Certificates of Insurance
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ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YV)
10/09/02
PRODUctR . . THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ARTHUR J GALLAGHER-BOCA RATON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
2255 GLADES RD SUITE 400E
Boca Raton, FL 33431-7379 INSURERS AFFORDING COVERAGE
INSURED INSURER A: United National Insurance Co.
City of Key West INSURER B: Midwest Employers Casualty Company
PO Box 1409 INSURER C:
Key West, FL 33040 INSURER 0:
I INSURER E:
cr t# 25
KEYWESTCITY
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,
r~~: TYPE OF INSURANCE POLICY NUMBER Pg~'f"Y,~~~~~ P'i,1j,f: 1";l.':!~reN LIMITS
A GENERAL LIABILITY CP0065360
~COMM ERCIAL GENERAL L1AB ILlTY
-D CLAIMS MADE [X] OCCUR
Including SIR
of $100,000
~'LAGGREGATE LIMIT AP~S PER:
I POLICY n ~~R.; I I LOC
A ~TOMOBILE LIABILITY CP0065360
..!... ANY AUTO
_ ALL OWNED AUTOS
I-- SCHEDULED AUTOS
_ HIRED AUTOS
_ NON.OWNED AUTOS
Including SIR
of $100,000
10/01/02
10/01/03
EACH OCCURRENCE $1 000.000
F'RE DAMAGE (Anyone fire) $
MED EXP (Anyone person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
PRODUCTS .COMP/OP AGG $
10/01/02
10/01/03
fE~~~~~~t~INGLE LIMIT $1,000,000
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accidenl)
EXCESS LIABILITY
~OCCUR 0 CLAIMS MADE
I DEDUCTIBLE
II RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
APP IIVll-f$K 'M T'''^''''~MENT
BY I \~(11 ,lid
DATE __'.\~~Tl.~Id5
WAIVER N/A ~ tiES
PROPERTY DAMAGE
(Per accident)
nRAGE LIABILITY
II ANY AUTO
AUTO ONLY. EA ACCIDENT $
$
$
$
$
$
$
OTHER THAN
AUTO ONLY:
EA ACC
AGG
EACH OCCURRENCE
AGGREGATE
A
B
CP0065360/2898S0FL
Including SIR of
10/01/02
$175,000
10/01/03
x 1"\y'~~;~1~'" I 10J~'
E,L. EACH ACCIDENT $1,000,000
E.L. DISEASE. EA EMPLOYEE $1,000,000
E,L. DISEASE. POLICY LIMIT $1,000,000
OTHER
DESCRIPTION OF OPERA TIONS/LOCA TIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
FOR: Military Memorial located at Mallory Square, Key West, Florida
The certificate holder is listed as additional insured as their interest may appear for the General Liability coverage
only.
CERTIFICATE HOLDER
1 X I ADDmONALINSURED'INSURERLETTER:
CANCELLATION
ACORD 25-S (7/97)1 of 2
#S15516/M15506
SHOULD ANYOFTHEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL30.....-DAYSWRITTEN
NOTICE TOTH E CERTIFICATE HOLDERNAMED TOTHE LEFT, BUTFAlLURE TO DOSOSHALL
1M POSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON TH E INSURER,ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
r~~ L. ~~ JRD CORPORATION 1988
Monroe County Tourist
Development Council
1201 White Street, Ste 102
AND Monroe County BOCC
1100 Simonton Street
I Kev WAC. FL ~~404
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.
ACORD25-S(7197)2 of 2 #S15516/M15506
'SEP-\7-02 15,58 FROM,MCTOC
10,3052960788
PAGE 2/2
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