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Insurance CertificatesC IE::W li::::,ti ....1... U JC ii:::::: ��='h Ih� :: C1i IF= 1:: ,ai ''= 4..__I! f = �� Ei � g i[ s il: : I""e dater 10/21/93 `c y --------------------------------------------------------------------------------------------------------------------------------- Producers This certificate is issued as a matter of information only and confers i no rights upon the certificate holder. This certificate does not •send, extend or alter the coverage afforded by the policies below. THE JOHNSONS INS AGCY ------------------------------------------------------------------------ PO BOX 2346 : COMPANIES AFFORDZMO COVERAGE MARATHON WESFL 33052 ;---------------------------------------- Codes Sub-codws Cc Ltr At USF&G SBMC �PPitI}VEQBY"RTSIC1ufAaAl;EMENT`---- i Insureds •-V---- -- - - - Ca Ltr Br USF&G SBMC BI i----------- Cc Ltr Cs GATE Cc Ltr Or TAVERNIER FL 33070------------------------------------- W81vm. MIA------_- YES-----_____ Cc Ltr Es COVERAGES This is to certify that 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 say 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. Ca : I Policy 1 Policy Ltr: Type of Insurance : Policy number :effective date :expiration date: Limits -----------------------------------------'---------------------------------------------------------------------- A :GENERAL LZABZLZTY 1MP300470687 : 7/01/93 ! 7/01/94 1 aggregates 1 000 000 General a r• •te$ � , [X1Commercial general liability i 1 1 g y � � i :Products-comp/ops •pgrrgr�s 1[ 11 1 Claims made i 1l�f� IX1 Occur :Parsonal/edvertising injs s Owner's Q contractor's rot i , , 17�1 000 i[ 1 P , � � Each occurrences :f 1 000 000 i[ 1 i i : :Fire damages :e 5a n� i i : :Medical expenses �• ((��vj6 ___--____-�___________________________ _ -------------/94 ---------------------------------------- B :AUTONO&ZLE LIABILITY ! 1MP300470687 ! 7/01/93 i :Combined Single , !s /n auto l All owned autos ! : i Limits :s 1,000,000 ,[ :Bodily injury l Scheduled autos :(Per person)$ �t �( Hired autos rX1 : :Bodily injury [X1 lion -owned autos : j� : :(Per acctdentJr s Garage liability , Receive,.: 2tisklMj t. & ' , Loss l:.�,.:'�, :Property damages �t ---------------------------- ' EXCESS LIABILITY : DATE ,. .,. ,( :Each Occurrence �s :[ i Umbrella form , 6 :Aggregate is +` Other than umbrella form v INITIAL ---------------------------------------- ---- -------------- -------------- --------------------------------------------------------------------------- ------------------------------------- ---- HORKER'S COMPENSATION : !Statutory Limits �________________ : AND ; ; :(Each ' --- : EMPLOYERS' LIABILITY ! ! : !(Oise• ifr� z ------------------------------------------ :OTHER____-______ -___ NOV 4 199, ------------------------------------------------------------------------------------------------------------------- Description of operations/locations/vehicles/restrictions/special items$ COUNTY A„TTY MENTAL HEALTH CLINIC **CERTIFICATE HOLDER IS ALSO ADDITIONAL INSURED**** CERTIFICATE HOLDER MONROE COUNTY ROOM #207 5000 COLLEGE ROAD KEY WEST FL 33M CANCELLATION Should any of the above described policies be cancelled before the expiration data thereof, the issuing company will endeavor to mail 10 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 company, its agents or representatives. Authorised representatives Susan J. Cherrybon UC ... ....... ... ......... ... .. ----------- ... . ........... . ..... U* ISSUE DATE (MM/DOIYY) .. SUhU As A MAI ILM Qr- INt-VKMAIIUN UNLY CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE POE & BROWN INC. DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE P.O. BOX 2412 POLICIES BELOW. OAYTONA BEACH, FL 32115-2412 COMPANIES AFFORDING COVERAGE 904-252-9601 COMPANY A LETTER Government Risk Insurance Co. COMPANY MANAGEMENT— B ApppOVED BY RISK INSURED LETTER Guidance Clinic of the Upper COMPANY C BY Keys , I nc . LETTER PO Box 363 COMPANY D DATE Tavernier LETTER FL 33070 COMPANY WAIVER-. N/A tz. LETTER E ............................ CO RAGES �:i: � 1. 1 1. * 1"...",.,*,��............�........ I �. .1. ..... ...... ...... ..... .. ... . ... ........ IS THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD DI INDICATED, INDICA1 ED, NOTWITHST ANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS TIr _I CERTIFICATE ERTIFICATE 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 SHOWNMAY HAVE BEEN REDUCED BY PAID CLAIMS Do LT; T YPE OF IINSURANCE POL ICY NUMBER POLICYEFFECTIVE POLIOVEXPIRATION LIMITS DATE(MM/DD/YY) DATE(MM/DO/YY) GENERAL LIASLITY GENERAL AGGREGATE PRODUCTS-COMP/OP A66 COMMERCIAL GENERAL LIABILITY COMMERCIAL CLAIMS MADE = OCCUR. PERSONAL & AOV INJURY EACH OCCURRENCE & CONTRACTOR'S PROT FIRE DAMAGE (Any one fire) MED EXPENSE (Any one person AUTOMOBLE LIABILITY COMBINED SINGLE ANY AUTO LIMIT BODILY INJURY ALL OWNED AUTOS SCHEDULED AUTOS (Per person) BODILY INJURY HIRED AUTOS NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE LIABILITY HGARAGE EXCESS LIABILITY EACH OCCURRENCE AGGREGATE UMBRELLA FORM ............. .................... OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION STATUTORY LIMITS EACH ACCIDENT = 100000 A AND 00270 7/01/93 7/01/94 DISEASE -POLICY LIMIT i 500000 EMPLOYERS'LIA811LITY UISLASE-tACH EMPILLYEt 100000 OTHER Received 16.9k M.gint. & Loss Control DESCRIPTION Of OPERATIONVLOCATICINtLIVEHICLEVSPECIAL ITEMS FNITIAL ...... ................. CANCELLATION., ................. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRIT TENNOTICE TO THECERTIPICATE HOLDEPNAMEDTO THE Monroe County Risk Management LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR Attn: Kaye Balida LIABLITYOF-A NY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENT ATIVES 5100 College Road : Key West, FL 33040 AUTHORIZED' VF PRESENTATIVE A0 070214000 A;98D ...... ....... ...... . .. ........ . . . ..... ; ..... ......... . ......... . ... 0"014i .......... t U Account Number: FL GUID 3631 Date: ' Initials: CERTIFICATE OF INSURANCE c/o: American Professional Agency, Inc. 95 Broadway, Amityville, NY 11701 This is to certify that the insurance policies specified below have been issued by the company indicated above to the Insured named herein and that, subject to their provisions and conditions, such policies afford the coverages indicated insofar as such coverages apply to the occupation or business of the Named Insured(s) as stated. THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE(S) AFFORDED �X THE POLICY(IES) LISTED ON THIS CERTIFICATE. Name and Address of Insured:r�;;r��}y�X P z BLANKET COVERAr_F (:XUI:I�Ai'lCE. C:LTtdTC 01 I FIE.. UPPER KEYS, INC h' . C3 . DOX 363 T'AVERN:I:E R, FL.. 330-70 Occupation or Business: 1,9 co&?? . SOCIAL. SEFiVI:CE AGEINCY Location of Operations: (if different than address listed above) APPROVED BY RISK MANAGEMENT BY DATE r t 1--7 1 1� WAIVER: N/A YES Type of Work Covered: PROF. MENTAL. HEAL.TH COUNE;EI-ING RecL 1, ;: v%, Risk Mgmt. & 'ioss Control DATE NMAL Policy Effective Expiration Limits of Coverages Number Date Date Liability f:� E��`%11=c::S::i 1:ONr if._:' 3. , i}G::i , ii:•su L.I:AB.-J,LT. I'Y oo 6171014 3. 31 J.jJ/0J.: 'r 3 NOTICE OF CANCELLATION WILL ONLY BE GIVEN TO THE FIRST NAMED INSURED ON THIS POLICY AND HE OR SHE SHALL ACT ON BEHALF OF ALL INSUREDS WITH RESPECT TO GIVING OR RECEIVING NOTICE OF CANCELLATION. Claim History: Comments: This Certificate Issued to: Name: GUIDANCE' CLJNTC OF THE Address: 1.1F'PER KI:YS, INC. P.O. BOX 363 TAVERNIF:'R, FL.. 33070 GE', '52 Authorized Representative Issue dates 4/14/74 ----------------_.----------------------------------------------4-------------------------------------------------------------------------- Produ-er; This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, i extend or alter the coverage afforded by the policies below. THE JDHNSDNS INS AGCY ------------------------------------------------------------------------- RT 5 BOX 798A COMPANIES AFFORDINO COVERAGE BIG PINE KEY FL 33043---------------------------------------------------- ------------------- Codes Sub -codas i s ___________________________________________________________________________________________I_----_____. Co Ltr At USFQC S61Ar' Insured: Co Ltr Br RISK MANAGEMENT APPR_4VED BY Co Ltr Cs THE GUIDANCE CLINIC '--------------------------gy- 944 ---- --,- ------------------- PD BOX 363 Ltr Dt Z TAVERNIER FL 33070 __ __ _ _Cv - - -------------- Co Ltr Et -..___________________-__---_____--__-__-_______-____----___----____--___---____---___---__________ -_ ��'__--______---_ WAIVER: - COVER'A(SEfS This is to certify that policies of insurance listed below have been issued to the insured named above for the policy period indicated, notwithstanding any requirement, torn or condition of any contract or other document with respect to which this certificate say be issued or may pertain, the insurance afforded by the policies described herein is rouble-t to all the terms, exclusions, and conditions of such policies. Limits shown -___--_____________________________________________________________________________________________________________________________ way have been reduced by paid -Islas. Co Policy Policy i Ltr: L try Type of Insurance Polio nambar ; y ----------------------------------------------------------------------------------------------------------------------------------- effective date :expiration da tei Limits A :GENERAL LIABILITY 1MP300470687 -Xyl 7/01/94 7/01/95 ,aenaral aggregate, + 1,000,000 Commercial general liability i LAI Claims ('I, i tFroducts-comp/ops aggrogsif 170G0l000 i L �L 1 made Occur LX� Par srjneliadverttsing finis + t 1,000,000 l Owner's 6 contractor's rot iL pEach occurrences i+ i 1000000 l• i Fir• damages i+ 5I -__-i i ___________________________________________________________________ !Medical expenses 1+ 5 yet ! VV :AUTOMOBILE LIABILITY i ii :Combined Single if Any auto iL :Limitr if All owned autos " `Bodily inJury ' Scheduled autos IL _ I i fPer person?r i+ Hired autos �Bodity irtJury i L Non -owned autos ifPar accident?s + Garage liability iL s ---------------------------------------------------------------------------------------------------------------------------------- i �Prnperty damages t+ .£XCESS LIABILITY , Each Occurrence :+ L Umbrella form : Aggregate :+ ;L } Other than umbrella form ;-------------------------- __________________________________________________________________________________ NORKER'S COMPENSATION _____________________________________________ Statutory Limits ------__ AND ifEach accident? if EMPLOYERS' LIABILITY ( �fOisrase -policy limit? ++ + i :(Disease -each employee) t+ s + __________________-.__-____-__-__-_-__ IOTHEN t t ( ` 1 i ______________________________________________________________________________________________________________-._--___-__--_ Description of operations/locations/vehicles/rastrictions/special items■ Received .disk MgmtA Loss Control MENTAL HEALTH CLINIC �/ DATE d..."l9y ------------------------------------------------------------------------------------------ Rev-,t.-� ---a c------------- CERI"I FF I CAI"E 1--OLDER MDNROE COUNTY (ADD'L INSURED) ROOM #207 5100 COLLEGE ROAD KEY WEST FL 33040 CANCELLF-*il.1'. ON Should any of the above described policies be cancelled before the : expiration date thereof, the issuing company will endeavor to t i days written notice to the certificate holder Hamad to the mail 10 left, but failure to mail such notice shall impose no obligation or i liatrtlity of any kind upon the company is agents or representatives. --------------- ---------------- - --- -- ---Tn7 -- ---------------- Authorize r en at as /�////j� / ' — LINO LMES -- .>• i..... Issue dates 4114/94 -------------------------------------------------------------------------------------------------- Producer: This certificate is issued as m 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. THE JOHNSONS INS AGCY ;------------------------------------------------------------------------- RT 5 BOX 798A COMPANIES AFFORDINO GOVERAGE BIG PINE KEY FL 33043 ;------------------------------------------------------------------------- Codes Sub -codes i , Co Ltr As __________________________________________________________________________ Insured: __________________________________ Ca Ltr Bs USF&G SBMC MANAGEMENT --------------------------------------- gY Co Ltr Co- THE GUIDANCE CLINIC ------------ ---------------------- P 0 BOX 363 - ----------- CO Ltr Or Sy___ _ TAVERNIER FL 33 ......... ------ ------------------------------------- I-L 1p 1 t-------- Ca Ltr Er PATE ------------------------------------------------------------------------------------- WAIVER' N/A this is to certify that policies of insurance listed below have been issued to the insured vowed above for the policy period indicated, notwithstanding any requirement, tore 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 h►rein is sublect to all the terms, exclusions, and conditions of such policies. Limits shown ____________________________________________________________________________________________________________________________________ way have been reduced by paid claims, Co ; ; Policy Policy Le" Type of Insurance ; Policy number ------------------------------------------------------------------------------------------------------------------------------------ ;effective date :expiration date; Limits iO£MERAL LIABILITY ;General aggregates �i iL J Commercial general liability ; ; + Products-camp/op ggre rti t s a g 'I ,i Claims made r Occur ;Persanalladrertising tnJr;i L 1 Owner's 6 contractor's prot ;Each occurrence; # IL ; ;Fire damage; :# I ---------------------------------------------------------------------------------------------------------------------------------__-- ;Medical expanses B 'AUTOMOBILE LIABILITY ; 1MP300470687 7/01/94 7/01/95 ;Gawbtned Single ;# iL Any auto I ;Limit; ti 1,000, All owned autos i ;bodily tnlury " Scheduled autos ; ;[Per person); if yV Mired autoa L � ;bodily inlury + i-R Non -awned autos ; '(Per acctdent)r i# L Garage liability 1 !L , ______________________________________________________________________________________________________________________________._-__-_ � ; ;Property damages ; +EXCESS LIABILITY t ; ;Each Occurrancr '# ;L _ Umbrella form ` t + 'Aggregate rr ate t t j °f Other than umbrella form t L i i---------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------ NORKER'S COMPENSATION ; ; ;Statutory Limits ;__________ ------------------- AND + '(Each accident) if EMPLOYERS' LIABILITY ; ; ;[Disease -policy limit) -__-----------------------------------------------------,__----__----____---___----------_-_-----_.-_--__-__--___----___----____---__- (Disease -each employee) �# t f t OTHER i , ; t t t � 1 I � t I i ------------------------------------------------------------------------------------------------------Received------------ ------ Description of opera U one/Localions/ve hiclrs/restrictions/special items# Risk Mgmt. Los ontrol GUIDANCE CLINIC DATE y °u �j'y -----IMTtAL-- CLRT` I F I CATE HOLDER 1,A114CEwLLA'1- I (JN ; Should any of the above described policies be cancelled before the expiration data thereof, the issuing company will endeavor to MONROE COUNTY//ADD'L INSURED ; mail 10 days written notice to the certificate holder named to the ROOM #207 ; left, but failure to mail such notice shall impose no obligation or 5100 COLLEGE KEY WEST ROAD FL 33040--------------- liability of any k nd upon the company, its qr. '. or representatives. -- ............. —=--------------^-*- --- -- ------------ i Authorized re pr onat e ------------------------------------------------------------------------------------------------------- LINDA R HOLMES UC 'i i b .; Adw Ir AChOi;110 C E OF INSURANCE CSR DATE (M Yl') 95 GUIDA-1 06/14/95 PRODUCER TI[IS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Johnsons Insu c nc IIOLDER.-MIS CERTIFICATE DOES NOT AMEND, EXTEND OR 89015 Overseas Hig ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tavernier FL 33070 COMPANIES AFFORDING COVERAGE The Johnsons Insurance gency COMPANY APPROVED BY RISK MANAGEMENT 305-852-9247 A USF&G INSURED �Q COMPANY BY_ B .The Guidance Clinic of the COMPANY DATE Upper Keys, Inc. C COMPANY D PO Box 363 Tavernier FL 33070 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 T TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATIONLIMITS DATE (MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ 1,000,000 _ X PRODUCTS - COMP/OPAGG $ excluded A COMMERCIAL GENERAL LIABILITY 1MP30047068703 07/01/95 07/01/96 CLAIMS MADE X� OCCUR PERSONAL & ADV INJURY $ 11000,000 _ EACH OCCURRENCE $ 1,000,000 OWNER'S & CONTRACTOR'S PROT FIRE DAMAGE (Arty o file) S 50,000 MED EXP (Arty o per ) $ 5,000 A AinOMOBILE LIABILITY ANY AUTO 1MP30047068703 07/01/95 07/01/96 COMBINED SINGLE L[MfI' f 1,000,000 X BODILY INJURY (Pcr P—) S ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per •mderu) S HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE S GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S OTHER THAN AUTO ONLY: ANY AUTO EACH ACCIDENT S AGGREGATE S EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE S UMBRELLA FORM OTHER THAN UMBRELLA FORM S WORKERS COMPENSATION AM) ___ STATUTORY LIMITS _ EMPLOYERS' LIABILITY EACH ACCIDENT $ THE PROPRIFTOR/ INCL PARTNERVEXECUTTVE DISEASE - POLICY LIMIT S DISEASE - EACH EMPLOYEE --- S OFFICERS ARE: EXCL OTHER jReceived :Li-:- DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLMSPECIAL ITEMS _ a — — Mental Health Clinic DATE NOTE: Certificate Holder is listed on the policy as Additional Insured. INITIAL CERTIFICATE HOLDER CANCELLATION MONCO-3 SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, TIIE ISSUING COMPANY WILL ENDEAVOR TO MAIL Monroe County Risk Management Key Bah l eda 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 5100 College Road OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Key West FL 33040 The Johnsons Insurance Agency ACORD 25-S (3/93) 1^C ; 0^6 ' ACORD CORPORATION 199. J / [.try ......... .... .: AIFORLI). CERTIFICATE OF INSURANCE csR $C DATE(MM/DD/YY) .....::::::.:::::........... _; GUIDA 1: 06/14/95 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Johnsons Insurance Agency IIOLDER. TIIIS CERTIFICATE DOES NOT AMEND, EXTEND OR 89015 Overseas Highway ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tavernier FL 33070 COMPANIES AFFORDING COVERAGE The Johnsons Insurance Agency COMPANY 305-852-9247 A USF8G APPPOVFn V BANIKENIENT INSURED COMPANY Q�IG B BY Gl� COMPANY C DATE The Guidance Clinic of the Upper Keys, Inc. PO Box 363 Tavernier FL 33070 COMPANY WAIVER: NiA YES _ ._..... ............ __ ........._..... ......... 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DDY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE S 1,000,000 X PRODUCTS - COMP/OP AGG S excluded A COMMERCIAL GENERAL LIABILITY 1 MP30047068703 07/01 /95 07/01 /96 CLAIMS MADE FX OCCUR PERSONAL & ADV INJURY $ 1,000,000 EACH OCCURRENCE S 1,000,000 OWNER'S & CONTRACTOR'S PROT FIRE DAMAGE (Any arc fi.) S 50,000 MED EXP (Any arc pctson) S 5,000 A AUTOMOBILE LIABILITY ANY AUTO 1MP30047068703 07/01/95 07/01/96 COMBINED SINGLE LIMIT S 1,000,000 X BODILY INJURY (P., P-` ) S ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (P raocklc m) $ HIRED AUTOS NON -OWNED AUTOS Re ivea Mgmt.& Loss Contro PROPERTY DAMAGE $ GARAGE LIABILITY DATE — 6 '� "� _ AUTO ONLY - EA ACCIDENT S OTHER THAN AUTO ONLY: `'' ANY AUTO INITIAL EACH ACCIDENT S -- AGGREGATE S EXCESS LIABILITY EACH OCCURRENCE S AGGREGATE S UMBRELLA FORM S OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND STATUTORY LIMITS EMPLOYERS' LIABILITY EACH ACCIDENT S THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE F]EXCLI DISEASE - POLICY LIMIT $ DISEASE - EACH EMPLOYEE S OFFICERS ARE: OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEIIICLES/SPECIAL ITEMS Mental Health Clinic NOTE: Certificate Holder is Listed on the policy as Additional Insured. CERTIFICATE HOI DER .... CANCELLATION ::.:::::.:..... . :::::: MONCO-3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Monroe County —Risk Management Key Bah L eda 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 5100 College Road OF AW KIND UPON TIIE COMPANY, Trg AGENTS QIf REPRESENT/ACTIVES. AuTHORI ED REPRES IVE `'-� Key West FL 33040 �Tj The Johnsons Insurance Agency ACORD 25-S (3/93)' ,-� ' ACORD CORPORATION'1993 IF IL :>::>:<:;:<::.:.::.:;;::.;:.::.:.;;;:.;:.;:.:.:.;:.;:.: DATE (MMIbOfv X. • .:. ...:. .........:........;:.;;:.;:.:;.;:.;;;:.;:.:;.;:.;:.;:.;:.; 6/26/95 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE POE & BROWN INC. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. BOX 2412 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. DAYTONA BEACH, FL 32115-2412 Received COMPANIES AFFORDING COVERAGE Risk Mgmt. & Loss ( COMPANY APPROVED RISK MANAGFhifNT 904-252-9601 C�I�ar— -BY A RiINSURED -pip — -scor COMPANY B Guidance Cl inic of the Upp4•1ii_IAL B ( ,a 3e ~ I G Keys, Inc. COMPANY PO Box 363 C Tavernier, FL 33070 COMPANY '�'V D COVERAGES :: ::•:..:::::::::::::::::. :::.::::::.:::::.:.......:::::::..:::::::::::::::::::::::::.:::.::.....:::::. THISISTOCERTIFY THATTHE POLICIES OFINSURANCELISTED BELOWHAVEBEENISSUEDT0THEINSUREDNAMEDABOVEFORTHEPOLICY PERIOD INDICATED,NOT WIT HST ANDINGANYREOUIREMENT,TERMORCONDITIONOF ANYCONT PACT OROTHERDOCUMENT WIT HRESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED ORMAY PERT AIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWNMAY HAVE BEEN REDUCED BY PAID CLAMS. co LTR TYPEOF INSURANCE POLICY NUMBER POLICYEFFECTIVE POLICY EXPIRATION LIMITS DATE (MM)DDIVY) DATE (MMIDDIYY) GENERAL LIABILITY GENERAL AGGREGATE $ rn...�.... n .,.LCENEp-n_L...5IL!Tv a°OLY.CTS-COMP/OP ACC,CLAIMS MADE ❑ OCCUR PERSONAL & ADV INJURY Is $ OWNER'S 6 CONTRACTOR'S PROT EACH OCCURRENCE S FIRE DAMAGE (Any one lire) $ MED EXP (Any one person) $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS Per accident ( ) PROPERTY DAMAGE $ GARAGE LIABILITY - AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND STATUTORY LIMITS EMPLOYERS" L I AB IL IT Y .. M 1�2n LV LV7 /n� n5 7/ V 1/ SJ " ^ //n 1/96 EACH ACCIDENT �.. i.^. n.n n.^. 1VVVVV THE PROPRIETOR/ PARTNERS/EXECUTIVE INCL DISEASE - POLICY LIMIT $ 500000 OFFICERS ARE: EXCL DISEASE-EACHEMPLOYEE $ 100000 OTHER DESCRIPTION OF OPERATIONS LOCATIONS VEHICLES SPECIAL ITEMS Certificate Holder is named as an Additional Insured as their interests may appear. Please call Pat Collins (904) 239-5779 with anir questions. R7 ! OLV. SHOULD ANY of THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAL Monroe County Risk Management 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, At t n : Kaye Miller BUT FAILURE TO MAL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 5100 College Road OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES. Key West, FL 33040 AUTIfOR-CEP REPRESENTATIVE 070214000 _'11 C'c , �- ,1 /C3 ............ ...::::.:::::.:::::::::.::::::::.: y��M JpA;:.::::.>::.>:.>:.::.>:.::.>:.>:.;:.s;;:.;:;.;: "Ui 11111 ::::. :............................................................ .. .. .. ........... :.;:.;;::.i;:::::`:::::i:. ,_•:., ..; .: ...,;. ,. bl".`. :;::;:;::::.::.::.::.::.>:.>:.>:.>::;::.::.;i::::.::::,:::i::i:.:::>:.>:.::.>:.>:.::.::.:::;i::.>:.:::.::.::.>:.>:.>:.>:.::.;:.:;;;;:: ..................:::::::::::::::..::::.::.::::.::::::.::::::::::.::...........................................................................................c :::::::::::::::..:...................................................... ::...............................::::::::::::::::::::::::::::::: ::.;:.;:.;.>:.::.>:.::.>::.::.>:.:>:::.::: .. Ro:::c ......................................... .............: Ruwiulian A 191•194� f%1rjj &A, I ,- I nt PlWila MONROE c,()tjN'rY, jrt,l RLDA pettiest For wnivcr 'or 1,1juirAitcc Requircni lts .It iq rCqjicSlLd U1 01 ttx: IMIM11WO rt:quirt-11411S, ss slxx i(lcd In tltc Coutttr's SLh�xiodt; oC Itt tunlu�:� Rcqulrau+Cnis, bo waivod qr 1uWiClOJ pa Ili; COUQv i[ig t)011U"11, .cmI Addrtss of Cr ntramr: - — —�45 Phone: Scope of work: Rcasou far Wais,cr. Approved -- ..__ Not AivnmTA Risk MaIM&CIucnt �� - %� : M._—.— --- Cvuntr Adr))inlytcolw' oppad; , Not A14)i-owd: _--•- Hoard or Comity Coumimiumm uppual: Apl)tuvcd: WC11161S QaAv: Mninukative inmrwim #470.1 WAIVt.R Not Appcovcd.- — E 70'A E,nr' uN S6,0� Ndt he it-�CZ- SJAA 'r so� � �It O��d .NNI�.1H' 7 "w AI;1 RD. CERTIFICATE OF INSURANCE CSR SG DATE(MM/DD/YY) GUIDA-1 06/30/95 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 1lUCCllC.1 The Johnsons Insurance A j ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency Risk M m[. &Loss Contr g y b HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 89015 Overseas Highway / / 2L� /�S ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tavernier FL 33070 DATE COMPANIES AFFORDING COVERAGE The Johnsons Insurance Agency INITIAL 305-852-9247 COMPANY A USF&G INSURED COMPANY Guidance Clinic of the B COMPANY Upper Keys, Inc. Keys, Inc. ATTN:Debra White C PO Box 363 Tavernier FL 33070 COMPANY D 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR PERSONAL & ADV INJURY $ EACH OCCURRENCE $ OWNER'S & CONTRACTOR'S PROT FIRE DAMAGE (Any one fire) $ MED EXP (Any one person) $ A AUTOMOBILE X LIABILITY ANY AUTO 1MP30047068703 ! 07/01/95 07/01/96 COMBINED SINGLE LIMIT $ 1,000,000 BODILY INJURY (Per persen) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: .................................... . .................................. . . ANY AUTO EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ UMBRELLA FORM $ OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' LIABILITY STATUTORY LIMITS EACH ACCIDENT $ THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE DISEASE - POLICY LIMIT $ DISEASE - EACH EMPLOYEE $ OFFICERS ARE: EXCL OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS 95 Ford Wind Star2FMDAF145SBA39399 95 Ford Wind Star2FMDA5149SA39406 CERTIFICATE HOLDER CANCELLATION MONRO-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL MONROE COUNTY BUILDING & ZONING lO DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, DEBB I BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 5100 College Road OF ANY KIND UPON THE COMP Y ITS AGENTS OR REPRESENTATIVES. Key West FL 33040 AUTHORIZE REPRESE 1 ATIVE ram; The Johnsons Insurance Agency ACORD 25-5 (3/93) ©ACORD CORPORATION 1993 Account Number: i"�- "'•III-' =:t Date: J-0 �'� `w Initials: MF CERTIFICATE OF INSURANCE AI'I;F.E?1'1-_A1,4 FI�CIME A, '5t.dRANCE i:.•01MF'ANY c/o: American Professional Agency, Inc. 95 Broadway, Amityville, NY 11701 This is to certify that the insurance policies specified below have been issued by the company indicated above to the Insured named herein and that, subject to their provisions and conditions, such policies afford the coverages indicated insofar as such coverages apply to the occupation or business of the Named Insured(s) as stated. THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE(S) AFFORDED BY THE POLICY(IES) LISTED ON THIS CERTIFICATE. Name and Address of Insured: tYt!.I �A1�l! E i� 1 1 I i I!w OF THE !' A 01. S () X 76 Occupation or Business: "Ci-Iai•_ %Irr.' i- E �G{::I'•I'm f Location of Operations: (if different than address listed above) Type of Work Covered: FR.0,F~ A *NEI-':-*T a1_ H":'A1_•T'H C-OUt-'.SEL.II}IC BLANKET COVERAGE APPROVED BY RISK MANACEMENT BY DATE �� WAIVER: N/A YES Policy Effective Expiration Limits of Coverages Number Date Date Liability P01Eca i1? br« 0 s ui i 'A`rsry1+7.. a 01"01.95 i0t-j :9i i: iiLIA~IL ` + is NOTICE OF CANCELLATION WILL ONLY BE GIVEN TO THE FIRST NAMED INSURED ON THIS POLICY AND HE OR SHE SHALL ACT ON BEHALF OF ALL INSUREDS WITH RESPECT TO GIVING OR RECEIVING NOTICE OF CANCELLATION. Claim History: Comments: This Certificate Issued to: Name: t NTY OF NROE Address: 1.'4 ! T : RI : I•::L i° Af-.1A EI�11~:N' ~••.I.(Di.G i_.l..:I...i...i C—,E .*'•.04it.i Cc : oln ceh +sz /�7/LG Received Risk Mgmt. & Loss DATE '9 � �S N"Ti A L " Authorized Represen ikw imlia» 41914943 uuj ruj A44'LI ,&., I VIO MONRO , cC)uN'['Y, Mt RIDA Bequest For Waiver of luxurauce 1Requircm¢nts it ie xegucswa dim Iix: fumuntmo r►:4uir036115. as eT>tr IRCII ill dIC CvuNly`s S,;hsxiule aC itt311r11L`�:C Roquiroulcnls, Eo %yo4od pr mWilioJ Vu tlx: rollowing wilinwi, CUIMCl fix'. Addmss u[ Cnnu:Idor:„� w `"i�i_c�•. !'hone: Scope of W+orh: Rcasou for Waivcr: Sip*lur4 of Contrllslu(: Risk, Man gamma 7�ytc cQurety A"tI111y4roILW oppea) Apprvr�cl: LIMC: RwId of County Counnlimiullcm opptmf: WcOug Duo: l4inirs,4aliro InrrnLliun Y47lM.I Approwd _-__ -- ..._ Not Appam-c l , _ - Nit Af><feowd: Appmvcd: �. Nol Approvcd: WAtV(3R CA,._ S6.0L Nd1 b9Sb-%CZ-SQ� IIt 5 A(IOS3j .NO111H' )•V 101 00 100 00:00 .nr 005 PO4 a�Q aQ � � r CERTIFI PRODUCER INSURANCE: GUIDA- The Johnsons Insurance Agency 89015 Overseas Highway Tavernier FL 33070 CSR SC 06/06/4 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. ------------------------------------------------------------ COMPANIES AFFORDING COVERAGE 305-852-9247 COMPANY ------------------------------------------------------------- A US F &G INSURED----------------- ------fQ'+_F.Q Y RISK.. MAMA! EMFNT______ ---------- COMPANY p G B---------------- CY� The Guidance Clinic of the COMPANY .,7E Upper Keys, Inc. C PO Box 363 --------------------------------- ---- -- - --- Tavernier FL 33070 COMPANY ,R. N!A ycS D > 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 I POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR DATE (MM/DD/YY) DATE(MM/DD/YY) m m ------------------------------- GENERAL LIABILITY [X ] COMMERCIAL GEN LIABILITY [ ] CLAIMS MADE [ X] OCC. [ ] OWNERS'S & CONTRACTOR'S PROTECTIVE ------------------------------- AUTOMOBILE LIABILITY [X ] ANY AUTO [ ] ALL OWNED AUTOS [ ] SCHEDULED AUTOS [ ] HIRED AUTOS [ ] NON -OWNED AUTOS [ ] ------------------------------- GARAGE LIABILITY [ ] ANY AUTO [ ] [ ] ------------------------------- EXCESS LIABILITY [ ] UMBRELLA FORM [ ] OTHER THAN UMBRELLA FORM ------------------------------- WORKERS COMP. AND EMP. LIAB. THE PROPRIETOR/PARTNERS/ EXECUTIVE OFFICERS ARE: [ ] INCL. [ ] EXCL. ------------------------------- OTHER 1MP30047068704 1MP30047068704 RE Risk Mgmt. ----------- [I�'(TIr1i 07/01/96 07/01/97 ----------------------------- 07/01/96 07/01/97 'd �)Ss �Cw—liroi b--A(I------ -------------- ---------------------------------- GENERAL AGGREGATE 1, 0 0 0, 000 PROD-COMP/OP AGG. 1, 000, 000 PERS. & ADV. INJURY not EACH OCCURRENCE 1, 000, 000 FIRE DAMAGE (ANY ONE FIRE) 50,000 MED. EXPENSE (ANY ONE PERSON) 5, 000 ------------------- -------------- COMB. SINGLE LIMIT 1, 000, 00 BODILY INJURY (PER PERSON) BODILY INJURY (PER ACCIDENT) PROPERTY DAMAGE AUTO ONLY (EA ACC) OTHER / AUTO ONLY: EACH ACCIDENT AGGREGATE EACH OCCURRENCE AGGREGATE ------------------- ------------- ]STATUTORY LIMITS EACH ACCIDENT DISEASE-POL. LIMIT DISEASE -EACH EMP. ---------------------------------- -DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS--- --------------------------------- ------------------- zealth care facilities -clinics dispensaries or infirmaries- =reatin out -patients only- no regular bed/board facilitie k*Certificate Holder is also listed on the policy as Additional Insured** > CERTIFICATE HOLDER MONCO-3 Monroe County Ka yy Miller �1D0 College Road Key West FL 33040 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 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 COMPANY,ITS AGENTS OR REPRESENTATIVES. -------------- AUTHORIZED REPRESENTATIVE / / t:----- -f------------------j----------- -ACORD 25-S (3/93) C-_ ! / /LLsT I The Johnson Account Number: FL GUID 3631 Date: 11/05/96 Initials: MF CERTIFICATE OF INSURANCE American Home Assurance Company �" c/o: American Professional Agency, Inc. 95 Broadway, Amityville, NY 11701 This is to certify that the insurance policies specified below have been issued by the company indicated above to the Insured named herein and that, subject to their provisions and conditions, such policies afford the coverages indicated insofar as such coverages apply to the occupation or business of the Named Insured(s) as stated. THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE(S) AFFORDED BY THE POLICY(IES) LISTED ON THIS CERTIFICATE. Name and Address of Insured: GUIDANCE CLINIC OF THE UPPER KEYS, INC. P.O. BOX 363� TAVERNIER, FL 33070 Occupation or Business: SOCIAL SERVICE AGENCY Location of Operations: (if different than address listed above) Type of Work Covered: PROF. MENTAL HEALTH COUNSELING Mnnak(Kd)tm=DecsK BLANKET COVERAGE APPROVED BY RISK M�NAOFIQIFNT o1</6 DATE WAI';ER: N'A "FS Policy Effective Expiration Limits of Coverages Number Date Date Liability PROFESSIONAL/ 1,000,000 LIABILITY SSA-6904713 10/01/96 10/01/97 1,000,000 NOTICE OF CANCELLATION WILL ONLY BE GIVEN TO THE FIRST NAMED INSURED ON THIS POLICY AND HE OR SHE SHALL ACT ON BEHALF OF ALL INSUREDS WITH RESPECT TO GIVING OR RECEIVING NOTICE OF CANCELLATION. Claim History: Comments: This Certificate Issued to: Name: COUNTY OF MONROE Address: ATTN: RISK MANAGEMENT 51 COLLEGE ROAD KEY WEST, FL 33040 CC Lo v! S '4_r¢TVA_Adr GEN 152 ACORDM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNY) 1 1 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 00025 t l HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR POE & BROWN INC ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO BOX 2412 ------COMPANIES AFFORDING_ COVERAGE _ DAYTONA BEACH FL 32115-241 c COMPAN`RISCDRP Insurance Company A INSURED b 0 t1l19 COMPANY q, APPROVED Y RISK MANAGEMENT p�Q/G GUIDANCE CLINIC OF THE UPPER KEYS B BY Ct_drx - PO BOX 363 COMPANY ` TAVERNIER FL 33070-0363 DAIS 1,2 COMPANY / 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 TR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE (MM/DDNY) DATE (MM/DDNY) GENERAL LIABILITY GENERAL AGGREGATE_ $ COMMERCIAL GENERAL_LIABILITY PRODUCTS - COMP/OP AGG $ CLAIMS MADE OCCUR PERSONAL & ADV INJURY $ OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ FIRE DAMAGE (An_one fire) $ _ MED EXP (Any one arson $-________ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS �V (3 BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: F EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS' LIABILITY TORYII EL EACH ACCIDENT $ QO II a THE PROPRIETOR/ INCL 26297 0 7/ 0 1/ 9 6 0 7/ 0 1/ 9 7 EL DISEASE - POLICY LIMIT $500 IM - PARTNERS/EXECUTIVE OFFICERS ARE: EXCL EL DISEASE - EA EMPLOYEE $1QO !w OTHER DESCRIPTION OF OPERATIONSA-OCATIONSNEHICLES/SPECIAL ITEMS CERTIFICATE HOLDER MONROE CNTY RISK MGMT 5100 COLLEGE ROAD KEY WEST FL_ 33040 ACORD 25-S (1/95) �(L� CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL If 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 COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE © ACORD CORPORATION 1988 Accounk Number: FL QUID 3 631 Date: 11/20/96 Initials: MF CERTIFICATE OF INSURANCE American Home Assurance Company c/o: American Professional Agency, Inc. 95 Broadway, Amityville, NY 11701 This is to certify that the insurance policies specified below have been issued by the company indicated above to the Insured named herein and that, subject to their provisions and conditions, such policies afford the coverages indicated insofar as such coverages apply to the occupation or business of the Named Insured(s) as stated. THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE(S) AFFORDED BY THE POLICY(IES) LISTED ON THIS CERTIFICATE. Name and Address of Insured: GUIDANCE CLINIC OF THE UPPER KEYS, INC. P.O. BOX 363 TAVERNIER, FL 33070 APPROti'ED Y RISK MANAGEMENT BY _ _ b.e /G DAzE //'�G �la c✓z)`'�C - YES Occupation or Business: SOCIAL SERVICE AGENCY '`-``'' Location of Operations: (if different than address listed above) Type of Work Covered: PROF. MENTAL HEALTH COUNSELING BLANKET COVERAGE ''ontrol Policy Effective Expiration Limits of Coverages Number Date Date Liability PROFESSIONAL/ 1,000,000 LIABILITY SSA-6904713 10/O1/96 10/O1/97 1,000,000 NOTICE OF CANCELLATION WILL ONLY BE GIVEN TO THE FIRST NAMED INSURED ON THIS POLICY AND HE OR SHE SHALL ACT ON BEHALF OF ALL INSUREDS WITH RESPECT TO GIVING OR RECEIVING NOTICE OF CANCELLATION. Claim History: Comments: This Certificate Issued to: Name: MONROE COUNTY RISK MNGT. Address: ATTN: KAY MILLER 5100 COLLEGE ROAD KEY WEST, FL 33040 S v c i,4-L Sd+� di cBzs' GEro'52 Its AM60u 41914993 uuj rui A4Y11 .4A. 1 Y...• IfA JNr Ak.la MONRUN, C'.CltifPCry, MORIDA livgaesl For Waivcr of luzurtjlcc RequimmiLi {t is ro911c$Wd UIM Ilk: 11WIMIRLO r4quircytl6its. as ecpocirlud ill die C oumy`s 5t;lrW1111; oC Itt�nmlt;+:c Ruquirc:twnls, bo irairad or uwdiGud oil t1w fOIIQti ing t�olttraut, Cuutr i fix: Addn--urCoot.racxor: Scope of Work: ofta Reason fbr Waivcr. �l y Sipotltut; of Cdntnicior.LN- ApproYcd Risk Msmgmcnt County Adnttiumcoli appuil; Apptvrxl: _�_ Nit AlKtrowd: uutc: Round or Comity Commimiumm appiml: Appmvcd' _ NtA Apptovc d.: — Sk tlug gala: tu%pir:*ATT InmLlim A70.1 WAIVER t l.n' a E,or_ oN 82: si Sl: 0L Ndf V9SV-•W -SOS' � GI 5 2:JJIIOS3j NNWl1H' 7'W' 101 00 100 00:00 005 PO4 avow i� 011, Lo I VGA \ �v \�" ` V �.�{.�.r 4 • • ^ + � + . ACHIM). CERTIFICATE OF INSURANCE DATE 07/07/9707/97 PRODUCER POE & BROWN INC THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 220 S RIDGEWOOD AVE P O BOX DAYTONA BEACH FL 32115 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING - -COVERAGE -- - COMPANY ARISCORP INS CO/FLORIDA _ INSURED GUIDANCE CLINIC OF THE UPPER KEYS co Balvv P 0 BOX 363 COMPANY C TAVERNEER FL 33070 COMPANY D 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. LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE(MM/DD/YY) LICYEXPIRATION DATE(MM/DD/YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ $ OMMERCIAL GENERAL LIABILITYPRODUCTS-COMP/OPAGG CLAIMS MADE OCCUR PERSONAL & ADV INJURY $ —OWNER'S EACH OCCURRENCE $ & CONTRACTOR'S PRO FIRE DAMAGE (Anyone fire) $ MED EXP (Anyone person) $ AUTOMOBILE LIABILITY ANY AUTO ;, ��; b4 Y(iJh k�A''iA �M�h�fi COMBINED SINGLE LIMIT $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS ;v r �_ BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS nATF FS PROPERTY DAMAGE $ GARAGE LIABILITY ) AUTO ONLY -EA ACCIDENT $ OTHER THAN AUTO ONLY: ANY AUTO EACH ACCIDENT $ .. __ AGGREGATE $ C' L EXCESS LIABILITY UMBRELLAFORM • /) EACH OCCURRENCE $ _ AGGREGATE $ - $ OTHER THAN UMBRELLA FORM A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 26207 07/01/97 07/01/98 X I STATUTORY LIMITS EACH ACCIDENT $ 100,000_ THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE R DISEASE -POLICY LIMIT $ 500,000 DISEASE -EACH EMPLOYEE 100,000 OFFICERSARE: EXCL OTHER ,$ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS For coverage questions contact Diana Starkey at (904) 239-5714. CERTIFICATE HOLDER CANCELLATION SHOULD ANYOFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE MONROE COUNTY RISK MANGEMENT EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 5100 COLLEGE RD 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, KEY WEST FL 33040 ( BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY ^Y KIND UPON THE _COMPANX, ITS AGENTS OR REPRESENTATIVES. AUT I EDJIEPRESENTA V DLS G ACORD CORPORATION 1993 !!e9OF l ACOR D 25 - S (3/93) 1 of 1 #S16040ZM16038 Account Number: FL GUID 3631 Date: 11/03/97 MF Initials: CERTIFICATE OF INSURANCE AMERICAN HOME ASSURANCE COMPANY c/o: American Professional Agency, Inc. 95 Broadway, Amityville, NY 11701 This is to certify that the insurance policies specified below have been issued by the company indicated above to the Insured named herein and that, subject to their provisions and conditions, such policies afford the coverages indicated insofar as such coverages apply to the occupation or business of the Named Insured(s)as stated. THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE(S) AFFORDED BY THE POLICY(IES) LISTED ON THIS CERTIFICATE. Name and Address of Insured GUIDANCE CI.,INIC OF THE UPPER KEYS, INC. P.O. BOX 363 TAVERNIER, FL 33070 Occupation or Business: SOCIAL SERVICE AGENCY Location of Operations: (if different than address listed above) Type of Work Covered: PROF. MENTAL HEALTH COUNSELING �dditt�raa#��k�kac� BLANKET COVERAGE PPROVED BY ISK M IAGEMENT RY r DATE WAIVER: NIA -- Covs Policy -1 Effective Expiration Limits of Coverages Number Date Date Liability PROFESSIONAL/ 1,000,000 LIABILITY SSA-6904713 10/01/97 10/01/98 3,000,000 NOTICE OF CANCELLATION WILL ONLY BE GIVEN TO THE FIRST NAMED INSURED ON THIS POLICY AND HE OR SHE SHALL ACT ON BEHALF OF ALL INSUREDS WITH RESPECT TO GIVING OR RECEIVING NOTICE OF CANCELLATION. Claim History: Comments: This Certificate Issued to: Name: COUNTY OF MONROE Address: ATTN: RISK MANAGEMENT 5100 COLLEGE ROAD KEY WEST, FL 33040 GEN 152 Authorized Representative .11�111�11. CERTIFICATE OF INSURANCE CSR SC DATE (MM/DD/YY) PRODUCER The Johnsons Insurance Agency 89015 Overseas Highway Tavernier FL 33070 GUIDA-1 03/13/98 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. COMPANIES AFFORDING COVERAGE The Johnsons Insurance Agency COMPANY 305-852-9247 A USF&G INSURED COMPANY B The Guidance Clinic of the COMPANY Upper Keys, Inc. C PO BOX 363 COMPANY D Tavernier FL 33070 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 At4y 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATIO DATE (MM/DD/YY) LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE Fx� OCCUR 1 MP30047068705 07/01 /97 07/01 /98 GENERAL AGGREGATE $ 1,000,000 X PRODUCTS - COMP/OP AGG S 1,000,000 PERSONAL & ADV INJURY S not coverd OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fire) S 50,000 MED EXP (Any one person) S 5,000 AUTOMOBILE LIABILITY X A ANY AUTO 1 MP30047068705 07/01 /97 07/01 /98 COMBINED SINGLE LIMIT S 1,000,000 ALL OWNED AUTOS SCHEDULED AUTOS - BODILY INJURY (Per person) $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ AoPRnVED BY R MA AGOAFNT PROPERTY DAMAGE $ GARAGE LIABILITY p Y_ AUTO ONLY - EA ACCIDENT $ ANY AUTO T E --- OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE S EXCESS LIABILITY / " `' 'WES EACH OCCURRENCE $ UMBRELLA FORM 1 AGGREGATE $ OTHER THAN UMBRELLA FORM Pa S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY �.. STATUTORY LIMITS EACH ACCIDENT S THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE FIEXCL O 1 DISEASE - POLICY LIMIT $ OFFICERS ARE: DISEASE - EACH EMPLOYEE $ OTHER A Property 1MP30047068705 07/01/97 07/01/98 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHHCLES/SPECIAL ITEMS health care facilities -clinics dispensaries or infirmaries - treating out -patients only- no regular bed/board facilitie **Certificate Holder is also listed on the policy as Additional Insured** CERTIFICATE HOLDER CANCELLATION' MONCO-3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Monroe County Kay Miller EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THIN CERTIFICATE HOLDER NAMED TO THE LEFT, 5100 College Road Key West FL 33040 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY NTHE OMPANY, ITS A ENTS OR REPRESENTATIVES. OF N�qn�� TI% PAS he oh' 0 f��'c�ge '� AGORA 25-5 (3/93) fATf77•I AGORA CORPORATION 1993 (7TTT)ANT( P.. A CORDTM C E RTI F I CAT E O F INS URA N C E DATE (MM/DD/YY) 06/11/01 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION BROWN & BROWN INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 220 SOUTH RIDGEWOOD AVENUE P O BOX 2 412 DAYTONA BEACH, FL 32115 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY _. AZENITH INS CO ------- --- INSURED GUIDANCE CLINIC OF THE -------- --- UPPER KEYS,, BNv P O BOX 363 r - -- ---- - - TAVERNEER , FL 33070 COMPANY COMPANY D 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 LTR '� POLICY EFFECTIVE POLICY NUMBER DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ PRODUCTS-COMP/OP AGG $ :COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR PERSONAL & ADV INJURY $ EACH OCCURRENCE $ OWNER'S 8 CONTRACTOR'S PROT I FIRE DAMAGE (Any one fire) $ MED EXP (Any one person) $ AUTOMOBILE LIABILITY ! ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS `� K� I' �'� �TF _ �•'. 41 COMBINED SINGLE LIMIT $ —. �.. BODILY INJURY $ (Per person) - j BODILY INJURY $ (Per accident) �. VC PROPERTY DAMAGE GARAGE LIABILITY ANY AUTO AUTO ONLY -EA ACCIDENT - $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ -' AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE _ �I OTHER THAN UMBRELLA FORM S A! WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 26207 0 7/ 0 1/ 0 1 0 7/ 0 1/ 0 2 X I STATUTORY LIMITS k' EACH ACCIDENT $10 0 , 0 0 0 THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE I--- DISEASE -POLICY LIMIT $5 0 0 , 0 0 0 _ DISEASE -EACH EMPLOYEE $1 0 0 , 0 0 0 OFFICERS ARE: EXCL OTHER ! DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS ANY QUESTIONS, PLEASE CALL 252-9601 EXT 2200 OR 1-800-877-2769 EXT 2200 ATTN: MARIA DEL RIO @ FAX # 305-295-4364 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE MONROE COUNTY BOARD OF COUNTY EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL COMMISSIONERS -�Q DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 5100 COLLEGE RD BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY KEY WEST, FL 33040 OF ANY KIND UPON THE COMP ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE j 14640 ii CcRaOIR2A ION 1993' ACORD 25-S (3/93)''1 of 1 S', 9 5 8 2 0 M 9 5 818 > ACORD CERTIFICATE OF LIABILITY INSURANCEesgt SC DATE(MM/DD/YY) UIDA.1 08/17/99 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Johnsons Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 89015 Overseas Highway ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tavernier FL 33070 COMPANIES AFFORDING COVERAGE The Johnsons Insurance Agency COMPANY Phone No. 305-852-9247 Fax No. A USF&G INSURED COMPANY B Guidance Clinic of the Upper Keys, Inc. ATTN:Debra White �/�J COMPANY C PO BOX 363 l Tavernier FL 33070 COMPANY D 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CK07400634 07/01/99 07/01/00 PRODUCTS - COMP/OPAGG $ 1,000,000 CLAIMS MADE Fx-1 OCCUR PERSONAL & ADV INJURY $ not coverd EACH OCCURRENCE $ 1 , 000 , 000 OWNER'S & CONTRACTOR'S PROT FIRE DAMAGE (Any one fire) $ 50 , 000 MED EXP (Any one person) $ 5,000 AUTOMOBILE LIABILITY A ANY AUTO CK07400634 07/01/99 07/01/00 COMBINED SINGLE LIMIT $ 1,000,000 X ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ X HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE $ =ice U ��/��- F _ r? GARAGE LIABILITY 'a AUTO ONLY - EA ACCIDENT $ ANY AUTO "v a OTHER THAN AUTO ONLY: EACH ACCIDENT $ t l AGGREGATE $ EXCESS LIABILITY UMBRELLA FORM � OTHER THAN UMBRELLA FORM "' EACH OCCURRENCE $ AGGREGATE $ WORKERS COMPENSATION ANDUVM EMPLOYERS' LIABILITY WC STATU- OTH- TORS LIMITS ER TOFL EACH P.CCIDENT e THE PROPRIETOR/ PARTNERS/EXECUTIVE INCL4- i t EL DISEASE -POLICY LIMIT $ EL DISEASE - EA EMPLOYEE $ OFFICERS ARE: EXCL OTHER I �I I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS Monroe County Board of County Commissioners as Additional Insured CERTIFICATE HOLDER DATE CANCELLATION' INITIAL QNRQo--2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Monroe County Risk Management Maria Del Rio 10 - DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 5100 College Road BUT FAILURE TO IL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Key West FL 33040 OF ANY IND PO THE COMPANY, ITS AGE TS OR REPRESENTATIVES. AUTHORIZE SE N TIVE The ohn o su a ce gency ACQRD25-S (1/95) ACORD CORPORATION 1988 r`_TTTT)AT%TY'TI' A COl \ DT. CERTIFICATE F INSURANCE — — — -- — DATE (MM/DD/W) 08/16/99 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION BROWN & BROWN INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 220 SOUTH RIDGEWOOD AVENUE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P O BOX 2412 DAYTONA BEACH, FL 32115 COMPANIES AFFORDING COVERAGE COMPANY AZENITH INS CO INSURED GUIDANCE CLINIC OF THE UPPER KEYS COMPANY B P O BOX 363 TAVERNEER , FL 33070 COMPANY C COMPANY D 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ PRODUCTS-COMP/OP AGG $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR PERSONAL & ADV INJURY $ EACH OCCURRENCE $ OWNER'S & CONTRACTOR'S PROT FIRE DAMAGE (Any one fire) $ MED EXP (Any one person) $ AUTOMOBILE LIABILITY ANY AUTO c Y _ COMBINED SINGLE LIMIT $ ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS [-AT 4�> �.` r l.Q: 1, w !Y� fY� u BODILYINJURY Perperrson$ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY -EA ACCIDENT $ OTHER THAN AUTO ONLY: ANY AUTO EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ UMBRELLA FORM $ OTHER THAN UMBRELLA FORM A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 26207 0 7/ 01 / 9 9 U 7/ 0 1/ 0 0 X I STATUTORY LIMITS EACH ACCIDENT $10 0 , 0 0 0 THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE DISEASE -POLICY LIMIT s500,000 DISEASE- EACH EMPLOYEE $10 0 , 0 0 0 OFFICERS ARE: EXCL OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/SPECIAL ITEMS ANY QUESTIONS PLEASE CALL 800-877-2769 XT 714 CERTIFICATE HOLDER DATE CANCELLATION y SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE MONROE COUNTY IT EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 5100 COLLEGE RD '1 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, KEY WEST, FL 33040 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTIiORIZ�RE� ACORD 25-5 3/93 Of { ),1 1 S 5 5 2 7 Fi M5 � 2 7 4; S KW Q ACORD CORPORATION 1993 Account Number: FL GUID 3631 Date: 11/08/00 Initials: LAURAJ CERTIFICATE OF INSURANCE AMERICAN HOME ASSURANCE CO. C/O: American Professional Agency, Inc. 95 Broadway, Amityville, NY 11701 This is to certify that the insurance policies specified below have been issued by the company indicated above to the insured named herein and that, subject to their provisions and conditions, such policies afford the coverages indicated insofar as such coverages apply to the occupation or business of the Named insured(s) as stated. THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE(S) AFFORDED BY THE POLICY(IES) LISTED ON THIS CERTIFICATE. Name and Address of Insured: GUIDANCE CLINIC OF THE UPPER KEYS, INC. BLANKET COVERAGE P.O. BOX 363 TAVERNIER, FL 33070 Type of Work Covered: SOCIAL SERVICE AGENCY Location of Operations: (I£ different than address listed above) Claim History: (! r1' fOP yF - Policy Effective Expiration Limits of Coverages Number Date Date Liability PROFESSIONAL/ 1,000,000 LIABILITY SSA-6904713 10/01/00 10/01/01 3,000,000 NOTICE OF CANCELLATION WILL ONLY BE GIVEN TO THE FIRST NAMED INSURED ON THIS POLICY AND HE OR SHE SHALL ACT ON BEHALF OF ALL INSUREDS WITH RESPECT TO GIVING OR RECEIVING NOTICE OF CANCELLATION. Comments: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS IS AN ADDITIONAL INSURED ON THE ABOVE CAPTIONED POLICY. This Certificate Issued to: Name: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS Address: 5100 COLLEGE ROAD KEY WEST, FL 33040 Autrfiorized Representative (''TTTT)ANC'P A CORDTM CERTIFICATE. 'OF INSURANCE '12/05/0°ATE'MM' / 0 0 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION BROWN & BROWN INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 220 SOUTH RIDGEWOOD AVENUE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P O BOX 2 412 COMPANIES AFFORDING COVERAGE DAYTONA BEACH, FL 32115 --- ------ -- - - - — - COMPANY AZENITH INS CO INSURED GUIDANCE CLINIC OF THE UPPER KEYS COMPANY B P O BOX 363 - - - - --- - TAVERNEER, FL 33070 COMPANY C COMPANY D 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MWDDNY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ PRODUCTS-COMP/OP AGG $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR �r R 1. PERSONAL & ADV INJURY $ EACH OCCURRENCE $ OWNER'S & CONTRACTOR'S PROT ` • FIRE DAMAGE (Any one fire) $ MED EXP (Any one person) $ AUTOMOBILE -- LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS ! *y R E C E I U [( A DEC I 1 PURCHASING , vC � �y - COMBINED SINGLE LIMIT ---- - BODILY INJURY (Per person) ---- INJURY - BODILY INJURY (Per accident) PROPERTY DAMAGE $ -- ---- ----- $ - -- — $ $ r GARAGE LIABILITY AUTO ONLY -EA ACCIDENT $ OTHER THAN AUTO ONLY: ANY AUTO EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ _ $ $ UMBRELLA FORM OTHER THAN UMBRELLA FORM JAGGREGATE i A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 26207 ' 0 7/ 0 1/ 0 0 0 7/ 0 1 / 0 1 X I STATUTORY LIMITS EACH ACCIDENT $1 0 0, 0 0 0 THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE OFFICERS ARE: EXCL DISEASE -POLICY LIMIT s500,000 DISEASE- EACH EMPLOYEE $1 0 0 , 0 0 0 ! OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS ANY QUESTIONS, PLEASE CALL 252-9601 EXT 2200 OR 1-800-877-2769 EXT 2200 ATTN: MARIA DEL RIO Q FAX # 305-295-4364 CERTIFICATEMOLDER > CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE MONROE COUNTY BOARD OF COUNTY EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL COMMISSIONERS 1 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 5100 COLLEGE RD BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY KEY WEST, FL 33040 OF ANY KIND UPON THE COMPANY, ITS R REPRESENTA,¢TAES. AUTHORIZED REPRESEH TIVE ACORD 25-S 0231;1 of 1 S 8 3 813 M8 3 811 > ' JCC ®AG RD C TION 1993 ACORo CERTIFICATE OF LIABILITY INSURANC R BT DATE(MM/DD/YY) IDA-1 12/01/00 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Johnsons Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 89015 Overseas Highway ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tavernier FL 33070 Phone: 305-852-9247 INSURERS AFFORDING COVERAGE INSURED INSURER A: The St. Paul Companies INSURER B: Guidance Clinic of the Upper INSURERC: Keys, Inc. ATTN:Debra White PO BOX 363 INSURER D: Tavernier FL 33070 INSURER E: !ial•/ a :I_TC1 ;*1 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. N LTR TYPE OF INSURANCE POLICY NUMBER POLICY E FE VE DATE MM/DD 4 P LI Y XP TI N DATE MM/DD/YY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE 0 OCCUR EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER POLICY PRO JECT 7 LOC PRODUCTS - COMP/OP AGG $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BFA00000626342 07/01/00 07/01/01 COMBINED SINGLE LIMIT (Ea accident) $1 OOO OOO r r X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) _ GARAGE LIABILITY ANY AUTO tt�� R '` �� VIP bU AUTO ONLY - EA ACCIDENT = OTHER THAN EA ACC AUTO ONLY: AGG $ s EXCESS LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ CH u �•,'? EACH OCCURRENCE $ AGGREGATE $ f _ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ATE w Cc 5 WC S LIMITS T ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ OTHER C 1 el —I !E— DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Guidance Clinic y 11-61n.7 -i lnowmcR LC I I CR: I i%JM MONRO15 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Monroe County Board of NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL County Commissioners IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 5100 College Rd Key West FL 33040 REPRESENTATIVES. J 26S (7l97) GUIDANCR ACORDTM CERTIFICATE OF INSURANCE DATE 2 jo5%oo PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION BROWN & BROWN INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 220 SOUTH RIDGEWOOD AVENUE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P O BOX 2 412 COMPANIES AFFORDING COVERAGE DAYTONA BEACH, FL 32115 -""-" - -_- - COMPANY AZENITH INS CO INSURED GUIDANCE CLINIC OF THE UPPER KEYS COMPANY B P O BOX 363 - --- -- -- TAVERNEER, FL 33070 COMPANY C COMPANY D 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MWDD/YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ PRODUCTS-COMP/OP AGG $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR PERSONAL & ADV INJURY $ EACH OCCURRENCE $ OWNER'S & CONTRACTOR'S PROT FIRE DAMAGE (Any one fire) $ I MED EXP (Any one person) $ AUTOMOBILE LIABILITY _ ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS R BODILY INJURY (Per person) $ — BODILY INJURY (Per accident) $ — .. rr,,, . R•; ,, ;h` ,. PROPERTY DAMAGE $ GARAGE LIABILITY ✓ AUTO ONLY -EA ACCIDENT $ OTHER THAN AUTO ONLY: ANY AUTO �C6 i EACH ACCIDENT $ AGGREGATE $ ` ✓ EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ UMBRELLA FORM $ OTHER THAN UMBRELLA FORM A j WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 26207 0 7/ O 1/ 0 0 0 7/ 01 / 01 X I STATUTORY LIMITS EACH ACCIDENT $1 O O, 0 0 0 THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE OFFICERS ARE: EXCL DISEASE -POLICY LIMIT $5 O O , 000 DISEASE- EACH EMPLOYEE $10 0 , 000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS ANY QUESTIONS, PLEASE CALL 252-9601 EXT 2200 OR 1-800-877-2769 EXT 2200 CERTIFICATE HOLDER CANCELLATION: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE MONROE COUNTY RISK MANGEMENT EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 5100 COLLEGE RD '40 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, KEY WEST, FL 33040 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS -!RR REPRESENTATIVES. AUTHORIZED REPATIVE AGORD 25.5 (*N)1 of 1 5 8 3 814 M8 3 81 l �JCC Q ACORD CORPORATION 1 95 ACORD CERTIFICATE OF LIABILITY INSURANC�R BT DATE(MM/DD/YY) IDA-1 1 08/17/00 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Johnsons Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 89015 Overseas Highway ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tavernier FL 33070 Phone: 305-852-9247 INSURERS AFFORDING COVERAGE INSURED INSURER A: The St. Paul Companies INSURER B: Guidance Clinic of the Upper Keys , Inc. ATTN : Debra White INSURER C: PO BOX 363 INSURER D: Tavernier FL 33070 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 LTR TYPE OF INSURANCE POLICY NUMBER :ECTIVE DATE IMMIDD/YY POLICY EXPIRATION DATE MM/D LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE ❑X OCCUR CK07400634 07/01/00 07/01/01 EACH OCCURRENCE $ 1 , 000 , 000 FIRE DAMAGE (Any one fire) $50,000 MED EXP (Any one person) $ 5 , 000 PERSONAL i ADV INJURY $ not coverd GENERAL AGGREGATE $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY j060T LOC PRODUCTS - COMP/OP AGG $ 1 , 0 00 , 000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS �_ ' I- ^ / "�• COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) f . BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO T AUTO ONLY - EA ACCIDENT $ EA ACC OTHER THAN AUTO ONLY: AGG $ $ EXCESS LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE $ S $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 7� U TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE f E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Guidance Clinic * Certificate holder is Additional Insure&I* I'�IV •IVVvI�(�. MYVI I IUMML Inauncu; Imaumcn LC I I cm; VMI\VGLL/1I IVn. - MONRO15 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRAT10 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Monroe County Board of NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL County Commissioners IMPOSE N OBLI TION OR LIABILITY OF ANY KIND UP�N THE INSURER, ITS AGENTS OR 5100 College Rd _ Key West FL 33040 REPRESE TA n ACORD CERTIFICATE OF LIABILITY 1NSURANC4SI A- DATE 02/0DD/0 IDA-1 02/05/02 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Johnsons Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 89015 Overseas Highway ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tavernier FL 33070 Phone : 305-852-9247 INSURERS AFFORDING COVERAGE MbUKCU INSURER A: The St. Paul Companies INSURER B: Guidance Clinic of the Upper INSURERC: Keys, Inc. ATTN:Debra White PO BOX 363 INSURER D: Tavernier FL 33070 INSURER E: 161e1V/ 4;7AH *1 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. LTR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MWDD/YY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR CK07400634 07/01/01 07/01/02 EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fire) $50,000 MED EXP (Any one person) $ 5 , 000 PERSONAL & ADV INJURY $ not coverd GENERAL AGGREGATE $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY PRO- LOC JECT PRODUCTS - COMP/OP AGG $ 1 , 000 , 000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS RA00900388 AP B R I DY 07/01/01 EM G 07/01/02 COMBINED SINGLE LIMIT (Ea accident) $1000 000 r r X BODILY INJURY (Per person) $ BODILY INJURY (Peraccidenq $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO DATE WAIVER N/A AUTO ONLY - EA ACCIDENT $ i V ES OTHER THAN _EA ACC AUTO ONLY: AGG $ $ EXCESS LIABILITY OCCUR El CLAIMS MADE DEDUCTIBLE RETENTION $ If—\ /I 1 Y// � I` / !_ EACH OCCURRENCE $ AGGREGATE $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEj $ E.L. DISEASE - POLICY LIMIT 1 $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS health care facilities -clinics dispensaries or infirmaries - treating out -patients only- no regular bed/board facilitie •... �+ IRJVRCV�IRJVRCR LCI I CK: V/'11\IiGLL/1I IV/4 MONRO155 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN The County of Monroe NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL BOCC 5100 College Rd IMPOSE NO OB IGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Key West FL 33040 REPRE N VES` n . e _ !n I i�r _ A ACORD CORPORATION Account Number: FL GUID 3631 Date: 2/05/02 Initials: MF CERTIFICATE OF INSURANCE AMERICAN HOME ASSURANCE CO. C/O: American Professional Agency, Inc. 95 Broadway, Amityville, NY 11701 This is to certify that the insurance policies specified below have been issued by the company indicated above to the insured named herein and that, subject to their provisions and conditions, such policies afford the coverages indicated insofar as such coverages apply to the occupation or business of the Named insured(s) as stated. THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE(S) AFFORDED BY THE POLICY(IES) LISTED ON THIS CERTIFICATE. Name and Address of Insured: GUIDANCE CLINIC OF THE UPPER KEYS, INC. P.O. BOX 363 TAVERNIER, FL 33070 Type of Work Covered: SOCIAL SERVICE AGENCY Location of Operations: (If different than address listed above) Claim History: Adft&ins RW1XXNa X zymure : BLANKET COVERAGE AP Y IS N NT DATE WAIVER N/A YES _ r Policy Effective Expiration Limits of Coverages Number Date Date Liability PROFESSIONAL/ 1,000,000 LIABILITY SSA-6904713 10/01/01 10/01/02 3,000,000 NOTICE OF CANCELLATION WILL ONLY BE GIVEN TO THE FIRST NAMED INSURED ON THIS POLICY AND HE OR SHE SHALL ACT ON BEHALF OF ALL INSUREDS WITH RESPECT TO GIVING OR RECEIVING NOTICE OF CANCELLATION. Comments: This Certificate Issued to: Name Address: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS 5100 COLLEGE ROAD KEY WEST, FL 33040 Authorized Representative ACORDM CERTIFICATE OF LIABIL "TY II SUF ANC:E i DATE ioa/2oo2' PRODUCER Serial # 616375 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Marsh USA HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 44 Whippany Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Morristown, NJ 07962 COMPANIES AFFORDING COVERAGE COMPANY AMERICAN HOME ASSURANCE COMPANY A INSURED EPIX I INC. L/C/F GUIDANCE CLINIC OF THE UPPER KEYS COMPANY INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA COMPANY ILLINOIS NATIONAL C 1480 ROUTE 9 NORTH, ASPEN CORP. PARK 1 COMPANY D WOODBRIDGE, NJ 07095 v' ERt3i3� ' 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 B Y 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. T LTR TYPE OF INSURANCE POLICY NUMBER POLICY DATE (MM/DD/YYE ( ) DATE EXPIRATION ( ) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR PERSONAL & ADV INJURY $ EACH OCCURRENCE $ OWNER'S & CONTRACTOR'S PROT FIRE DAMAGE (Anyone fire) $ MED EXP (Anyone person) $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS R ► APP MAN B MENT (Per person) BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS BY PROPERTY DAMAGE $ DATE GARAGE LIABILITY vV ivr!mAUTO ONLY - EA ACCIDENT $ ANY AUTO Ojelt� OTHER THAN AUTO ONLY: EACH ACCIDENT $ e AGGREGATE $ EXCESS LIABILITY ` EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ $ OTHER THAN UMBRELLA FORM B WORKER'SMPENSATION AND CO EMPLOYERS'LIABILITY RMWC 5897449 9/01/2002 9/01/2003 v WC STATU- o H- r�RruMlrs T EL EACH ACCIDENT _ $ 1,000,000 THE PROPRIETOR/ X INCL PARTNERS/E: TIVE EL DISEASE - POLICY LIMIT $ 1,000,000 EL DISEASE - EA EMPLOYEE $ 1,000,000 OFFICERS ARE: EXCL OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS COVERAGE IS PROVIDED FOR LEASED EMPLOYEES BUT NOT SUBCONTRACTORS OF: GUIDANCE CLINIC OF THE UPPER KEYS CC • o CERTIFICATE HOLDER ' x :CANCELLI�TIQN, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 1100 SIMONTON STREET 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, KEY WEST, FL 33040 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON TH O ITS AGE OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVy �cr��. �C ACIDRD 4J..�A(1100 )-, .a: y� t� y4 y�'�y 1� ..�� YOR? ?M! lF.7a4:1OI' vi!I GAFMPRO\CERTPROS 2003.FP5 ACORD CERTIFICATE OF LIABILITY INSURANC DEL DATE(MWDD/YY) IDA-1 09/17/02 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Johnsons Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 89015 Overseas Highway ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tavernier FL 33070 Phone : 305-852-9247 INSURERS AFFORDING COVERAGE INSURED INSURER A: The St. Paul Companies INSURER B: Guidance Clinic of the Upper INSURERC: Keys, Inc. ATTN:Debra White PO BOX 363 INSURERD: Tavernier FL 33070 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY L TI N DATE MM/DD/Yl LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 7 OCCUR CK07400634 07/01/02 07/01/03 EACH OCCURRENCE $ 1 , 000 , 000 FIRE DAMAGE (Anyone fire) $50,000 MED EXP (Any one person) $ 5 , 000 PERSONAL & ADV INJURY $ not coverd GENERAL AGGREGATE $ 1 , 000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY PRO LOC JECT PRODUCTS - COMP/OP AGG $ 1 , 000 , 000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS M APP Ov ` ` A MEN'j COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO DATE WAIVER NIA YES_ ' AUTO ONLY - EA ACCIDENT E OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ C l i EACH OCCURRENCE $ AGGREGATE $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TORY LIMITS TH E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSA/EHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS health care facilities -clinics dispensaries or infirmaries - treating out -patients only- no regular bed/board facilitie • 1 II.JVRLU� ........C. mm lI/119V LLLPi I RAM MONRO— 6 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Monroe County StreBOCCet IMPOSE NO OB ATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1100 Simonton Street Key West FL 33040 REPRE EN ES. ACORD 25S CORPORATION ACORD CERTIFICATE OF LIABILITY INSURANCFD EL FDATE(MM/DD/YY) IDA-1 09/17/02 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Johnsons Insurance Agency 89015 Overseas Highway HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tavernier FL 33070 Phone: 305-852-9247 INSURERS AFFORDING COVERAGE INSURED INSURER A: The St. Paul Companies INSURER B: Guidance Clinic of the Upper Keys, Inc. ATTN:Debra White INSURERC: INSURERD: PO Box 363 Tavernier FL 33070 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. LTR TYPE OF INSURANCE POLICY NUMBER DATE MWDD/E YY PIRATION POL'C D/YY DATEYMM/D LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER POLICY F PRO- JECT LOC PRODUCTS - COMP/OP AGG $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BA01159409 07/01/02 07/01/03 COMBINED SINGLE LIMIT (Ea accident) $1 000 000 r � X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AP BY A MA M NT AUTO ONLY - EA ACCIDENT E OTHER THAN EA ACC AUTO ONLY: AGG $K $ EXCESS LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ DATE WAIVER NIA YES + / EACH OCCURRENCE $ AGGREGATE E s $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS •�••• • 1 IrvJURCR LCI ICR: V/11\LrGLLJ111V1\ MONRO— 6 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 1100 Simonton Street Monroe County IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Key West FL 33040 RE RES ATIVES. The 25S (7/97) rnR PAR OTIANI I QRR Account Number: FL GUID 3631 Date: 1/24/03 Initials: MF CERTIFICATE OF INSURANCE AMERICAN HOME ASSURANCE CO. C/O: American Professional Agency, Inc. 95 Broadway, Amityville, NY 11701 This is to certify that the insurance policies specified below have been issued by the company indicated above to the insured named herein and that, subject to their provisions and conditions, such policies afford the coverages indicated insofar as such coverages apply to the occupation or business of the Named insured(s) as stated. THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE(S) AFFORDED BY THE POLICY(IES) LISTED ON THIS CERTIFICATE. Name and Address of Insured: GUIDANCE CLINIC OF THE UPPER KEYS, INC. P.O. BOX 363 TAVERNIER, FL 33070 Type of Work Covered: SOCIAL SERVICE AGENCY Location of Operations: (I£ different than address listed above) Claim History: Blanket Coverage BY DATE --L� WAIVER NIA.,c EMENT YES — Policy Effective Expiration Limits of Coverages Number Date Date Liability PROFESSIONAL/ 1,000,000 LIABILITY SSA-6904713 10/01/02 10/01/03 3,000,000 NOTICE OF CANCELLATION WILL ONLY BE GIVEN TO THE FIRST NAMED INSURED ON THIS POLICY AND HE OR SHE SHALL ACT ON BEHALF OF ALL INSUREDS WITH RESPECT TO GIVING OR RECEIVING NOTICE OF CANCELLATION. Comments: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS IS AN ADDITIONAL INSURED ON THE POLICY. This Certificate Issued to: Name: MONROE COUNTY RISK MANAGEMENT Address: 1100 SIMONTON STREET KEY WEST, FL 33040 ec• Autrhorized Representative ACORD CERTIFICATE OF LIABILITY INSURANCFuusR SC DATE(MM/DD/YY) IDA-1 1 08/15/03 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Johnsons Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 89015 Overseas Highway ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tavernier FL 33070 Phone : 305-852-9247 INSURERS AFFORDING COVERAGE INSURED INSURER A: The St. Paul Companies INSURER B: Guidance Clinic of the Upper Keys, Inc. ATTN : Debra White INSURER C: PO BOX 363 INSURER D: Tavernier FL 33070 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 LTR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/Y) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY BKO1548087 07/01/03 07/01/04 FIRE DAMAGE (Any one fire) $ 50,000 CLAIMS MADE a OCCUR MED EXP (Anyone person) $ 5,000 PERSONAL & ADV INJURY $ not coverd GENERAL AGGREGATE $ 1 , 000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1 , 000 , 000 POLICY PRO- JECT LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMB (Ea accident) $ (Per person) ILY INJURY $ ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS APP Y S M A BY A EN? BODILY INJURY (Per accident) $ / DATE PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY WAIV AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE � AGGREGATE $ i $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT 1 $ OTHER DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS health care facilities -clinics dispensaries or infirmaries - treating out -patients only- no regular bed/board facilitie tf:_C2k,t6 . VCR I Irl-IM l C I7VLUGR = AUUI I1L)NAL 1NbUK1=U; IKJUKtK Lt I I tK: k"KN iCL -A I IVIV MONRO-6 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 _DAYS WRITTEN Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 1100 Simonton Street Monroe County IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Key West FL 33040 REPRESE TIVES. A�nnn ee � ivifty DATE (MM/DD/YY) ` ACORDM 08/25/2003 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRODUCER Serial # 616375 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Marsh USA HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 44 Whippany Road Morristown, NJ 07962 COMPANIES AFFORDING COVERAGE COMPANY A AMERICAN HOME ASSURANCE COMPANY INSURED EPIX I INC. UC/F COMPANY B INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA GUIDANCE CLINIC OF THE UPPER KEYS 1480 ROUTE 9 NORTH, COMPANY C ILLINOIS NATIONAL ASPEN CORP. PARK 1 WOODBRIDGE, NJ 07095 COMPANY D THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INDICATED, NOTWITHSTANDING THE INSURANCE AFFORDED B Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. EXCLUSIONS AND CONDITIONS POLICY EFFECTIVE POLICY EXPIRATION LIMITS CO CO TYPE OF INSURANCE POLICY NUMBER DATE (MWDD/YY) DATE (MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG $ CLAIMS MADE OCCUR PERSONAL & ADV INJURY $ OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ FIRE DAMAGE (Anyone tire) $ MED EXP (Anyone person) $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO APP"VOY 3 MAN , ME T ALL OWNED AUTOS �Y45 BODILY INJURY $ (Per person) SCHEDULED AUTOS HIRED AUTOS DATE BODILY INJURY $ (Per aocidem) NON -OWNED AUTOS WAIVER N/A rYES.u. PROPERTY DAMAGE $ GARAGE LIABILITY I v AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY r EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ X CER B WORKER'S COMPENSATION AND RMWC 5897449 9/01/2003 9/01/2004 TORY LIMBS EMPLOYERS' LIABILITY EL EACH ACCIDENT $ 1,000,000 THE PROPRIETOR/ X INCL EL DISEASE - POLICY LIMIT $ 1,000,000 PARTNERSIEXECUTNE EL DISEASE - EA EMPLOYEE $ 1,000,000 OFFICERS ARE: EXCL OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS COVERAGE IS PROVIDED FOR LEASED EMPLOYEES BUT NOT SUBCONTRACTORS OF: GUIDANCE CLINIC OF THE UPPER KEYS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 1100 SIMONTON STREET 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, KEY WEST, FL 33040 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KI UP E COMPA ITS AGENTS OR REPRESENTATIVES. � AUTHORIZED R ES VE C:\FMPRO\CERTPROS 2003.FP5 CSR SG DATE (MM/DD/YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE GUIDA-1 1 09 11 03 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Johnsons Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 89015 Overseas Highway ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tavernier FL 33070 Phone : 3 05 - 8 52 - 9247 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: The St. Paul Companies INSURER B: Guidance Clinic of the Upper INSURERC: Keys, Inc. ATTN:Debra White PO BOX 3 6 3 INSURER D: Tavernier FL 33070 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATEYMM/DDM! IRATION DCTIVE ATE MCY M/DD LIMITS A X GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FX] OCCUR BKO1548087 07/01/03 07/01/04 EACH OCCURRENCE $ 1 , 000 , 000 PREMISES(E..Nccu'_rDence) $ 300,000 MED EXP (Any one person) $ 10 r 000 PERSONAL & ADV INJURY $ 1 , 000 , 000 GENERAL AGGREGATE $ 2 , 000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC JECT PRODUCTS - COMP/OP AGG $ 2 , 000 , 000 A X AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BA01414204 07/01/03 07/01/04 COMBINED SINGLE LIMIT (Ea accident) $ 1 000 000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO 6 tt�� A P PM BY .� MA NT AUTO ONLY - EA ACCIDENT $ EA ACC AUTO ONLY: AGG $ $ EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ DATE . L C-4-_- M EACH OCCURRENCE $ AGGREGATE $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? Ii yes, describe under SPECIAL PROVISIONS below 4 _ t TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS health care facilities -clinics dispensaries or infirmaries - treating out -patients only- no regular bed/board facilitie 95 Ford Wind Star TRUCK 2FMDAF145SBA39399 CERTIFICATE HOLDER CANCELLATION Monroe County Risk Management Kay Miller 5100 College Road Key West FL 33040 MONRO - 2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE C RTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO O IGAT19W?R LIABILITY OF ANY KIND UP.QN THE INSURER, ITS AGENTS OR ACORD 25 (2001108) GG © ACORD CORPORATION 1988 [ ACMpm ] %� Q j DATE t.,AM/DD/YY) 10/21/2003 PRODUCER Serial # 622229 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Marsh USA HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 44 Whippany Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE Morristown, NJ 07962 COMPANY A AMERICAN HOME ASSURANCE COMPANY INSURED EPIX I, INC L/C/F GUIDANCE CLINIC OF THE UPPER KEYS COMPANY B INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA COMPANY C ILLINOIS NATIONAL 1480 ROUTE 9 NORTH, ASPEN CORP. PARK 1 COMPANY D WOODBRIDGE, NJ 07095 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 B Y 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. CID LTR TYPE OF INSURANCE POLICY NUMBER ATEYMM/DD/YYE ( ) EXPIRATION DATE ( ) I LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR PERSONAL & ADV INJURY $ JOINER'S EACH OCCURRENCE $ & CONTRACTOR'S PROT FIRE DAMAGE (Anyone fire) $ IVIED EXP (Anyone person) $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY g SCHEDULED AUTOS (Per person) BODILY INJURY (Per accident) HIRED AUTOS NON -OWNED AUTOS APPZ B R M f� s/'.','i��f'F N+ $ BY PROPERTY DAMAGE $ GARAGE LIABILITY DATE M1 AUTO ONLY - EA ACCIDENT $ ANY AUTO WAIVE YES ^1 A _ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ 1 UMBRELLA FORM AGGREGATE $ $ OTHER THAN UMBRELLA FORM B WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY RMW C 5897449 9/01 /2003 9/01 /2004 X TORN LIAMITS OER EL EACH ACCIDENT $ 1,000,000 THE PROPRIETOR/ X INCL PARTNERS/EXECUTIVE EL DISEASE - POLICY LIMIT $ 1,000,000 EL DISEASE - EA EMPLOYEE $ 1,000,000 OFFICERSARE: EXCL OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS COVERAGE IS PROVIDED FOR LEASED EMPLOYEES BUT NOT SUBCONTRACTORS OF: GUIDANCE CLINIC OF THE UPPER KEYS G C9 (�b �'. �� V`OL a` C, C,ERTFFICATE HOLDE1R.., - CANC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE MONROE COUNTY RISK MANAGEMENT EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 5100 COLLEGE ROAD 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, KEY WEST, FLORIDA 33040 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE AC01D PtATION:1988 CAFMPRO\CERTPROS 2004.FP5 Certificate of Insurance This certificate is issued as a matter of information only and confers no rights upon you the certificate holder. This certificate is not an insurance policy and does not amend, extend, or alter the coverage afforded by the policies listed below. Named Insured(s): Gevity HR, Inc and its wholly owned subsidiaries including but not limited to Gevity HR, LP; Gevity HR II, LP; Gevity HR III, LP; Gevity HR IV, LP; Gevity HR V, LP; Gevity HR VI, LP; Gevity HR VII, LP; Gevity HR VIII, LP; Gevity HR IX, LP; Gevity HR X, MARSH LP; Gevity HR XI, LLC; Gevity HR XII Corp. 600 301 Boulevard West Bradenton, Florida 34205 Insurer Affording Coverage Coverages: Member American Home Assurance Co., of American International Group, Inc. (AIG) The policy(ies) of insurance listed below have been issued to the insured named above for the policy period indicated. The insurance afforded by the policy(ies) described herein is subject to all the terms, exclusions and conditions of such policy(ies). Certificate Exp. Date Type of Insurance ❑ Continuous El Extended *® Policy Term PolicyNumber Limits Employers Liability Workers' 1-1-2005 RMWC2633886 Bodily Injury By Accident Compensation RMWC2633892 $ 2,000,000 Each Accident Bodily Injury By Disease RMWC2633912 RMWC2633913 $ 2'000,000 Policy Limit RMWC2633920 Bodily Injury By Disease $ 2,000,000 Each Person Other: Employees Leased To: Effective Date: 1/ $R D BY 1 MAN E ENT BY 3890-00 Guidance Clinic of the Upper K DATE 'NAIVER N/A . ---YES- The above referenced workers' compensation policy(ies) provide(s) statutory benefits only to the employees of the Named Insured(s) on such policy(ies), not to the employees of any other employer. *If the certificate expiration date is continuous or extended term, you will be notified if coverage is terminated or reduced before the certificate expiration date. However, you will not be notified annually of the continuation of coverage. Notice of Cancellation: Should any of the policies described herein be cancelled before the expiration date thereof, the insurer affording coverage will endeavor to mail 30 days written notice to the certificate holder named herein, but failure to mail such notice shall impose no obligation or liability of any kind upon the insurer affording coverage, its agents or representatives. Certificate Holder: Michael C. Weiss Monroe County Risk Management Authorized Representative of Marsh USA Inc. 5100 College Rd Key West, FL 33040-4319 (866) 443-8489 l/1/2004 Phone Date Issued