Certificates of Insurance
ACORDN CERTIFICATE OF LIABILITY INSURANCF:i~z~%H I DATE (MM/DDNY)
03/14/00
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
J Rolfe Davis Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 945255 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Maitland FL 32794-5255 INSURERS AFFORDING COVERAGE
Phone: 407-691-9600
INSURED INSURER A: Auto-Owners Insurance CO.
INSURER B: Scottsdale Insurance Company
John Fitz~erald, Inc. INSURER c: TIG Insurance Comoanv
P.O. Box 55 INSURER 0:
Sanford FL 32772-0655
I 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.
I~f: TYPE OF INSURANCE POLICY NUMBER b~f~CiMitb~~YE p~..H~~~r6~J.:.?N t.IMITS
B
GENERAL LIABILITY
-
X COMMERCIAL GENERAL LIABILITY
f--[ CLAIMS MADE ~ OCCUR
X XCU Included
f--
EACH OCCURRENCE
FIRE DAMAGE (Anyone fire)
MED EXP (Anyone person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
ACC073646
08/09/99
08/09/00
A
-
GEN'L AGGREGATE LIMIT APPLIES PER
~ ,---, PRO- n
I POLICY I I JECT LOC
AUTOMOBILE LIABILITY
-
X ANY AUTO
-
4114558700
08/09/99
08/09/00
COMBINED SINGLE LIMIT
(Ea accident)
ALL OWNED AUTOS
BODILY INJURY
(Per person)
-
SCHEDULED AUTOS
-
X HIRED AUTOS
-
X NON-OWNED AUTOS
-
BODILY INJURY
(Per accident)
-
PROPERTY DAMAGE
(Per accident)
GARAGE LIABILITY
~ ANY AUTO
EXCESS LIABILITY
C ~ OCCUR D CLAIMS MADE
I DEDUCTIBLE
I RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
AUTO ONLY - EA ACCIDENT
OTHER THAN
AUTO ONLY:
XLL38018098
08/09/99
08/09/00
EACH OCCURRENCE
AGGREGATE
SIR
OTHER
,"-'J~" r)"'){;;:. "I",'.;.,:{;'
., ''fi\.tC.b( ~ --
'r~~Tr _ -- ~l ~ (fl).
,...r..".. _...... ..I~yrs_
. I'~ , > .... '...:--,
I TORY LIMITS! !U~~-
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYE $
E.L. DISEASE. POLICY LIMIT $
$ 1000000
$ 50000
$ 5000
$ 1000000
$ 2000000
$ 1000000
$ 1000000
$
$
$
EA ACC
AGG
$
$
$
$ 1000000
$ 1000000
$ 10000
s
$
DESCRIPTION OF OPERATIONSlLOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE: Astro City Playground - Higgins Beach - Certificate holder is an
additional insured as respects general liability & auto liability. Fax:
~~::~::~:~2~h~~o~~:~ ~/~:;~O ~07-323-0999 (insd). This Certificat~),,~:~~_~~~tjiJ?J &.1
....r:.::: ---.
I y I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION .... ..\../ _.
M()~()~ (" I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
A5f 0) C +y /i....rt:.. : ~TION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
...."i - DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
J ,....~:""e c....e.rf:t: . BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF
ettl t, i,""S ~f(( <!;-; j 1)"'~ , KIND UPON THE INSURER. ITS AGENTS OR REPRESENTATIVES.
lJi,,,,-,,, F. ~.Lr I /' ~
2.......(VtNo"-......F~+-.-r-....l'"'s ;....<>. ~ ~ ~
(~+-....v-) -;~ /'---
'3'-~1It. ''''s~{f.f~.5~0 .?--/)" -l/~
.+" s;..( <.5 e.~' .."'t'<,.....'((Do"'....c~
'"
CERTIFICATE HOLDER
MOnroe County B.O.C
5100 College Rd.
Key West FL 33040
I
ACORD 25-5 (7/97)
ACORD CORPORATION 1988
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
l'JSURANCE POLICY AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW.
.-
Name and
address of
Insured.
LIBERTI'. .;.
MUTUAL" '
This is to Certify that
I NOVACARE EMPLOYEE SERVICES,INC.
CLIENT - JOHN' FITZGERALD, INC.
402 43RD STREET WEST
BRADENTON. FL 34209
L ~
Is, at the issue date of this certificate. insured by the Company under the policy(ies) listed below. The ins~rance afforded by the.listedpolicy(ies) is subject to all their terms, exclusions
and conditions and is not altered by any requirement, term or condition of any contract or other document With respect to which thiS certificate may be Issued.
I
EXP.DATE
* 0 CONTINUOUS
TYPE OF POLICY o EXTENDED POLICY NUMBER LIMIT OF LIABILITY
o POLICY TERM
WORKERS COVERAGE AFFORDED UNDER WC EMPLOYERS LIABILITY
COMPENSATION LAW OF THE FOllOWING STATES: Bodily Injury By Accident
WA2-63D-004155-017 All STATES EXCEPT $1,000,000,00 Each
6/17/97 MONOPOLISTIC STATE Accident
TO FUND STATES Bodily Injury By Disease
7/1/2000 $1,000,000.00 Policy
Limit
WC2-631-004155-027 10, MT, OR, WI & NV Bodily Injury By Disease
$1,000,000.00 Each
Person
GENERAL LIABILITY General Aggregate - Other than Products/Completed Operations
o OCCURRENCE Products/Completed Operations Aggregate
o CLAIMS MADE Bodily Injury and Property Damage Liability Per
Occurrence
Personal Injury Per Person!
RETRO DATE Organization
Other [Other
AUTOMOBILE LIABILITY ..~.. Each Accident - Single Limit
.' 0\'r.~ ~'( '..,' B.1. and P.O. Combined
0 .~- r ) --- -- Each Person
OWNED ~~----
0 v 'T Each Accident or OccurrencE
NON-OWNED "
0 HIRED "'.-\' ---- - l yd -- Each Accident or OccurrencE
(~-.,]--
~. " , .
OTHER " .,
ADDITIONAL COMMENTS
COVERAGE IS PROVIDED FOR ONLY THOSE EMPLOYEES lEASED TO, BUT NOT SUBCONTRACTORS OF:
JOHN FITZGERAlD,INC.
CLIENT DATE: 6/17/97
. 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.
SPECIAL NOTICE-OHIO: ANY PERSON WHO, WITH INTENT TO DEFRAUD OR KNOWING THAT HE IS FACILITATING A FRAUD AGAINST AN INSURER, SUBMITS AN
APPLICATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT IS GUlL TV OF INSURANCE FRAUD.
IMPORTANT NOTICE TO FLORIDA POLICYHOLDERS AND CERTIFICATE HOLDERS: IN THE EVENT YOU HAVE ANY QUESTIONS OR NEED INFORMATION Liberty Mutual Group
ABOUT THIS CERTIFICATE FOR ANY REASON, PLEASE CONTACT YOUR LOCAL SALES PRODUCER, WHOSE NAME AND TELEPHONE NUMBER APPEARS IN THE
LOWER RIGHT HAND CORNER OF THIS CERTIFICATE. THE APPROPRIATE LOCAL SALES OFFICE MAILING ADDRESS MAY ALSO BE OBTAINED BY CALLING THIS
NUMBER.
NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.) BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL
NOT CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST DAY", I ^ \ \ (,)
IMONROE BOCC 300l l~ TY\. ~~~ ll~
CERTIFICATE 5100 COLLEGE ROAD A-4 Helene McBrearty
HOLDER KEY WEST, FL 33050 AUTHORIZED REPRESENTATIVE
L
~
Wayne, PA
OFFICE
(610)-971-9394
3/21/2000
PHONE NUMBER
DATE ISSUED
This certificate is executed by LIBERTY MUTUAL GROUP as respects such insurance as is afforded by Those Companies
BS 772L R2
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.
~-
Name and
address of
Insured.
LIBERlYfr;. ':'
MUTUAL@ ,
This is to Certify that
I NOVACARE EMPLOYEE SERVICES. INC.
CLIENT:JOHN FITZGERALD INC
402 43RD STREET WEST
BRADENTON. FL 34209
L ~
Is, at the issue date of this certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(ies) is subject to all their terms, exclusions
and conditions and is not altered by any requirement, term or condition of any contract or other document with respect to which this certificate may be issued.
I
TYPE OF POLICY
EXP.DATE
. 0 CONTINUOUS
o EXTENDED
POLICY TERM
POLICY NUMBER
LIMIT OF LIABILITY
6/17/97
TO
7/112000
W A2-63D-004155-0 17
COVERAGE AFFORDED UNDER WC
lAW OF THE FOllOWING STATES:
ALL STATES EXCEPT
MONOPOLISTIC STATE
FUND STATES
EMPLOYERS LIABILITY
Bodily Injury By Accident
$1 ,000,000.00 ~~i~ent
Bodily Injury By Disease
$1 ,000,000.00 ri~~y
WORKERS
COMPENSATION
WC2-631-004155-027
Bodily Injury By Disease
$1 ,000,000.00 ~~;~on
General Aggregate - Other than Products/Completed Operations
10, MT, OR, WI & NV
GENERAL LIABILITY
D OCCURRENCE
Products/Completed Operations Aggregate
D CLAIMS MADE
Bodily Injury and Property Damage Liability
Per
Occurrence
Personal Injury
Per Person!
Organization
RETRO DATE
Other
DOWNED
D NON-OWNED
D HIRED
OTHER
Each Person
Each Accident or Occurrenc
AUTOMOBILE L1ABILlT
[1~TE
_a::a~-OD
Each Accident - Single Limit
B.1. and P.D. Combined
\.IV
l~.,:' '\TR:
,~~.. ;-
,./ vcs
Each Accident or Occurrenc
ADDITIONAL COMMENTS
COVERAGE IS PROVIDED FOR ONLY THOSE EMPLOYEES LEASED TO, BUT NOT SUBCONTRACTORS OF:
JOHN FITZGERALD INC.
CLIENT DATE:6/17/97
* 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.
SPECIAL NOTICE-OHIO: ANY PERSON WHO, WITH INTENT TO DEFRAUD OR KNOWING THAT HE IS FACILITATING A FRAUD AGAINST AN INSURER, SUBMITS AN
APPLICATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT IS GUILTY OF INSURANCE FRAUD.
~M:c,~Wf~~ ~~~~~~ltZlEL?S~D:N~O~~~~~~~~~~;s~Ngo~~Bfl~~~~ ~g~~~~~L:E~Np~~~0t~~: YWH~~~~~NJE~NEJi~L~~~~NNl~S~r:E~R~N~~~s IN THELiberty Mutual Group
LOWER RIGHT HAND CORNER OF THIS CERTIFICATE. THE APPROPRIATE LOCAL SALES OFFICE MAILING ADDRESS MAY ALSO BE OBTAINED BY CALLING THIS
NUMBER
NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW) BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL
NOT CANCEL OR REDUCE THE INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST DAY",.!. ^ \ \ (:)
ICOUNTY OF MONROE / ASTRO CITY 000 l~ TY\. ~~~~
CERTIFICATE PLAYGROUND HIGGS BEACH l7 , Helene McBrearty ~
HOLDER 5100 COLLEGE RD AUTHORIZED REPRESENTATIVE
KEY WEST FL 33040 DATE Wayne, PA (610)-971-9394
L INiTIAL =.J OFFICE PHONE NUMBER
02/18/200C
DATE ISSUED
This certificate is executed by LIBERTY MUTUAL GROUP as respects such insurance as is afforded by Those Companies
BS 772L R2