Certificates of Insurance
C E R T I Fie ATE 0 FIN S UR A NeE
THIS CERTIFICATE DOES NOT AMEND, EXTEND OR OTHERWISE ALTER ruE TERMS AND CONDITIONS OF THE POLICIES REFERRED TO HEREIN.
A4~'
Date: August 29,2000
CERTIFICATION TO:
Monroe County
Atto: Risk Management
5100 College Road
Key West, FL 33040
~'\
"
THE FOLLOWING POLICIES HAVE BEEN ISSUED TO:
Robert Feldman
3529 Sunrise Drive
Key West, FL 33040
Aircraft Liability Policy No. PBP1079082 of
ONE OR MORE MEMBER COMPANIES OF
ASSOCIATED AVIATION UNDERWRITERS
Policy Period: from AUlZllst 25.2000 to AUlZust 25.2001
Covera2es
Limits of Liabilitv
Single Limit Bodily Injury and Property
Damage Including Passengers
$ 1.000.000
Each Occurrence *
* Passenger Liability Limited To
$ 100.000
Aircraft Physical Damage Policy No. PBP1079082 of
ONE OR MORE MEMBER COMPANIES OF
ASSOCIATED AVIATION UNDERWRITERS
Policy Period: from AUlZust 25. 2000 to AUlZust 25. 2001
Covera2e
FAAI::::tionNO."y'Yh~\. _\(P'~_
(1'" 1 14------
~ \,,..-('"
f-- ,-
Make and Model of Aircraft
1978 Cessna 210M
All Risks Basis
It is agreed that solely with respect to liability arising out of acts or omissions of the Named Insured on premises leased from
Monroe County, the following shall apply:
1. The following is hereby included as an additional Insured under Liability Coverage D:
Monroe County
Attn: Risk Management
5100 College Road
Key West, FL 33040
2. In the event the policy is cancelled by the Company, thirty (30) days prior written notice shall be given to the
Monroe County.
BY:
s
($J
SAFECO @
CERTIFICATE OF INSURANCE
\li~
This certifies to the Certificate Holder
Name: MONROE COUNTY j
Address: 5100 College Road, Key West, FL 33040 ..
Attn: Risk Management ~
that the following indicated insurance has been afforded to the Insured
Name: Robert Feldman
Address: 3529 Sunrise Drive, Key West, FL 33040 w~\VrR:
N,r.,~fS--
,~
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CL . ~~J1/~
~
covering in accordance with the terms thereof, the following aircraft, locations or hazards:
1978 Cessna 210, N29008,
6 seats total
AIRCRAFT - Limits of Liabilit
Policy Number: ACE 752590 8A
Policy Period: 12:01 AM Standard Time
to
COVERAGE
AIRPORT - Limits of Liabilit
Policy Number:
Policy Period: 12:01 AM Standard Time
to
$
$
$
$
$
each person
each occurrence
each person
each occurrence
each occurrence
Bodily Injury Liability excluding Passengers $
$
each occurrence
Passenger Bodily Injury Liability
$
$
Property Damage Liability
$
Single Limit Bodily Injury and
$
$
each occurrence
aggregate products
Amount of Insurance
100,000.
N 29008
N
N
Medical Pa ments
All Risks of Physical Damage
Amt. Deductible $ 50. Not in Motion
$ 250. In Motion
each occurrence
Hangarkeeper's Liability - Not in Flight
Amt. Deductible $ each occurrence
CHEMICAL - Limits of Liability
COVERAGE
Polic Period: 12:01 AM Standard Time
CHEMICAL CATEGORIES
to
o Comprehensive Chemical
o Restricted Chemical
o Excludin Chemical
Polic
$
$
$
$
$
$
$
Number:
each person
each occurrence
a re ate
each occurrence
a re ate
each occurrence
a re ate
Bodily Injury Liability excluding Passengers
Property Damage Liability
DEDUCTIBlES
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 listed above. It is the Company's intention, in the event of
cancellation of any of the insurance described above, to give 10 days advance written notice of such cancellation to the Certificate
Holder at the address stated above.
Nonchemical $
Chemical $
each occurrence
each occurrence
AUTHORIZED REPRESENTATIVE
@ Registered trademark of SAFECO Corporation.
SR 70 35/EP 4/91 (Filed IJS 4/88)
TEL No.305 296 8575
Mar 17,95 4:13 P.02
~
AVEMCO INSUftANCECOMPANY
411 Aviation Way
Fr.derick, MO 2110 1
CWlfll~~ 0.. ]NSU~
TJ.IIS CE:RTIFICA Te IS ISSU;O TO~
MONROE COUNTY AI RPORT I Ie or
AIRPORT MANAQIR A R SKBtL!t
KEY WEST INTERNATIONAL AIRPORT
3491 S ROOS&VlLT BLVD
KlY WIST, PC 33041
Cite; 02/06/95 .
. -DIlIlatIJtTIVIi g~HIi!iDUYi-"
APPROVED BY RISK MANAGEMENT
BY~ ~~~
OATE ~ - 01 fr<:z-..s-
W~!VER: N/A ~ES
POUCVHOI OPA- RO"IIRT 't' 'ILDMAN
. 3529 SONRISS DRIVE
KBY waST, .L 33040
POLICY NVMBER:
313541-5
POLICY I'I!RIOD: From 2/16/95 To 2/16/96
112101 "In. 1...1 tk'n. .t poll..,.hol....I. ."11"...1
INSURED AIRCRAFT: N71731 1969 CESSNA
COVERAG!:S ANO LIMITS OF LIABILITY:
LIABILITY - BOdily Injury
( I N eluding Occupants) and
"rop.rty OllT'llgl
182
$
100,000
IICh I),r.on
pl"Qfarty darrlase
I)
500,000
,
500,000
45,000
laCh ,ccld.nt
AIRCRAFT DAMAGE I I N eluding In Flight)
$
Insured Value lei.
.
200
not in motion deductible
The moat ,,,,,,,e..t 41.t. ....v-" i.. the to, p1tht "ern.r l~ the
mOlt lurr.nt OIrtltlN't. for thi, In.urtd ,ro,.rty, .nd r'p'ICtl
.11 e..tiflen... if any. pr....lou.1y '..u.d.
This Certifiaata of INuranca neithar affirmativ.ly nor nll.tlvely .",encll, extenel. or .Itet. the ;ovtn..
.fforded by 1M Policy, ft Is Issued " II mitt... Of Informltion only and con'.rs 110 rights upon the
ce,tlflc.te holder. It Is htrth.r ....d ttut In the t",nt 0' elnotll,tion ot thi. poli~V, the comp.ny will lIill'
30 d.vs prior written notice of callcelldon to the ,.ttlflcft. hol.r.
$
200
in motion deductible
OISTRIBUTION:
Certificate Holder
Polic:yholdor
Regional Office
Fil.
AVEMCO fNSUPlANC! COMPANY
All;
b-Fl ('2-94)
c c '.IS 6:- -v -7r ..... ",n C' eJ .c:= .sr
r/~e-
By
~~/~t'
Authorlz.d Rept.....uti".
(CTtl283)
NON -'COMMEFlCIAL
AlaCRAFT .POLlCY
No..NC . OJ 1313541-5
CAVEMCO@ INSURANCE
I
COMPANY
CERT /7FORMS
Fl
DATA PAGE
(A CAPITAL STOCK INSURANCE COMPANY)
411 Aviation Way
Frederick, Maryland 21701
1. Policyholder and Address:
ROBERT T FELDMAN
3529 SUNRISE DRIVE
KEY WEST, FL 33040
2. Lienholder 'XW~1l&I1r ~ISK MANAdtt.lENT .
BY _~~t!J;(IC;
c~~~/C
DATE ~-e2 ?7~
WAIVER: N/A /' YES
4. Aircraft Description: Reg. No.: N717 31
Year Make and Model
3. Policy Period (12:01 A.M. local time at your address):
Mo. Day Yr. Mo. Day Yr.
2/16/95 to 2/16/96
Based In
1969
CESSNA
182
FL
5. Insurance is provided for the coverages for which limits
of liabilit and remiums are shown below:
COVERAGES
A Bodily Injury ( INcluding ccupants) $
and Pro ert Dama e Liabilit
B Aircraft Damage (I Ncluding In Flight) $
Less deductible
C Medical Expenses $
Expanded Liability Coverage for Family Members
Endorsements at time of issue S 110 G 1046
1
ANNUAL
PREMIUMS
each
$ 3,
each accident
$ 200
in motion
560.00
44,000
insured value
NOT PURCHASED
GI057
The limits shown are the limits you have selected. OTHER LIMITS ARE
AVAILABLE. If you wish to change these limits, please contact us.
FL PREMIUM ADJUSTMEN
33.28
TOT AL AIRCRAFT PREMIUM $
865.28
6. Approved Pilot(s):
This policy applies when your insured aircraft is in flight, only while being operated by
one of the following pilots who holds a currently effective Pilot Certificate (unless a pre-solo
student pilot) issued by the FAA:
A. ROBERT T FELDMAN,
PRIOR TO OPERATING THE INSURED AIRCRAFT, MUST HAVE A CURRENTLY VALID
AND EFFECTIVE MEDICAL CERTIFICATE, AND, PRIOR TO ACTING AS PILOT IN
COMMAND OF THE INSURED AIRCRAFT, MUST SATISFY FAA FLIGHT REVIEW
REQUIREMENTS.
B. COMMERCIAL PILOTS IN THE EMPLOY OF AN FAA APPROVED AIRCRAFT
REPAIR STATION IN CONNECTION WITH ,INSPECTIONS OR REPAIRS TO
BE OR THAT HAVE BEEN PERFORMED ON THE INSURED AIRCRAFT; OR,
BY AN FAA INSPECTOR OR ANY CERTIFICATED FLIGHT INSTRUCTOR
WHILE ACCOMPANIED BY AN APPROVED PILOT FOR THE PURPOSE OF
INSTRUCTING THAT PERSON.
C. ...-
19 1/)
--~:;:;":::";:;;"
,y=~;-
"~ -~-
/' (Authorized Representative)
C. ANY PRIVATE, CO~~FCIAL OR AIRLINE TRANSPORT PILOT WHO MEETS ALL
OF THE FOLLOWING REQUIREMENTS:
1. HOLDS AN AIRPLANE SINGLE ENGINE LAND RATING;
- CONTINUED ON BACK -
COUNTERSIGNED / - / (J
At ORLANDO. FLORIDA
THIS FORM ATTACHES TO P~R~Ef1P2 (1-93)
Cc ! /.3 -m~
nnc-F130 (11-93) p
BY
C/ 1/ A/02/04/H/15
CFLOl
01/09/95
(DC0112)
6. Approved Pilot(sl continued:
2. HAS A CURRENT AND EFFECTIVE MEDICAL CERTIFICATE;
3. SATISF.I,ES-T.ME -FAA'.S.FLIGHT REVIEW REQUIREMENTS:
4. HAS LOGGED 10 HOURS IN THE SAME MARE AND MODEL AS THE INSURED
AIRCRAFT.
CL--3~C A/j
(? 6?~ ,/
't:&
3h
(DCDD 12)
FLORIDA AMENDATORY ENDORSEMENT
The following are substituted for GENERAL PROVISIONS 6 and 7 of your Policy:
6. NONRENEWAL
If we decide not to renew this Policy, we will mail you a notice of nonrenewal with our reasons.
This notice will be sent to the address shown in Item 1 of the Data Page. It will be sent at least
45 days before the Policy Period ends. Proof of mailing will be proof that you were notified. If
we offer to renew and you do not pay the renewal premium, you have declined our offer.
7. CANCELLA TION
To cancel this Policy, you must tell us in writing at what future date the cancellation should be.
We may cancel by mailing you a cancellation notice. This notice will be sent to the address
shown in Item 1 of the Data Page. If this Policy has been in effect for 90 days or less, the notice
will be sent at least 20 days before the cancellation date unless cancellation is for a material
misstatement or misrepresentation, or failure to comply with our underwriting requirements.
Only 10 days' notice will be given if cancellation is for nonpayment of premium.
If this Policy has been in effect for more than 90 days, the notice will be sent at least 45 days
before the cancellation date. Only 10 days' notice will be given if cancellation is for nonpayment
of premium. We may cancel only for the following reasons:
a. nonpayment of premium;
b. material misrepresentation by you;
c. failure to comply with underwriting requirements established by us within 90 days of the
effective date of coverage;
d. a substantial change in the risk; or
e. cancellation is for all insureds under such policies for a given class of insureds.
The notice will include the reason(s) for cancellation. Proof of mailing will be proof that you
were notified.
Upon cancellation, you may be entitled to a premium refund. We will send that refund to you.
Our making a refund is not a condition of cancellation.
If we cancel for a reason other than nonpayment of premium, the refund will be figured on a pro
rata basis. If you cancel for any reason, or if we cancel because of your nonpayment of prem-
ium, the refund will be 90% of the pro rata amount.
The receipt and deposit of your premium payment by us or our agent after mailing a notice of
cancellation will not reinstate the Policy. However, cancellation for nonpayment of premium will
not be effective if the required payment is received before the cancellation date.
The information below is required only when this Endorsement is issued after preparation of your
Policy.
This Endorsement is effective MO./Day/Yr. 2/16/95 at 12: 01 A.M.
your address shown in Item 1 of the Data Page and is a part of Policy Number
issued by A VEMCO Insurance Company,
~
local time at
313541-5
~~ErS~ .
Ale
nnc-S 11 0 (4-93)
COUNTERSIGNED
By:
19_
Authorized Representative
(EN2388)
AVEMCO INSURANCE COMPANY
411 Aviation Way
Frederick, MD 21701
Received
" . Mgmt. & Loss Control
.;;'-'1. /1:3 I /
..dTIAL 7'..........
CERTIFICATE OF INSURANCE
THIS CERTIFICATE IS ISSUED TO:
MONROE COUNTY AIRPORT I/C OF
AIRPORT MANAGER A R SKELLEY
KEY WEST INTERNATIONAL AIRPORT
3491 S ROOSEVELT BLVD
KEY WEST, FL 33041
Date: 01/18/95
- -DESCRIPTIVE SCHEDULE --
POLICYHOLDER: ROBERT T FELDMAN
3529 SUNRISE DRIVE
KEY WEST, FL 33040
APPROVED BY RISK MANAGEMENT
BY ~O'--?;P~
DATE ~- .!? -:7-5-
W~IVER: N/A ~ES
:;:;J,,t!.r
F/N~,cd'
POLICY NUMBER:
313541-5
POLICY PERIOD: From 1/06/95 To 2/16/95
(12:01 a.m. local time at policyholder's address)
INSURED AIRCRAFT: N71731 1969 CESSNA 182
COVERAGES AND LIMITS OF LIABILITY:
LIABILITY - Bodily Injury
( I N eluding Occupants) and
Property Damage
$ 100,000 each person
$ 500,000 property damage
$ 500,000 each accident
$ 45,000 Insured Value less
$ 200 not in motion deductible
AIRCRAFT DAMAGE (I N eluding In Flight)
The most current date shown in the top right corner is the
most current certificate for this insured property, and replaces
all certificates, if any, previously issued.
This Certificate of Insurance neither affirmatively nor negatively amends, extends or alters the coverage
afforded by the Policy. It is issued as a matter of information only and confers no rights upon the
certificate holder. It is further agreed that in the event of cancellation of this policy, the company will give
30 days prior written notice of cancellation to the certificate holder.
$
200
in motion deductible
DISTRIBUTION:
Certificate Holder
Policyholder
Regional Office
File
AVEMCO INSURANCE COMPANY
AIC
n-F 1 (12-94)
By
~/q~~
Authorized Representative
('c: ~
(CT0293)
The Certificate Holder shown on front of this Certificate is an Insured person under that definition
of the Policy. However, they are an insured person only for liability arising out of their agree-
ment to let another Insured person store or use the Insured aircraft on their airport. THE CER-
TIFICA TE HOLDER IS NOT AN INSURED PERSON WHEN THEIR LIABILITY ARISES OUT OF THEIR
MANUFACTURE, REPAIR, SERVICE, SALE, OR USE OF THE INSURED AIRCRAFT.
We will notify the Certificate Holder when this Policy is cancelled. Notice will be sent at least 30
days before the cancellation date. Only 10 days' notice (or that notice required by the policyholder's
state, if more) will be given if we cancel for nonpayment of premium.
If the Certificate Holder has other liability insurance, that insurance shall apply first. The addition of
this Certificate Holder as an Insured person does not increase the limits of liability on this Policy.
4/1/93
(CT0072)
~._,;-, -,
pPIES.OF A CERTIFICATE OF
...R,..ANCE .F.OR THE FACILIT~ wnl:.-RE
; ~~~C~T;:IS BASED ARE ENCLOSED.tANCE COMPANY
, .EASE', SEND ONE COpy TO YOUR iation Way
",.IRPORTTO CERTIFY COVERAGE. MD 21701
,
CERTIFICATE OF INSURANCE
Date: 02/09/96
THIS CERTIFICATE IS ISSUED TO:
MONROE COUNTY AIRPORT I/C OF
AIRPORT MANAGER A R SKELLEY
KEY WEST INTERNATIONAL AIRPORT
3491 S ROOSEVELT BLVD
KEY WEST, FL 33041
- -DESCRIPTIVE SCHEDULE..:-=-
POLICYHOLDER: ROBERT T FELDl4AN
3529 SUNRISE DRIVE
KEY WEST, FL 33040
APPROVED BY RISK pp',"r,r,..,..q.IT
f'~ /#~_~~
;;,',,'E 0--:~?:.~Z-b~
;"'1,'IJER: ~""./
POLICY NUMBER:
313541-5
POLICY PERIOD: From 2/16/96 To 2/16/97
(12:01 a.m. local time at policyholder's address)
INSURED AIRCRAFT: N71731 1969 CESSNA 182
COVERAGES AND LIMITS OF LIABILITY:
LIABILITY I - Bodily Injury
( I N eluding Occupants) and
Property Damage
j
AIRCRAFT DAMAGE (I N eluding in Fiightl
$ 100,000 each person
$ 500,000 property damage
$ 500,000 each accident
S 45,000 Insured Value less
$ 200 not in motion deductible
The most current date shown in the top right corner ;s the
most current certificate for this insured property, and replaces
all certificates, if any, previously issued.
This Certificate of Insurance neither affirmatively nor negatively amends, extends or alters the coverage
afforded by the Policy. It is issued as a matter of information only and confers no rights upon the
certificate holder. It is further agreed that in the event of cancelliltion of this policy, the compilny will give
30 days prior written notice of cancellation to the certificate holder.
$
200
in motion deductible
DISTRIBUTION:
Certificate Holder
Policyholder
Regional Office
File CC:~)t{~
AIC ~
n-Fl (12-94)
A VEMCO INSURANCE COMPANY
By__
~~~
Authorized Representative
(CT0293)
WITH RESPECT TO N71731
AIRPORT USE - AIRPORT HANGAR ENDORSEMENT
u have a written airport use or airport hangar agreement for your insured aircraft with:
.
MONROE COUNTY AIRPORT I/C OF
AIRPORT MANAGER A R SKELLEY
KEY WEST INTERNATIONAL ~IRPORT
3491 S ROOSEVELT BLVD
KEY WEST, FL 33041
e agree to include them as an "insured person" under that definition in your Policy. We also agree to waive
lr recovery rights against them for loss to your Insured aircraft (you do too).
e agree to these changes provided their liability for bodily Injury, property damage, or loss arises out of their
~reement to let you use their airport or their hangar. THESE CHANGES DO NOT APPLY WHEN THEIR LIABILITY
RISES OUT OF THEIR MANUFACTURE, REPAIR, SERVICE, SALE, OR USE OF YOUR INSURED AIRCRAFT.
Ie will notify this Insured person when your Policy is cancelled. Notice will be sent at least 30 days before
1e cancellation date. Only 10 days' notice (or that notice required by your state, if more) will be given if we
ancel for nonpayment...of premium.
this insured person has other liability insurance, that insurance shall apply first. The addition of this in-
'Jred person to your Policy does not increase the Limits of Liability provided.
.
The information below Is required only when this Endorsement is issued after preparation of your
Policy.
This Endorsement is effective Mo./Day/Yr: 2/16/96 at 12: 01 A.M.
your address shown in Item 1 of the Data Page and is a part of Policy Number
issued by A VEMCO Insurance Company.
local time at
313541-5
~
~~1R~~ .
31046 (7-93)
COUNTERSIGNED
By:
19_
Authorized Representative
(EN2691)
m.
SAFECD@
CERTIFICATE, OF INSURANCE
/
This certifies to the Certificate Holder
Name: MONROE COUNTY
Address: 5100 College Road, Key West, FL 33040
Attn: Risk Management
that the following indicated insurance has been afforded to the Insured
Name: Robert Feldman
Ad~~s: 3529 Sunrise Drive, Key West, FL 33040
APPPOVFD BV RiSK 'PN~('nILNT
pV.,_. ..~-L./ ~.~ ~~/G
--~~C~~
, ., ..-------I-?--".;~? ~ -
v/'
covering in accordance with the terms thereof, the following aircraft, locations or hazards:
1978 Cessna 210, N29008
6 seats total
, . -j~f;JiYd ': . ..-. ....
_..__.._-~
; ; ,r. i.
AIRCRAFT - limits of liabili
Policy Number: ACE 7525908
Policy Period: 12:01 AM Standard Time
08/03/96 to 08/03/97
$ each person
$ each occurrence
$ each person
$ each occurrence
$ each occurrence
COVERAGE
AIRPORT - Limits of Liabilit
Policy Number:
Policy Period: 12:01 AM Standard Time
to
Bodily Injury Liability excluding Passengers $
$
$
$
Passenger Bodily Injury Liability
Property Damage Liability
Amount of Insurance
$100,000.
$
$
Single Limit Bodily Injury and
$
$
each occurrence
aggregate products
$
29008
Medical Pa ments
All Risks of Physical Damage
Amt. Deductible $ 250 Not in Motion
$ 250 In Motion
Hangarkeeper's Liability - Not in Flight
Amt. Deductible $ each occurrence
CHEMICAL - Limits of Liability
COVERAGE
Polic Period: 12:01 AM Standard Time
CHEMICAL CATEGORIES
to
o Comprehensive Chemical
o Restricted Chemical
o Excludin Chemical
Polic
$
$
$
$
$
$
$
Number:
each person
each occurrence
a re ate
each occurrence
a re ate
each occurrence
a re ate
Bodily Injury Liability excluding Passengers
Property Damage Liability
DEDUCTIBlES
Nonchemical $
Chemical $
each occurrence
each occurrence
This certificate is issued as a matter of information onl y and confers no rights upon the Certificate Holder. This certificate does
not amend, extend or alter the coverage afforded by the policies listed above. It is the Company's intention, in the event of
cancellation of any of the insurance described above, to give 30 days advanc written ~otice of such cancellation to the Certificate
Holder at the address stated above.
C:C~yj~~
r
SR 70 35/EP 4191 IFi led llS 4/88)
12-02-1396 11: 1:::3Ar1 FRCiM t.jATIOHPJR CiTL
.f$) 1 .
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i ! · AIRCRAF')t/AIRPORT POLICY CHANGE ENOt1>RSEMENT
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1'"is polley ;8 fhangedas indicate~ below for: i ' I I
: ~: n9 change in ~remiu~' r::J rn a4ditiOnal p"er1um ~
Lf1 'a ~re"'lium to' be adju~l.d at audit 0 r return prerniu1 of. . i$
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i The iinsprancei affolttd by this policy under the Uability ! ov~rage is e~end~ to:
I I I I I
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i i MONROE COUNTY i I I
t: 5100 COLLEGE ROAD I :
.1 I JII' TTKENY IWEST,FL 3~940 j j! I !
t I . : Ii .A : rISK MANAGliMIiNT I: '. !
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)' as ~n additio~al ins~r$d but only as respects liability !aris~g'out of thel Named
Insuted~s operations lot the aircraft insured hereunder. i i. i ,.
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! The: coverage: affordied by this endorsement to the a~ditionaJ insurbd isl excess
i cov~ra~e andapPfie~ionlY after all other coverage to the ~dtfltional ins~red ~a$ been
J eXihausted., I !.!
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: q 'a ~remjum to ~e adiusrd at audit D ~ retu," premium if. . ,
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MEMORANDUM COpy
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SAFECD@
CERTIFICATE, OF INSURANCE
This certifies to the Certificate Holder
Name: MONROE COUNTY
Address: 5100 College Road, Key West, FL
Attn: Risk Management
that the following indicated insurance has been afforded to the Insured
Name: Robert Feldman
Address: 3529 Sunrise Drive, Key West, FL 33040
AP~V RISK M~,NAGqlEI-iT
covering in accordance with the terms thereof, the following aircraft. locations or hazards: r---yj/ //. ~A! I G;
BY. ti //~'~
1978 Cessna 210, N29008 6 seats total [)f;TE_'lj..d:S....:l C.
~A 7,:-:---
,.;;,-
" 1
"'.-.'fl-''l''~.'.1O..-::: .
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---'-~-.-...._..,.' -. -.' ,,-.... --..
33040
~~ ': '::- Q.
AIRCRAFT - Limits of Liabili
Policy Number: ACE 7525908
Policy Period: 12:01 AM Standard Time
08/03/96 ~ 08/03/97
$ each person
$ each occurrence
$ each person
$ each occurrence
$ each occurrence
COVERAGE
AIRPORT - Limits of Liabilit
Policy Number:
Policy Period: 12:01 AM Standard Time
to
Bodily Injury Liability excluding Passengers $
$
$
$
Passenger Bodily Injury Liability
Property Damage Liability
$
Single Limit Bodily Injury and
$
$
each occurrence
aggregate products
Amount of Insurance
$ 100,000.
$
$
29008
Medical Pa ments
All Risks of Physical Damage
Amt. Deductible $ 250 Not in Motion
$ 250 In Motion
Hangarkeeper's Liability - Not in Flight
Amt. Deductible $ each occurrence
Number:
COVERAGE
Polic Period: 12:01 AM Standard Time
CHEMICAL CATEGORIES
to
o Comprehensive Chemical
o Restricted Chemical
o Excludin Chemical
CHEMICAL - Limits of Liability
Polic
$
$
$
$
$
$
$
each person
each occurrence
a re ate
each occurrence
a re ate
each occurrence
a re ate
Bodily Injury Liability excluding Passengers
Property Damage Liability
DEDUCTIBLES
Nonchemical $
Chemical $
each occurrence
each occurrence
This certificate is issued as a matter of information onl y and confers no rights upon the Certificate Holder. This certificate does
not amend. extend or alter the coverage afforded by the policies listed above. It is the Company's intention, in the event of
cancellation of any of the insurance described above. to give 30 days advance written notice of such cancellation to the Certificate
Holder at the address stated above.
SR 70 35/EP 4191 (File~ ";A~ "1A1
("C ~ ~~ Ipt.~
, ($)'
SAFECO.
AIRCRAFT/AIRPORT POLICY CHANGE ENDORSEMENT
This policy is changed as indicated below for:
[i] no change in premium
D a premium to be adjusted at audit
c:J an additional premium $
D a return premium of. . $
ADDITIONAL INSURED ENDORSEMENT
The insurance afforded by this policy under the Liability Coverage is extended to:
MONROE COUNTY
5100 COLLEGE ROAD
KEY WEST, FL 33040
ATTN: RISK MANAGEMENT
as an additional insured but only as respects liability arising out of the Named
Insured's operations of the aircraft insured hereunder.
The coverage afforded by this endorsement to the additional insured is excess
coverage and applies only after all other coverage to the additional insured has been
exhausted.
Named Insured
Robert Feldman
Annual Written Premium
Old $
Policy NlcB 7525908
Short Rate
AP
$
x
= $
Difference
Unearned
New $
Pro Rate
RP
Endorsement No. Typing Date Policy Period
2 11/22/96ep 08/03/96 7
94-6006
AUTHORIZED REPRESENTATIVE
ORIGINAL COPY
SR 85 02/EP 9196
WP
SRegistered trademark of SAFECO Corporation.
,(;).
.SAFECOlS
AIRCRAFT/AIRPORT POLICY CHANGE ENDORSEMENT
This policy is changed as indicated below for:
CJ no change in premium
CJ a premium to be adjusted at audit
CJ an additional premium $
CJ a return premium of. . $
The Policy Number as shown on Endorsement No.2 is corrected to read: ACE 7525908
Named Insured I Policy No.
Robert Feldman ACE 7525908
Annual Written Premium Short Rate AP
- -
Old $ $ x = $
Difference Unearned
New $ Pro Rate RP
Endorsement No. I Typing Date I Policy Period I Effective Date of Endorsement
3 11-25-96Ia August 3,1996/97 November 19,1996
946006
AUTHORIZED REPRESENTATIVE
MEMORANDUM COpy
SA 85 02/EP 9196
WP
"'Aegistered trademark of SAFE CO Corporation.
C E R T I Fie ATE 0 FIN SUR AN C E
THIS CERTIFICATE DOES NOT AMEND, EXTEND OR OTHERWISE ALTER THE TERMS AND CONDITIONS OF THE POLICIES REFERRED TO HEREIN.
MI'~
~h~
Date: August 3, 1998
CERTIFICATION TO:
Monroe County
Attn: Risk Management
5100 College Road
Key West, FL 33040
\';' I
THE FOLLOWING POLICIES HAVE BEEN ISSUED TO:
Robert Feldman
3529 Sunrise Drive
Key West, FtJ3040
Aircraft Liability Policy No. PBP1017877 of
ONE OR MORE MEMBER COMPANIES OF
ASSOCIATED A VIA nON UNDER WRITERS
Policy Period: from August 3, 1998 to August 3, 1999
Coverae:es
Limits of Liability
Single Limit Bodily Injury and Property
Damage Including Passengers
$ I ,000,000.
Each Occurrence *
* Passenger Liability Limited To
$ 100,000.
Aircraft Physical Damage Policy No. PBP1017877 of
ONE OR MORE MEMBER COMPANIES OF
ASSOCIATED A VIA nON UNDERWRITERS
Policy Period: from August 3, 1998 to August 3, 1999
Make and Model of Aircraft
FAA Identification No.
1978 Cessna 210M
N29008
Coverae:e
All Risks Basis
It is agreed that solely with respect to liability arising out of acts or omissions of the Named Insured on premises leased from
Monroe County, the following shall apply:
1.
The following is hereby included as an additional Insured under Liability Coverage D:
i>Y
Monroe County
Attn: Risk Management
5100 College Road II'! IVI='R' .~: / y S
Key West, FL 33040 1 '.'.' ~ - F.
In the event the policy is cancelled by the Company, thirty (30) days prior written not~~l.!tbe. ~ aiiven to the
Monroe County. C(', -~
DATE
2.
ASSOCIATED AVIATION UNDERWRITERS
BY: ~ t(~
C E R T I FIe ATE 0 FIN S VR AN C E
THIs CERTlFICAlE DOES NOT AMEND, EXlEND OR OTHERWISE ALlER THE ~~mONS OF THE POUCIES REFERRED TO HEREIN.
J ~. ~(I)~ A4~'
C( '"
-
THE FOLLOWING POLICIES HAVE BEEN ISSUED TO:
Robert Feldman
/ vrs _____ 3529 Sunrise Drive
1'-'~"JtR'. \'<. " ,< -- Key West, FL 33040
/(01
ONE OR MORE MEMBER COMPANIES OF
ASSOCIA lED A VIA nON UNDERWRITERS
Aircraft Liability Policy No. PBPI045317 of
Policy Period: from August 3. 1999 to August 3. 2000
Coveral!es
Limits of Liability
Single Limit Bodily Injury and Property
Damage Including Passengers
$ 1.000.000
Each Occurrence *
* Passenger Liability Limited To
$ 100,000
Aircraft Physical Damage Policy No. PBP1045317 of
ONE OR MORE MEMBER COMPANIES OF
ASSOCIATED A VIA TION UNDERWRITERS
Policy Period: from August 3. 1999 to August 3, 2000
Make and Model of Aircraft
FAA Identification No.
1978 Cessna 210M
N29008
Coveral!e
DA11' -"
9 /_~ ~1!-'
- -ltQ.._----
All Risks Basis
IN lTli\ L
It is agreed that solely with respect to liability arising out of acts or omissions of the Named Insured on premises leased from
Monroe County, the following shall apply: -
1. The following is hereby included as an additional Insured under Liability Coverage D:
Monroe County
Attn: Risk Management
5100 College Road
Key West, FL 33040
2. In the event the policy is cancelled by the Company, thirty (30) days prior written notice shall be given to the
Monroe County.
ASSOCIATED A VIATIO~ ~WRITERS, /
BY:~ ~/~~
USAIG Certificate of Insurance
This is to certify to:
Monroe County Board of County Commissioners
Attn: Maria Salvik, Risk Management Specialist
APR
BY
DATE
that: Robert Feldman & Jeffrey Cardenas WAIVER N/A -=::::::::YES : ~
whose address is 243 Front St. Ci}fu~~
Key West, FL 33040 ~~f1I{{}.e.
is at this date insured with one or more member companies of the United States Aircraft Insurance Group, for the Limits of Coverage
stated below, at the following locations: the United States of America, its territories and possessions, Canada, Mexico, the Bahamas,
the islands of the West Indies, Central America or while enroute between these places.
1100 Simonton Street
Key West, FL 33040
whose address is:
Descriptive Schedule of Coverages
1978 Cessna 210, N29008
Kind of Insurance
Policy Numbers(s)
Expiration Date(s)
Limits of Coverage
AIRCRAFT LIABILITY
Combined Liability Coverage for
bodily injury and property damage
360AC-610674
08/25/2002
Each Person
Each Occurrence
Subject to a maximum limit per passenger of
$ 1,000,000.00
$ 100,000.00
Medical coverage
$
3,000.00
AIRCRAFT PHYSICAL
DAMAGE - ALL RISKS
Not In-Motion Deductible
In-Motion Deductible
Amount of Insurance
$
$
$
AIRPORT LIABILITY
Combined Liability Coverage for
bodily injury and property damage
Hangarkeeper's Liability
Each Occurrence
$
Deductible
Each Aircraft
Each Occurrence
$
$
$
This certificate or verification of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the
policies listed herein. Notwithstanding any requirement, term or condition of any contract or other document, with respect to which
this certificate or verification of insurance may be issued or may pertain, the insurance afforded by the policies described herein is
subject to all terms, exclusions and conditions of such policies.
The "Who's covered" section of your policy, under "Your Liability Coverage," includes Monroe County Board of County
Commissioners, but only for claims resulting from your ownership, maintenance or use of the aircraft.
The Aviation Managers of the USAIG (United States Aircraft Insurance Group) agree that in the event of cancellation of the
policy(ies), they will endeavor to give the party to whom this certificate is issued 30 days advance notice of such cancellation, but the
Aviation Managers shall not be liable in any way for failure to give such notice.
UNITED STATES AVIATION UNDERWRITERS, INC., Aviation Managers
Address: 111 West Port Plaza, Suite 320, St. Louis, MO 63146 - Telephone: (314) 576-2960 - Telefax: (314) 576-2024
By ~bll(Y1 ~
C.C: ~
date: June 24. 2002
F-108d (Rev. 10/97)
USAIG Certificate of Insurance
whose address is
Momoe County Board of County Commissioners
Attn: Maria Salvik, Risk Management Specialist BAyPP~, K!A. AGEMENT
1100 Simonton Street =
Key West, FL 33040 DATE 7
WAIVER N/ALY~~
is at this date insured with one or more member companies of the United States Aircraft Insurance Group, for the Limits of Coverage
stated below, at the following locations: the United States of America, its territories and possessions, Canada, Mexico, the Bahamas,
the islands of the West Indies, Central America or while emoute between these places.
Robert Feldman & Jeffrey Cardenas
This is to certify to:
whose address is:
that:
243 Front St.
Key West, FL 33040
Descriptive Schedule of Coverages
1978 Cessna 210, N29008
Kind of Insurance
Policy Numbers(s)
Expiration Date(s)
Limits of Coverage
AIRCRAFT LIABILITY
Combined Liability Coverage for
bodily injury and property damage
360AC-619807
08/25/2003
Each Person
Each Occurrence
Subject to a maximum limit per passenger of
$ 1,000,000.00
$ 100,000.00
Medical coverage
$
5,000.00
AIRCRAFT PHYSICAL
DAMAGE - ALL RISKS
Not In-Motion Deductible
In-Motion Deductible
Amount of Insurance
$
$
$
AIRPORT LIABILITY
Combined Liability Coverage for
bodily injury and property damage
Each Occurrence
$
Hangarkeeper's Liability
Deductible
Each Aircraft
Each Occurrence
$
$
$
This certificate or verification of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the
policies listed herein. Notwithstanding any requirement, term or condition of any contract or other document, with respect to which
this certificate or verification of insurance may be issued or may pertain, the insurance afforded by the policies described herein is
subject to all terms, exclusions and conditions of such policies.
The "Who's covered" section of your policy, under "Your Liability Coverage," includes Monroe County Board of County
Commissioners, but only for claims resulting from your ownership, maintenance or use of the aircraft.
The Aviation Managers of the USAIG (United States Aircraft Insurance Group) agree that in the event of cancellation of the
policy(ies), they will endeavor to give the party to whom this certificate is issued 30 days advance notice of such cancellation, but the
Aviation Managers shall not be liable in any way for failure to give such notice.
UNITED STATES A VIA TlON UNDERWRITERS, INC., Aviation Managers
Address: 111 West Port Plaza, Suite 320, St. Louis, MO 63146 - Telephone: (314) 576-2960 - Telefax: (314) 576-2024
~
/'~.L00 f[
Authoriz~ S~gnature
c.c.:~
By
date: September 26, 2002
F -1 08d (Rev. 1 0197)
W. BI? 'WN & ASSOCIATES
INSURANCE SERVICES
19000 MacArthur Blvd., Suite 700
Irvine, CA 92612
(949) 851-2060
CERTIFICATE OF INSURANCE
THIS IS TO CERTIFY TO: Monroe County Board of County Commissioners
1100 Simonton Street, Key West, FL 33040
THAT THE FOLLOWING POLICY OF INSURANCE HAS BEEN ISSUED TO:
East Coast Hangars, LLC
P.O. Box 189, Naples, FL 34106
POLICY NO.
POLICY PERIOD FROM:
INSURANCE COMPANY:
DESCRIPTION OF COVERAGES AND LIMITS OF LIABILITY:
NAF3017708
October 25, 2003 TO: October 25, 2004
XL Specialty Insurance Company
Airport Liability:
Single Limit Bodily Injury and Property Damage $ 1,000,000.00 each occurrence
But aggregate as respects products/completed operations and personal injury including:
i:8J Premises D Personal Injury
D Products/Completed Operations i:8J Contractual
D Independent Contractors D
D Hangarkeeper's Liability: $
$
Deductible: $
each aircraft
each occurrence
each loss
Additional Coverages:
The above Certificate Holder is included as an Additional Insured but only to the extent of liability
vicariously imposed upon the Additional Insured solely as the result of an act or omission of the Named
:::c: :: ~:~m:~:~::::nnection Mfu the Nam~'~:rn~~~"i::i. .G'~Md~T Ct5 J[b!1-
e;l . ~ I..f 11
This certificate is effective June 25, 2004 DA1~;':"" ~."'~. - (C. ~
11/i'.I\li:ri; \1 'I"_~ n. _..ftIf ffif\tl
.'1L....'1 !:..., ,__,. ~~/'J1N
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the
policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document with respect
to which this certificate of insurance 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.
Should any of the above described policy(ies) be canceled before the expiration date hereof, the issuing company will
endeavor to give 30 days* notice to the certificate holder named herein. However, failure to mail such notice shall not
impose any obligation nor any liability of any kind upon the company. its representatives or agents.
*10 days for non-payment
By:
~~~
Date ofIssue: June 28, 2004
W. Brown & Associates
Insurance Services
Cert No.: 2
/ .
~c..~
W. BROWN & ASSOCIATES
INSURANCE SERVICES
19000 MacArthur Blvd., Suite 700
Irvine, CA 92612
(949) 851-2060
CERTIFICATE OF INSURANCE
THIS IS TO CERTIFY TO: Monroe County Board of County Commissioners
1100 Simonton Street, Key West, FL 33040
THAT THE FOLLOWING POLICY OF INSURANCE HAS BEEN ISSUED TO:
East Coast Hangars, LLC
P.O. Box 189, Naples, FL 34106
POLICY NO.
POLICY PERIOD FROM:
INSURANCE COMPANY:
DESCRIPTION OF COVERAGES AND LIMITS OF LIABILITY:
NAF3022049
July 20, 2004 TO: July 20, 2005
XL Specialty Insurance Company
Airport Liability:
Single Limit Bodily Injury and Property Damage $ 1,000,000.00 each occurrence
But aggregate as respects products/completed operations and personal injury including:
i:8J Premises D
D Products/Completed Operations i:8J
D Independent Contractors D
D Hangarkeeper's Liability: $
$
Deductible: $
Personal Injury
Contractual
each aircraft
each occurrence
each loss
Additional Coverages:
The above Certificate Holder is included as an Additional Insured but only to the extent of liability
vicariously imposed upon the Additional Insured solely as the result of an act or omission of the Named
Insured or its employees in connection with the Named Insured's Operations.
OI~riJIl
- i 1-' :..' _. ", '. :'~ ~. ..1. ..- '-. -; or
APP . . 1-;)1\ r,JL-.~!i \.~;~.'\iILi'~ '. .
8 -{ ,:t1} .. . ,.'.....M.......... CC ( .
DATE ----~:3::q~...........~ if'b
\jjA...~.. yt:S......._....
* Subject to Y2K Endorsement
\Nt-l:\/I-::8
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the
policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document with respect
to which this certificate of insurance 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.
Should any of the above described policy(ies) be canceled before the expiration date hereof, the issuing company will
endeavor to give 30 days* notice to the certificate holder named herein. However, failure to mail such notice shall not
impose any obligation nor any liability of any kind upon the company, its representatives or agents.
*10 days for non-payment
BY~~ ~
W. Brown & Associates
Insurance Services
.-/ .
C.c '~-L,;
Date ofIssue: February L 2005
Cert No.:
2