte Holder is Additional Insured when reuired by written contract CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Monroe County BOCC ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West FL 33040 2f 'yir4fl_T ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD