Certificates of Insurance
CERTIFICATE OF INSURANCE ISSUE DATE (MMIOOIYY)
0844565 10/07/02
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
K & K Insurance Group, Inc. AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
1712 Magnavox Way CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
P.O. Box 2338 COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Wayne, In 46801
COMPANIES AFFORDING COVERAGE
INSURED COMPANY A
LETTER TIG INSURANCE COMPANY
NATIONAL COUNCIL OF CORVETTE CLUBS, INC.
FLORIDA KEYS CORVETTE CLUB COMPANY B
LETTER
COMPANY C
LETTER
COVERAGES
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. TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION
LTR POLICY NUMBER DATE (MMIDDNY) DATE (MINDDNY) LIMITS (in thousands)
General Liability 12:01AM 12:01AM General Aggregate $ NONE
A IX] Commercial General Liability KSP3803019300 12/15/99 12/15/02 Products-Com plOps Aggregate $ 1000
o Claims Made EUoccur. Personal & Advertising Injury $ 1000
DOwner's & contractors Prot. Each Occurrence $ 1000
~ 100 000 R"R"RO"R~ Fire Damage (Anyone fire) $ 300
AND OMISSIONS Medical Expense (Anyone person) $ "
Participant Legal Liability $ 1000
Automobile Liability Combined
o Any auto Single $
Limit
B All owned autos Bodily
Scheduled autos Injury $
(ner nerson)
o Hired autos Bodily
o Non-owned autos ~~.~.ij}G Injury $
APP"NiD~ (ner accident)
o Garage Liability IJ-N...." a1erty
0 BY ~ ...Y' . I , 1/. L mage
$
Excess Liability DATE ~l' t I.~d. , Each
0 Occurrence Aggregate
o Other than Umbrella form WAIVER I fA/' YES $ $
Workers' Compensation Statutory
and $ Each Accident
Employers' Liability $ Disease-Policy Limit
$ Disease-Each Employee
AD&D $
Participant Primary Medical $
Accident Excess Medical $
Weeklv Indemnity $ X
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS
TYPE OF EVENT: CAR SHOW FOR CORVETTES EVENT DATES: 11/1-2/02
LOCATION: 9TH ANNUAL "CORVETTES IN PARADISE" SHOW @ HOLIDAY ISLE, I SLAMORADA ,
FLORIDA SEE ATTACHED ADDENDUM
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE
MONROE COUNTY BOARD OF COUNTY CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE
COMMISSIONERS, TDC, EMPLOYEES & ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS
OFFICIALS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO
ATTN: RISK MANAGEMENT THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE
5100 COLLEGE ROAD NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
STOCK ISLAND, FL 33040 COMPANY, IT~AGENT~OR REPRESENTATIVES.
I AUTHORIZED R1~~7:t A J .... c..../7 .:;>
q:;:;=' .-...../\
SL39 / ( ~ 1-92
JAM
~c..'~
, -ADDENDUM
P AGE
FOR
C E R T I F I CAT E
K & K INSURANCE GROUP, INC.
CERTIFICATE:
844565
DATE ISSUED:
10/07/02
ACCOUNT NAME: NATIONAL COUNCIL OF CORVETTE CLUBS, INC.
TYPE OF INSURANCE:
GENERAL LIABILITY
POLICY NUMBER:
KSP3803019300
ADDITIONAL INSUREDS: PER POLICY
A. ANY PERSON OR ORGANIZATION ENGAGED IN OPERATING, MANAGING,
SANCTIONING, OR SPONSORING THE "COVERED PROGRAM" OR PROVIDING THE
PREMISES FOR A "COVERED PROGRAM", INCLUDING OFFICIALS OF THE
"COVERED PROGRAM".
B. ANY PARTICIPANT (EXCLUDING DRIVERS) "COMPETITION VEHICLE" OWNER AND
"COMPETITION VEHICLE" SPONSOR AND OFFICIALS OF THE "COVERED
PROGRAM" .
C. ANY "PARTICIPANT" DRIVER, BUT ONLY WITH THE RESPECTS TO "BODILY
INJURY" OR "PROPERTY DAMAGE" TO PERSONS OTHER THAN ANY OTHER
DRIVER.
D. MONROE COUNTY BOARD OF COUNTY COMMISSIONERS, TDC, EMPLOYEES &
OFFICIALS; BUT ONLY AS RESPECTS TO THE OPERATIONS OF THE NAMED
INSURED.
. CERTIFICATE OF INSURANCE 693535 I'~~ UAI~~7;~';~ 1
..
,
~ODUCER
( THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
K & K Insurance Group, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1712 Magnavox Way HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 2338 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Wayne, In 46801 COMPANIES AFFORDING COVERAGE
INSURED --
COMPANY ATIG INSURANCE COMPANY
NATIONAL COUNCIL OF CORVETTE CLUBS, INC. LETTER
FLORIDA KEYS CORVETTE CLUB COMPANY B
LETTER
COMPANY C
LETTER
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD IN-
DICATED, 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 CONDI-
TIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
CO, TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS (in thousands)
LTR DATE (MM/DD/YY) DATE (MMIDD/YY)
General Liability 12:01AM 12:01AM General Aggregate $ NONE
A KJ Commercial General Liability KSP3803019300 11/02/01 11/05/01 Products-Comp lOps Aggregate $ 1000
D Claims Made KJ Occur, Personal & Advertising Injury $ 1000
DOwner's & Contractors Prot, Each Occurrence $ 1000
D Fire Damage (Anyone fire) $ 300
Medical Expense (Anyone person) $ 5
Participant Legal Liability $ N/A
Automobile Liability Combined
D Any auto Single $
Limit
D All owned autos Bodily
D Scheduled autos Injury $
(per person)
D Hired autos Bodily
D Non-owned autos Injury $
(per accident)
D Garage Liability Property
D '" . Damage $
Excess Liability Each
D Occurrence Aggregate
~.:.. I
D Other than Umbrella form "f.i'lNr::~1 1.1,. I" .... r"~ ..~ 4'
. . $ $
. .... . 1- ,~'
Workers' Compensation ~,,~ .A 1I1l)_ Statutory
and ,l1ld -- $ Each Accident
Employers' Liability , $ Disease-Policy Limit
G'.,'F_-- ./ $ Disease-Each Employee
;,t,..,.r-n- ';"'. " .<1 ~V~\_ AD&D $
Participant Primary Medical $
Accident Excess Medical $
I Weekly Indemnitv $ X
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/ RESTRICTIONS I SPECIAL ITEMS
TYPE OF EVENT: CAR SHOW
LOCATION: ISLAMORADA, FL
SEE ATTACHED ADDENDUM
CERTIFICATE HOLDER CANCELLATION
MONROE CPUNTY BOARD OF COUNTY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE
COMMISSIONERS CANCELLED BEFORE THE EXPIRATION DATE THE~EOF, THE
C/O RISK MANAGEMENT ISSUING COMPANY WILL ENDEAVOR TO MAIL ~ DAYS
WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
5100 COLLEGE ROAD, ROOM 203 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO
STOCK ISLAND OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY
KEY WEST, FL 33040 ITS AGENT~ OR REPRESEN~TIVES, '
w'"o"'~ """'" ,~ ~ '.(
to.,") I)
_ ~~"",0'"C:/~,"../l
-- v 7/'
SL 39
1-92
ADDENDUM
POLICY NUMBER: KSP-38030193
ADDITIONAL INSUREDS: PER POLICY
A. Any person or organization engaged in operating, managing, sanctioning, or
sponsoring the "covered program" or providing the "premises" for a
"covered program", including officials of the "covered program".
B. Any "participant" but only with respect to "bodily injury" or "property damage" to
persons other than any other "participant", "competition vehicle" owner, "competition
vehicle" sponsor or employee.
C. Any "competition vehicle" owner and "competition vehicle" sponsor but only with
respect to "bodily injury" or "property damage" to persons other than any other
"participant", "competition vehicle" owner, "competition vehicle" sponsor or
employee.
D. Monroe County BOCC and Monroe County Tourist Development Council; but only as
respects to the operations of the Named Insured.
.. ISSUE DATE (MMIDD/YY)
CERTIFICATE OF INSURANCE 728912 0 8/14/01
PRODUCEfl THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
K & K "Lnsurance Group, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1712 Magnavox Way HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 2338
Fort Wayne, In 46801 COMPANIES AFFORDING COVERAGE
INSURED
COMPANY A T I G INSURANCE COMPANY
NATIONAL COUNCIL OF CORVETTE CLUBS, INC LETTER
FLORIDA KEYS CORVETTE CLUB COMPANY B
LETTER
COMPANY C
LETTER
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD IN-
DICATED, 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 CONDI-
TIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS (in thousands)
LTR DATE (MM/DD/YY) DATE (MM/DD/YY)
General Liability 12:01AM 12:01AM General Aggregate $ NONR
A [Xl Commercial General Liability KSP3803019300 11/02/01 11/04/01 Products-Camp lOps Aggregate $ 1000
o Claims Made [Xl Occur, Personal & Advertising Injury $ 1000
DOwner's & Contractors Pro!. Each Occurrence $ 1000
[Xl 100.000 ERROR Fire Damage (Anyone fire) $ 100
AND OMISSIONS Medical Expense (Anyone person) $ "i
Participant Legal Liability $ 1000
Automobile Liability Combined
o Any auto Single $
'ff\J1JJ '~:'-"i,~t<\ r....fH/-;.. Limit
o All owned autos . - ~ 'I /] Alr~/j/j Bodily
o Scheduled autos W (.r. Injury $
(per person)
o Hired autos " Bodily
---- --~~
o Non-owned autos DI Injury $
" - (per accident)
o Garage Liability " ,. --- '/
./ Property
0 - VFS_ Damage $
,':' ','rQ. ,-~ ,
Excess Liability Each
0 Occurrence Aggregate
o Other than Umbrella form $ $
Workers' Compensation Statutorv
and $ Each Accident
Employers' Liability $ Disease-Policv Limit
$ Disease-Each Employee
AD&D $
Participant Primarv Medical $
Accident Excess Medical $
Weeklv Indemnity $ X
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / RESTRICTIONS / SPECIAL ITEMS
TYPE OF EVENT: CORVETTE SHOW
LOCATION: 8TH ANNUAL "CORVETTES IN PARADISE" SHOW @ HOLIDAY ISLE, ISLAMORADA,
FLORIDA * SEE ATTACHED ADDENDUM
CERTIFICATE HOLDER CANCELLATION
MONROE COUNTY BOARD OF COUNTY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE
COMMISSIONERS C/O RISK MANAGEMENT CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE
ISSUING COMPANY WILL ENDEAVOR TO MAIL -.2.Q... DAYS
ATTN: WAYNE ROBERTSON WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
5100 COLLGEGE ROAD LEFT, BUT FAILURE TO ,.., -. '~H NOTICE SHALL IMPOSE NO
STOCK ISLAND OBLIGATION ~~Y OF AJ~ KIND UPON THE COMPANY,
ITS AGENTS 0 PRESENTAj ES.
KEY WEST, FL 33040 """",." ""~
//
,
1-92
SL 39
ADDENDUM
POLICY NUMBER: KSP - 3803019300
ADDITIONAL INSUREDS: PER POLICY
A. Any person or organization engaged in operating, managing,
sanctioning, or sponsoring the "Covered Program" or providing the
Premises for a "Covered Program", including officials of the
"Covered Program".
B. Any "participant", (excluding drivers) "Competition Vehicle" owner
and "Competition Vehicle" sponsor and officials of the "Covered
Program" .
C. Any "participant" driver, but only with respect to "bodily injury" or
"Property Damage" to persons other than any other driver.
D. Monroe County Board of County Commissioners, employees &
officials; but only as respects to the operations of the named insured.