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MONROE COUNTY
RISK MANAGEMENT & LOSS CONTROL
Wing II, Room 207, PS B.
STOCK ISLAND, KEY WEST, FLORIDA 33040
(305) 294-4641 Fax (305) 292-1036
DATE 9/Y'/9'u'
DATE
/\, ---)
BY ~796-, k /'d ~
BY
RMCC.847.3
PRINTED IN U.SA
CERTIFICATE OF INSURJ,U'iC:E
2/28/9J
PRODUCER
KEEN SATTLE
MEAi) .~ CO
p 0 aox 171870
MIAMI LAKES FL 33017-1870
r r I~J!I"" ;l,"lIES
.Ri~CiE
CODE
SUB-CODE
SOUTH~RN UNO. INC.
"".~, Y a
INSURED
INITIAL
FLUTI~ ENTERPRISES OF THE
FLORIDA KEYS INC
PO 80X 15783
PLANTATION FL 33318
I:! '~~l;/~ Y C
::,""PANY D
DATE
>\I~~~N E
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED 3EI OW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE COR 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 I.FFORDED 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
OWNER'S & CONTRACTOR'S PROT
t:.i.\C ~i ':;C'~" UP>::<t:N::'::F
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POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MMIDD/YY) DATE (MMIDDIYYI
.~L'. U"'ITS l!'l. THOUSANDS
.~ GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
GL~317749
12/09/89 12/09/90 c;EMiHAL~~iGi1LGA:~
Pf1DSUC rS.;:,',CMrY,'C:"S AGGREGATE
CLAIMS MADE
OCCUR.
F~FRSONAl. &. .l..[),,'EF; i ,StNG INJURY
C~,MACE~ i~ [!re)
'"A E<JCt.,l C:XiPENSE (Any Of HI person)
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON.OWNED AUTOS
GARAGE LIABILITY
.UMBINED
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WORKER'S COMPENSATION
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I DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/RESTRICTIONS/SPECIAL ITEMS
! AODITIONAL INSURED MONROE
I
I
(EACH ACCIDENT)
AND
C:JISEASf -..POliCY LIMIfI
EMPLOYERS' LIABILITY
'DISEASE--EACH EMPLOYEE:
OTHER
COUNTY
irE HOLDIJIt
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED PC'LlC!ES SE ....:ANCELLEO BEFORE THE
EXPIRATION DATE THEREOF THE ISSUING COMPANY WILL ENDEAVOR TO
MAiL 30 DAYS WRITTEN NOTICE TO THE CEfiT'''iCATE HOLJER !\lAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOT!,~E ~:HA,_l. IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY,
I
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MON;:(OE COUNTY
500 WHITEHEAD STREET
KEY WEST FLORIDA 33040
peA)
KEEN BATTLE MEAD & CO
7850 N. W. 146th Street
Miami Lakes, Fl. 33016
\, f-J L i)
FLUTIE ENTERPRISES OF THE
FLORIDA KEYS INC.
300 S. Pine Island Road S-l05
Plantation, Florida 33314
,.",'li;';",
tif' ::,~~f.~~"~~)i,'
x
X
ML 262840
12/9/90
(.~ z.;:
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V\/('}RI( RS (~()P)Jr)[i"JS{:\!,'
':,::1\!PLO''{EH~:,' Lli:'SI'
HE F~
CERTIFICATE HOLDER NAMED AS ADDITIONAL INSURED
MONROE COUNTY
BOARD OF COUNTY COMMISSIONERS
5100 Junior College Road - Wing II
Public Service Blvd.
Stock Island, Key West, Fl 33040
Attn: Donna - Risk Management
12/7/90
u
fif\C~E
MONTICELLO INSURANCE COMPANY
,,' "", ~'\'~~1;t
12/9/9~
1,000
1,000
30
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... AtMtI..CERIIEICA'EOF'INSl.JRAmCE> I88UE DAlE ~/YV)
'.. '. ........ ...... . ...... ..... .'. . ....... '. ......... .... ....... .. ........................................ ... 11 25 91
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERnFlCATE HOLDER. THIS CEFmFlCATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
KEEN BATTLE MEAD & CO
POBOX 171870
MIAMI LAKES FL 33017-1870
INSURED
FLUTIE ENTERPRISES OF FLORIDA
INC
300 S PINE ISLAND RD S-105
PLANTATION FL 33324
~~YA
MONTICELLO rNSPMNCE CO C/O
F R MACNEILL .. '
. ..............................................
~~YB
~~YC
Recei vt!d
Risk ~~ & Loss Control
DATE \~ ~0 ~
INITIAL ~1Y
~~YD
THIS IS TO CERTlFY THAT THE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDmON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POUCIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID ClAIMS.
TYPE OF III8URANCE
POUCV NUMBER
ML262840
GENERAL LIA8LIrY
COMMERCIAL GENERAL UABILITY
CLAlMS MADE X OCCUR.
OWNER'S & CONTRACTOR'S PROT.
AUTOIIOIILE LIA8LIrY
NfY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE UABIlITY
EXCE88 LIA8LIrY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKER" COMPENSATION
AND
EMPLOYERS' LIA8LIrY
011ER
POUCV EFFECTIVE . POUCV EXPIRATION
DAlE (MMIDD/YV) DAlE (MMIDD/YV)
~1T8
12/09/91 12/09/92
11000 000
.
.
GENERAL AGGREGAlE
PRODUCTS-COMPIOP AGG.
PERSONAL & ADV. INJURY
EACH OCCURRENCE
FIRE DAMAGE (Any one ...)
lIED. EXPENSE (~ 0IlI peqon)
000
COMBINED SINGLE .
UMIT
BODILY INJURY .
(Per person)
BODILY INJURY .
(Per acckIenl)
PROPERTY DAMAGE .
.
.
DE8CRPTION OF 0PERA11ONM.OCA1ION8IVEHICLE8I8PECIAL nEM'
ADDL INSURED - MONROE COUNTY BOARD OF COUNTY COMMISSIONERS C/O COUNTY
ADMINISTRATORS OFFICE 5100 JUNIOR COLLEGE ROAD - WING II PUBLIC SERVICE BLVD
STOCK ISLAND KEY WEST FLORIDA 33040 - ATTENTION DONNA - RISK MANAGEMENT
MONROE COUNTY
5100 JUNIOR COLLEGE
PUBLIC SERVICE BLVD
KEY WEST FLORIDA
RD WING II
STOCK ISL
33040
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL .1..!L DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUGATION OR
UABIUTY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHOR
GO
CERTIFICATE OF INSURANCE 12 10 92
PRODUCER I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
I HOGG ROBINSON OF FLORIDA INC I NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, I
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
I ~OC~. ~~~N ~ 4 ~~ 1- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --I
I 33427-2490 I COMPANIES AFFORDING COVERAGE I
PHONE407-241-1177
I-~~~~;~~---------------------------------------------1-~~;~~;-~~~~~;-~-----iiiiiiiiii--iiiii1i~,r~,~~----c;()i(i?~--------------1
I I-~~;~~;-~~~~~;-i--------------- - - -------~r----,-- - - - - - - - -~ - - ---------1
I J~gTjEp!~EtlfmSRgInF~f~~A, I-~~;~~;-~~~~~;-C--------(,-~;n~~,-nfj{/, . yfxR,-, - ~~: oooo_mmoooomool
I ~~:mON, FL 1-~;;;-~;;;;;-Dmoomr;XfrUij~'1-,-qf'r~ j/1r-oooooo I
I I-~;~~;-~~~~~;-~nnnnnn-nnnnnn~-'''~n~__ i~-L\Wn-nnl
I> CO~~~~G~~ ;~-~;;;;;;-;~~;-;~~;~;;;-~;-;~;~;~~~;-~;;;;~-;;~~-~~~;-;;;~-;;~;~-;~-;~;-;~;~;;~-~~;~~;-;~-;~;-;~~;~;--------I
I PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO I
WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO
I----~~~-~~~~~:_~~~~~~~~~:_~~~-~~~~~~~~-~~-~~~-~~~~~~~~:-~~~~~~-~~~~-~~-~~~~-~~~~-~~~~~~~-~~-~~~~-~~~~~~:-------------------\
I COI TYPE OF INSURANCE I POLICY NUMBER I POLICY EFF I POLICY EXP I ALL LIMITS IN THOUSANDS I
LTR DATE DATE
1---I-c;ii!nB~i,--i:i~i~iC~ii---I----------------------------1--------------I--------------I-~~~~;~~-~~~;~~~~----iC--O()O---
I AI IX] COMMERCIAL GEN LIABILITY I 3AF5930 112/09/92112/09/931-;;~~:~~;;;~-~~~:-liC--O()O---
I I [] [] CLAIMS MADE [JI OCC. 1 I I 1-;~;~:-~-~~~:-;~~~;;liC--O()O-n
I I [] OWNER'S & CONTRACTORS I I I 1-~~~~-~~~~;;~~~~-----liC--oo-o---
I I PROTECTIVE I I I I-;~;~-~~~~---------I-----------
I I [] I I I I_~~~~_~~_~~~~~nnnl___n~_~n_
1---I-i.~iiliCiiiiiJ!--i:iiiii------I-------------------~~~-!1~~~~~~~9}---------1-~~~~~~;;;;;~----1-------~---
I [ ] ANY AUTO INITI^~ -, ~...zp-- _ ~-----;-~~~~;;------- ---00000000
I [ ] ALL OWNED AUTOS L.i2_;41L~r---;- ,(x R PERSON)
[ ] SCHEDULED AUTOS I v lY l.l ():bC 00 - 00 00 00 00 00 00 00 00 00 00 - 00 00
I I [] HIRED AUTOS I I {L L~\.o I BODILY INJURY I
[ ] NON-OWNED AUTOS (PER ACCIDENT)
I I ~ ~ GARAGE LIABILITY I I I-;;;~;~;------------I-----------
1---I-~j[Ci~iiii-~iCiUBiCi:i~lr----- ----------------------------1--------------1--------------I-------i-~~~~-~~-i--~~~;;~~;---
I I ~ ~ ~:~:L~~A~ORu:BRELLA FORM I I I I I
1---1-------------------------------- ----------------------------1--------------1--------------I-~~~~~~~;-----------------------
I I WORKERS' COMP I I I EACH ACC
~ DISEASE-POLICY LIMIT
I---I----~~~~~~~~:---~~~--- ----------------------------1--------------1--------------I------------~~~~~~~:~~~~-~~~~~~~~
I I OTHER I I 1 I
I---!-------------------------------------------------------------!--------------!--------------!---------------------------------1
I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS I
OWNER OF 215 BUS SHELTER/STOPS.
I CERTIFICATE HOLDER AS ADDITIONAL INSURED. I
I> CERTIFICATE HOLDER <===============================> CANCELLATION <============================================================1
= SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX- I
MONROE COUNTY - RISK MGMT = PIRATlON DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10
SLOO JUNIOR COLLEGE RD WING II = DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT I
PUBLIC SERVICE BLVD STOCK ISLD = FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF
~~~ 4 r:ST, FL ~n ~~~ _ ~~~~ _ ~~ _ ~~~ _~~~~~~ _ ~~_~G~~~~ _~_ E~~~SE~~~CT~V~~: _ 00 u, 00_00 00.__ __I
== AUTHORIZED REPRESENTATIVE (,l ('_/"'0.
CORD 25-S \....: - ...........
CERTIFICATE OF INSURANCE
PRODUCER
HOGG ROBINSON OF FLORIDA
P. O. BOX 2490
02/11/93
1 TrllS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS I
1 NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, 1
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
1---------------------------------------------------------------------------1
BOCA RATON, FL I
33427-2490 I COMPANIES AFFORDING COVERAGE I
PHONE4 07 -2 41-1177
-----------------------------------------------------1---------------------------------------------------------------------------1
INSURED I COMPIiNY LETTER A ESSEX INSURANCE COMPANY
1-~~~~~;-~~~~~;-Bnn-ASSociATEDnBU -ii- Ssn,nCO)jimRCEml
J~gT~E p~=iE'~mgS R8Io Fwr~~A, 1- ~~~~~; - ~~~~~; -C- - - - - - - - - - - - - - - - - - - n - - ~ - - - (, ~ - - - - -if?: - _n - u un-I
~~IATION, FL I-~~~~~;-~~~~~;-D-------n~-n-------' ;/)_~~~y-----,.j---------nnl
[' CO:;::G~~ ;~.~;;;;;;.;;=;.~;;;;;~;.;;;;;:;~;.~;;!;~~~~:~~~~i~;!;:;;;;;;:;~:TH;j;;~:;~~;:;~~~iif~~
I PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT To~(~~I~ f c
I WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ~~
I ALL TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
1---------------------------------------------------------------------------------------------------------------------------------
1 col TYPE OF INSURANCE 1 POLICY NUMBER POLICY EFF POLICY EXP ALL LIMITS IN THOUSANDS
ILTRI 1 DATE DATE
1---I-c;~iiEii1\i,--~iAi3i~j[~il---I---------------------------- -------------- -------------- ---------------------------------
I A IX] COMMERCIAL GEN LIABILITY 1 3AF5930 12/09/92 12/09/93
[] [] CLAIMS MADE []I OCC. 1
1
1
I
1
-~UTOii()B-I~E--~iAi3------I------------------------ -- -------------- --------------
[ ] ANY AUTO I
[ ] ALL OWNED AUTOS I
[ ] SCHEDULED AUTOS
[ ] HIRED AUTOS I
[ ] NON-OWNED AUTOS
[ ] GARAGE LIABILITY 1
I []
- - -\-Exciss - ij[~Bj[i,-ITY- - - - -1- - - - - ---- - - - - . _.. - '. -... - -. -. - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - Un_ - - - --
I [] UMBRELLA FORM 1
[ ] OTHER THAN UMBRELLA FORM
---1--------------------------------1---------------------------- -------------- -------------- ---------------------------------
STATUTORY
BI WORKERS' COMP 1420-00448 12/17/92 01/01/94 100 EACH ACC
1 AND 500 DISEASE-POLICY LIMIT
---I-ii;r~i!~lll!ll-~:--~][~---I---------------------------- -------------- -------------- ~~::.;---~~~~~::~~~-:~P~?TEE
___!________________________________!_________________________________________________~i~~_~~~~_~_~~~_~9~~~q~______________
DESCRIPTION OF OPERATlONS/LOCATlONS/VEHICLES/SPECIAL ITEMS DATE-9 - / ~- - 5! 3'
OWNER OF 215 BUS SHELTER/STOPS. ' ,-"t:::!!
CERTIFICATE HOLDER AS ADDITIONAL INSURED. INITIAL
I> CERTIFICATE HOLDER <===============================> CANCELLATION <============================================================
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX-
= PIRATION 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 LIABILITY OF
= ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTAT .
=-------------------------------------------~~-- --------------------
~ AUTHORIZED REPRESENTATIVE ~ ~ ~,~ ~
INC
[ ] OWNER'S & CONTRACTORS
PROTECTIVE
GENERAL AGGREGATE 11 000
---------------------1-----------
PRODS-COMP/OPS AGG. 1 000
---------------------1-----------
PERS. & ADVG. INJURY 1 000
---------------------\-----------
EACH OCCURRENCE 1 000
---------------------1-----------
FIRE DAMAGE
(ANY ONE FIRE) I 50
~-------------------- -----------
MEDICAL EXPENSE I
(ANY ONE PERSON) 5
---------------------1-----------
CSL
---------------------1-----------
BODILY INJURY
(PER PERSON) 1
---------------------1-----------
BODILY INJURY I
(PER ACCIDENT)
---------------------1-----------
PROPERTY
[ ]
[ ]
1 EACH OCC 1 AGGREGATE
I 1
MONROE COUNTY BOARD OF COUNTY
COMMISSIONERS-RISK MGMT CO.
5100 COLLEGE ROAD
KEY WEST, FL
1 33040
~CORD 25-S (3/88)
CERTIFICATE OF INSURANCE 12/03/93
I PRODUCER I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
I HOGG ROBINSON OF FLORIDA INC I NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, I
I ~oc~. d~~N ~ 4 ~~ 1- - EXTEND - OR AL T" - T HE _ cOVERAGE _ AFFO"ED - BY _ T HE _ POLICIE' _ BEL~: -- -- - - -- ----I
I 33427-2490 I COMPANIES AFFORDING COVERAGE I
1 PHONE407-241-1177 I I
1__ . . . . - . . . . . . -- . - . . . . .. . . . - . . . oo. .. . 00 00 _ . . . ... _ . 00 . . I. . . . . . . . . . . . . . - . . -- .. - -- --. -- -- -- -.. - -- - - -- - -- - u - - - -- U - 00 -- - - - U 00 -- - U 001
I INSURED I COMPANY LETTER A Essex Insurance Company I
1 I. . . . -- . . -- . .. .. -- -- 00 . . . --. . . . . -- . . .'.' -- . .. . -- - - . . - -- -- u, --. -- U - -- -- - u-I
I FLUTIE ENTERPRISES OF FLORIDA, I COMPANY LETTER B I
I ~~iii~ ~t 2037 I: ::::~:: ~;;~j~ :~::::: ~ ~i\ \i~\~~::~; ::::: ::::::::::: I
1 1- ;~;;;; - ~;;;;; -i - - - - - - - - - - --;y --tq ~------------------ - ---I
I> COVERAGES <===============================================================~-- -----===-=- =================================1
I THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE J~SUR AM~BOVE FOR THE POLICY I
I PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ft~TRlfl!t~ '6dcul'ltNl 't1ITH RESPECT TO I
, WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO
I___.~::_::~~::.:~::~:~~~::_~~~_:~~~~T~~~:_~~_:~:~_~~:~:~:::.:~~~::_:~~~~_~~:.~~~:.~::~_~:~~::~_B:_~~~~_::~~~::.________....______I
I COI TYPE OF INSURANCE POLICY NUMBER I POLICY EFF I POLICY EXP ALL LIMITS IN THOUSANDS I
ILTRI I DATE DATE
\. _ _ I. - . . . . . - . . -- . . . . . - . -. . . . . . . . . . .. . - . . . . . . . . . . - . . . . . . . 00 . - . .00 I. . - . . .00 . . . . . - "..00. - . . . --. . -. - -- 00 _.'.00 -- -- - --. - -- - -- -- ---1
I 1 GENERAL LIABILITY I GENERAL AGGREGATE 11 000 I
I I I ..--.-...-.-----.----1------..---1
I AI IX] COMMERCIAL GEN LIABILITY 3AF5930 112/09/93 12/09/94 PROOS.COMP/OPS AGG. 11 000 I
I I [] [] CLAIMS MADE [JG OCC. I -~~~~~.~-~~~~~-~~~~~;ll--0(iO---1
I I [] OWNER I S & CONTRACTORS I - ~~~~. ~~~~~~~~~~ ---. -11--0 0- 0---1
I I PROTECTIVE I .---.-....----......- 1----.....--,
I I I FIRE DAMAGE 1 I
\ I [] I (ANY ONE FIRE) I 50 I
I I ____..0000__00..__.001_____00....
I [] 1 MED I CAL EXPENSE 1
I I (ANY ONE PERSON) I 5
_ . _ I' -- .. - . . -- 00 . _ . . . . . - -- - - - - . - . - - - -- - . . - .. 00 . - - - - - - . 00 00 __ - __ . \.00 . __ __ . .. __ - .. - - 00 . 00 . . .. - . __ __ ... - -- -- -- u' 00 -,- 00 --.. ----
1 AUTOMOBILE LIAB \ I CSL I
I [] ANY AUTO I I .~~~~;-~~~~~;.-----.I.--------..
[ ] ALL OWNED AUTOS I I (PER PERSON) I
[ ] SCHEDULED AUTOS I I ...------------..----1--------.--
[ ] HIRED AUTOS I I BODILY INJURY I
[ ] NON-OWNED AUTOS I I (PER ACCIDENT)
[ ] GARAGE LIABILITY 1 I -----------.---.-----1-----..----
[ ] I I I PROPERTY I
'E'XCE-SS --LIAB Ii:I TY-- .. -1- - -- -- -- -- ---. -- - u__ -- --- -- ~ec~i~~ -.. --1-' - -- - -- --. --- --' -- -- i - ~~~~ - ~~~ - i 00 ~~~~~~~;~ - 00
[ ] UMBRELLA FORM I l{jsk Mgrtlt. &: Loss Control 1 I
I [ ] OTHER THAN UMBRELLA FORM I I r- I I I
1- - - .... - . . . - . . - . . . . . . . . . . . . - . . . . . . . I. . . . . . . - . - - . . . . . DATE- . . . . - IIi! - f- - !!J.3-. I.' . .. . . . - -- . -- .. -" -- -- - -- -- u - -- -- -- -- -- -- ----I
I WORKERS' COMP I INE1AL _I -;f::Z kL'- STATUTORY EACH ACC I
I I AND I I r- DISEASE-POLICY LIMIT I
1 I EMPLOYERS' LIAB I I I DISEASE-EACH EMPLOYEE 1
1--. 1-----.........-..--....--....-.- 1-............---..........-. 1--............ I.............. -.--.--.......-.--------.......--1
1 I OTHER I I I I
I I I I I 1
I I I I I I
I' . . . . . . . . . . . -- -- -- -- - -- --' - - -- . -- -- -- . --. - -- -- - . - -- -- --.. --. . . - -- --. . . - -. . - . --' -- -- -- -- -- -- u -- - - -- 00 -- -- -- -- u - -- -- -- - -- -- --. ul
1 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS I
I OWNER OF 215 BUS SHELTER/STOPS. I
I I
I CERTIFICATE HOLDER AS ADDITIONAL INSURED. I
I 1
I> CERTIFICATE HOLDER <===============================> CANCELLATION <============================================================1
1 = SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX- I
I MONROE COUNTY BOARD OF COUNTY PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 1
\ COMMISSIONERS-RISK MGMT CO. = DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT I
1 5100 COLLEGE ROAD = FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF
1 KEY WEST, FL = ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. I
I 33040 =...--..---........-~-.-----.-...--........---------.--.-..-...----------..-1
I = AUTHOR I ZED REPRESENT, . ~
CORD 25-8 r
~A__ ..1~.'
c.c..: ~w~
CERTIFICATE OF INSURANCE
PRODUCER
HOGG ROBINSON OF FLORIDA
P. O. BOX 2490
05 27 94
I 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.
------------------------------------------------------------......--..-----1
BOCA RATON, FL
I 33427-2490 I COMPANIES AFFORDING COVERAGE 1
PHONE407-241-1177
1_----------------------------------------------------1---------------------------------------------------------------------------
INSURED COMPANY LETTER A Essex Insurance Company
I FLUTIE ENTERPRISES OF FL KEYS, -~;;,:;;~~;-~~~~~;-iu--AssoCIATED--BUSlNESS--,--COMMERCE---
igc Bg~A i 9~~~ 7 SELECT MARKETING -~;;~~; -~~~~~; -C--- ----------- - - - - - - - - - __u___ -- ---------------------- ----I
DA"IE, FL ----------------------------------.--------------------------------.---.---
33329 COMPANY LETTER D
INC
Cl>>4PANY LETTER E
> 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 MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO
ALL TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
---------------------------------------------------------------------------------------------------------------------------------
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POll CY E FF
DATE
POll CY EXP
DATE
ALL LIMITS IN THOUSANDS
--- -------------------------------- ---------------------------- -------------- -------------- ---------------------------------
GENERAL LIABILITY
GENERAL AGGREGATE
1 000
12/09/93 12/09/94 PRODS-COMP/OPS AGG.
l( M N~6~M~Nl ~ ~ -;~;~:-i.-~~~:-i~~~;; 1--000---1
)/ ,---d -~~~~-~~;;~~~~----- -----------1
L,f --=- ~ -;i;~-~~~~--------- -----------1
~ 1 I-~~~~-~~-~~~~~------ --..-------1
~ I v!s 1 I MED I CAL EXPENSE I
WMVEtt ~1~.L..--f- . (ANY ONE PERSON)
iUTOMoiiLEuLliB-- - - -- --- - - ----------------------,;.1" - - -- - - - - - n_ -1- - --- - - ------- -~~~ - - -- - ------------ ---------.-
I I --------------------- -.---------
[ ] ANY AUTO Risk IVig~;.i..cr')n~,tjj BODILY INJURY
~ ~ ~~~E~~~~ :~~~~ DATE -:.,II,,~J;"l-, I-~~~~-~~~~~~~-------- -----------1
1 [ ] HIRED AUTOS (i..nnAL "..' .....ud t I BODILY INJURY I
[ ] NON-OWNED AUTOS --- - :I!:E:!.......,__. (PER ACCIDENT)
I ~ ~ GARAGE LIABILITY I I-;;~;~;~;------------ -----------\
1--- -i!ji~~~:~~~::::~~~~--I-------------------.--------I--------------'--------------'-------i-;~~;-~-i--~;~;;---I
---1-------------------------------- ----------------------------1-------------- -------------- -~~~~~~~;-----------------------I
B WORKERS' COMP B0083601 101/01/94101/01/951 100 EACH ACC 1
AND 500 DISEASE-POLICY LIMIT
--- ----~~::~~~~~-~~--~~-~~---I----------------------------1-------------- --------------I--~?-~-----~~~~~~~:~~~~-~~~~~~~~I
OTHER I I I I I
-----------------.------------------.----------------------..--.--.-----------------------------------------.-------------.-.----1
I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS I
MONROE COUNTY AS ADDITIONAL INSURED ON GENERAL LIABILITY.
I
I> CERTIFICATE HOLDER <===============================> CANCELLATION <============================================================
I = SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX- I
MONROE COUNTY = PIRATlON DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10
I PUBLIC WORKS ATTN: WENDY = DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLD,ER NAMED TO THE LEFT, BUT I
5100 COLLEGE ROAD = FAILURE TO MAIL sUCH NOTICE SHim: '. R LIABILITY OF
I ~~B4~EST, FL :--~~~-~~~~-~~~-~~~-~~~-~;,~~~~~-~~;~ ~:- "------------1'
L _ : AUTHORIZED REPRESENTAM - .....6 ~ .'i..--:~~" ~.;.-....JI
~CORD 25 S (3/88) ---";;";;;;.._ =.1
A
DC] COMMERCIAL GEN LIABILITY
3 AF 5930
[] [] CLAIMS MADE []I OCC.
ArPRO'Jf.t) 9Y
cll' l
rv ,
[ ] OWNER'S & CONTRACTORS
PROTECTIVE
DC] OL&T
OAiE
[ ]
C c .; /)..l.~ kf7 -b~:~
"
~~I_~
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
Acordia of Arizona
3020 E. Camelback Rd.
Su i te 200
Phoenix, AZ 85016
602-381-2800
COlPANY
A National Unio\\eqcH anee
COlPANY lsk MgmL & Loss Control
B
ELLER MEDIA CO.
(Patrick Media Group, Inc.
Shelter Advertising of Am)
1360 N.W, 78th Ave.
COlPANY
C
; ."!"i ,~
b0
COlPANY
o
INDICA TED,NOTWITHST ANDINGANYREQUIREMENT. TERMORCONDITlONOF ANYCONTRACT OROTHERDOCLMENT WITHRESPECT TOWHICHTHIS
CERTlFICA TE MAY BE ISSUED DRMA Y PERT AIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LMITS SHOWNMAY HAVE BEEN REDUCED BY PAID CLAMS.
CC T'lPEfW INIURANOE POLIOY NIl..... POLIO'" EFFECTIW POLICY EJ:PlRAT
LTR D.m (...MIDDIYY) D.m ("'I!lIDDlYY) LI...ITS
Cll!Nl!RAL L1ABLITY ClEIERAL AOOREOATE .
A X COMlERCIAL OEIERAL LIABILITY (TX) 5012683 11/01/95 11/01/516 PROOUCTS.COlP/OP AOO .
QAIMS MADE [K] OCCI..R (AOS) 5012684 11/01/95 11/01/96 PERSONAL L AOV I~Y .
OWIER'S L CONTRACTOR'S PROT EACH OCC\.MEtCE .
FIRE DAMAClE (Ant one lire) .
lED EXP (Ant one person) .
AUTOhlOBlLE L1ABLITY COIil3IIED SIIO..E LIMIT
A X ANY AUTO (TX) 5267456 11/01/95 11/01/96 1000000
X ALL OWIED AUTOS ElOOIL Y I N.J.RI .
X SCl-EDU.ED AUTOS (AOS) 5267457 11/01/95 11/01/96 (per person)
X HIRED AUTOS ElOOIL Y I~Y
X NON.OWIED AUTOS (per accident)
PROPERTY DAliIAClE .
GARAGe LIABLITY AUTO ON.. Y . EA ACCIDENT .
ANY AUTO oL/t; OTt-ER THAN AUTO ON.. Y: 111; ~ ~ ~ 1 j j j j j~ j 1 j j j j j j 111 j 1111 ~ ~ 11 j j 1
~/C-
DATE EAQi ACCIDENT .
AOOREOATE .
1!X_L1ABLITY EAQi OCC\.MEtCE .
UlI3RELLA FORM AOCftOATE .
OTt-ER THAN UIil3RELLA FORM .
WORKERS COMPENSATION AND X STATUTORY LIMITS :::::::;:::;:;:::::::::::::;:::;:;:::
.. .................
.....................................
~hlPLoYERS'L1ABLITY .;.;.;.;.;.;.;.;.:.:.:.;.;.;.;.;.;.;.
A (CA) 4063737 11/01/95 11/01/96 EAQi ACCIDENT . 500000
A Tt-E PROPRIETORI X INCL (WI) 4063738 11/01/95 11/01/96 DISEASE. PQICV LIMIT .
PARTIERS/EXECUTlYE 500000
CfFICERS ARE: EXQ DISEASE. EAQi ElPl.OYEE . 500000
OTH!R
A Workers Comp/EL (AOS-DED) 4063739 11/01/95 11/01/96 (same as above)
Certificateholder is Additional Insured (except on work comp).
~~ ~:r~:f YIO-:~
"OULD ANY fW TH~ ABOVI! DI!SOR8D POLIO" II! OANOB.UD .roM: TH~
~XPlR'TION D'~ THIMOf'. TH~ ISSUINGI CO"ANY wu. U.'VOA TO ....L
60 D'YS WRana NOT_ TO TH~ oarPIO.m HOLD!R N'hI!D TO TH~ LDT.
BUT 'ALUII! TO "'AL IUOH NOT_ "ALL l..-ose NO OBLIG.TION OR LIABLITY
fW ANY KIND UPON TH~ CO"ANY, ITS AGII!NTS OR IlI!PRBmIr'TND.
,:.,: .......... _. ::,.:.:._,::... ..,: ..........:'1....::11'.....:11..:.. ....:..r....:::...,..::t:::::.::.II:..:.:'..::I. .'.:::-:..::.11.....:::....... ...:...r.... ..::::.::: '.}...::...::...' "::"'::',::'..::'. .., .
,... A~h.,.' t. :.:'.:, :':.... .:. ',' .,...... 'II:: '..,........ ....... . .... . .:. ....: .:.:.:.. .:.,. . .
':::::Iijij'ODilC!li .'. ..'.:::::-.. ' :" ':" '":;:.:.i: ':::, :::. :.:):(:, ::,::::;': :'. ':". '{.J... .:: :::::::: :::: ..... . ...:.. . ::: ...,.:.:.. .::., ;": ,,:,,::,:,..:::"::'::::.::...::::::.:-:::::::::::{.: :.;:):\:.:: ::'" .
"'OAT~tMMjililNyf"
Acordil of Arizonl
3020 E. Camelback Rd.
Su i te 200
Phoenix, AZ 85016
602-381-2800
slg
ONL Y 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
ELLER MEDIA COMPANV
South Florida Division
9202 N. W. 101 Street
Medley, FL 33178
COMPANY
A Nltional Union Fi e In
COMPANY
B APPROVED BY RISK MP..it,GFm/>JT
COt.PAN~y
C
COMPA~ATE
o
Co
O/eLf::
// -;J.~~_<?-~r.;...
/99!!!:::.;;:.:.;.:.:.:,:.:J\=::;;:::,;.':::':::.:"':."::::::::::::::r:i/f'::::'i)i(f::'::::::::::::}\::):(:=:.:",,:". .,: ,...' .. ,. ...::: ,'\W;:i@iM::::tMMV@" .
THISIS TO CERTIFY THA T THE POLICIES OF INSURANCE L1STEDBELOWHAVE BEENISSUED TO THEINSURED"NAMEDABOVEFOR T HE POLICY PERIOD
INDICA TED,NOTWITHST ANDINGANYREQUIREMENT. TERIv10RCONDITIONOF ANY CONTRACT OROT HERDOCUMENT WIT HRESPEC T TO WHICH THIS
CERTlFICA TE MAY BE ISSUED ORMAY PERT AIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL r HE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LMITS SHOWNMAY HAVE BEEN REDUCED BY PAID CLAIMS
00 TYPI!Of INSURANCE POLICY NUMBER POLICY!!f'f!!CTIVI!': POLICY E:XPIRATIO
LTR DATE: (MMIDDIYY) DATE: (MM'DD'YY) LiMITS
GENERAL L1ABLITY GHlORAl AOOREGA TE $ 2000000
A COMloERCIAl OEtoERAl LIABILITY GL1437948 11/01/96 11/01/97 PRODUCTS,COMP/OP AGO $ 2000000
CLAIMS MADE [2t] OC~ PERSONAL 8. ADV INJURY $ 1000000
OWtoER'S 8. CONTRACTOR'S PROT EACH OCCURRENCE $ 1000000
FIRE DAMAGE (Anyone lire) $ 100000
MED EXP (Anyone person) $ 10000
AUTOMOBLI! LIABILITY COMBINED SINGLE LIMIT
A X ANY AUTO CA1438940 (TX) 11/01/96 11/01/97 1000000
X All OWtoED AUTOS BOOll Y INJURY
SCtEDU..ED AUTOS CA1438941 (AOS) 11/01/96 11/01/97 (Per person)
X HIRED AUTOS BODll Y INJURY
X NON.OWtoED AUTOS (Per accident)
PROPERTY DAMAGE
" ;.rfJj' ,.(-
GARA~ L1ABLITY AUTO ONL Y EA ACCIDENT
~._~r__.'
ANY AUTO OTHER THAN AUTO ONL Y
---- -...-----..---- - -- ._------_._.~--
t\ EACH ACCIDENT
AGGREGATE
-
I!XCI!SSLIABLITY . ,-.1. EACH OCCURRENCE
UloEIRELLA FORM AGGREGA TE
OIt-ER THAN U!oflRELLA FORM
WORlCI!RS COMPE:NSAT!ON AND X STATUTORY LIMITS
I!hlPLoVl!RS'L1ABLITV
A WC 11 324 13 (CA) 11/01/96 11/01/97 EACH ACCIDENT 1000000
A Tt-E PROPRIETORI INCL WC1132414 (W I) 11/01/96 DISEASE. POLICY LIMIT
PARTI'ERSIEXECUIIVE 11/01/97 1000000
OFFICERS ARE, EXCL DISEASE. EACH EMPLOYEE 1000000
OTHI!A
A WC/Employers Lilb WC1132412 ( AOS) 11/01/96 11/01/97 as per a b ov e
hIS
workers compensation, the Certificate Holder is named as
but only as respects tnei r interests in tne operat ions
E:XPIRATION DATE THI!AE:OF. THE: ISSUING COMPANY Will ENDEAVOR TO MAIL
Monroe County
Risk Management
SLOO Jr. College Rd. Wing I I
Public Service Blvd. Stock Is.
Ke.y. W.st FL 33040
:::jqq"-(:f.'~(".[t::::::::::::::i:::::::::::::::\\::::::::\:::::::tt::'t::\mt::m::::::/::\t,:::
90 DAYS WRITTE:N NOTICE: TO THECE:RTIFICATE HOLDE:R NAMED TO THE LEFT,
BUT fAILURE: TO MAIL SUCH NOTICE: SHALL IMPOSE NO OBLIGATION OR LIABILITV
Of ANY KIND UPON THE: COMPANY. ITS AGE:NTS OR REPRESENTATIVES,
o
..........................................,.....................
........................
. . . . . . . . . . . . . . . . . . . .
003792007
A
.....RPJ~Q~fQRAnQ~J~$~
//
~,~
b':J~y AND CONF~\~SS,.u6DR~~ls MU'~O~I'I fJE CERTIFICATE
Ac 0 r d i . of A r i z on. 5 I 9 HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
3020 E C.me I b .c k Rd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Su i t e 200 I'{ tV COMPANIES AFFORDING COVERAGE
Pnoen i x AZ 850 16 COtof'ANY
.
602-38 1 -2800 A N. t i on. I Un i on F ire I ns Co
- COtof'ANY
ELLER MEDI A cc*p N4V (5 F L D IV) ,6'0 B
(P . t r i c k Med i . G roup I nc ) ., COtof'ANY '" flU'L,U 01 K~~" ~
.
9202 N W 10 1 St r eet C REV I SED ..." ~<<..AI V"-- ~ c.~
Med I ey . FL 33 178 COtof'ANY y;~ ~/7rf
I D '''H' 7
THISIS TOCERTlFY THA T THE POLICIES OF INSURANCE L1STEDBELOWHAVE BEEN ISSUED TO THEIN~llEi~M'~ OVEFOR~POLlCY PERIOD
INDICA T ED, NO TWIT HST ANDINGANYREQUIREMENT . T ERM ORCONDITIONOF ANYCONT RACT ORO T I:m lJv1 ' '..",TllRES 'T TOWHICH THIS
CERTlFICA TE 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. LMLtS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS.
00 TYPI! 01' INSURANCI!: POLIOY NUhIlO POLIOY El'PEOTIVI! POLIOY I!XPRATION
LTA DATE (MMlDDlYY) DATE (MMlDD/YY) LIMITS
CIDIalAL LlABLITY GEtERAL AOOREOA TE $ 2000000
f--
A IT COMlERCIAl GEtERAL LIABILITY GL 1437948 1 1 /0 1 /96 1 1 /0 1/97 PRODUCTS-COtof'ICY Aoo $ 2000000
~CLAIIoIS MADE [XJ OC~ PERSONAL &. ADV I~Y $ 1000000
OWtER'S &. CONTRACTOR'S PROT EACH OCC\..MENCE $ 1000000
-
FIRE DAMAGE (Ant one fire) $ 1 00000
-
lED EXP (Ant one person) $ 10000
AUTOhlOllLl! LlABLITY COt.l3ltED SINCl.E LIMIT $
-
A ~ ANY AUTO CA1438940 ( TX) 1 1 /0 1 /96 1 1 /0 1/97 1000000
~ alL OWtED AUTOS BODILY I~Y $
SCl-EDU.ED AUTOS CA143894 1 ( AOS ) 1 1 /0 1 /96 1 1 /0 1/97 (per person)
~
~ HIRED AUTOS BODILY I~Y $
~ NON.owtED AUTOS (Per accident)
f-- PROPERTY DAMAGE $
GlAR~ LIABLITY AUTO 011. Y EA ACCIDENT $
I-- ... ,_... ........ ...
ANY AUTO OTt-ER THAN AUTO 011. Y: .....................................
::::::::::::::::::::::::::::;:::;::::
- .;.:-:.;.;.:-:-:.;.;.;.;.;.;.:-:-:.;.
- EACH ACCIDENT $
'i ';'L rvI i' rrn . ~' . l.o~,$ C, [n"::\1.: AOOREOATE $
o.
EXOESSLIABLITY ..__--11 ~Lt tY?.. ,.,. EACH OCCl.MENCE $
R Uhl3RELLA FORM tX\TL ~ AOOREOATE $
OTt-ER THAN Uhl3RELLA FORM ";,\," , I ./. ......,... $
-.---
WORKERS OOIooFENSATION AND xl STATUTORY LIMITS ............ .....
;:;:;:;:::;:;:;:::;:;:;:::::::;::::::
EMPLOYDlS'LlABLITY . . . . . . . . . . . . . . . . . .
. ...... .... ........
............ ......
A WC1 13241 3 (CA) 1 1 /0 1 /96 1 1 /0 1/97 EACH ACCIDENT $ 1000000
Tt-E PROPRIETORI R'n (W DISEASE PO..ICY LIMIT $
A PARTtERS/EXECUTlVE WC1 1 324 14 I ) 1 1 /0 1 /96 1 1 /0 1/97 1000000
OFFICERS ARE: EXCL DISEASE . EACH EIoI'LOVEE $ 1000000
OTHER
A WC/Emp I oye rs L i .b WC1 1 3241 2 ( AOS) 1 1/0 1 /96 1 1 /0 1/97 .s pe r above
, lYE....
W i t n tne excep t i on of wo rk. r $ compens.t i on . tne C. r t i f i c .t. Ho I de r i $ n.m.d .$
.n Add i t i on . I I ns u r ed b u t on I y .s respec ts t ne i r i n t er es ts i n tne ope r . t i ons
of tne N.med I nllured
): ,:,:,:,<::,:): "::,:;:,:,::,,:\,,::,.}:,:,:,:,:,:;,, ::,.::,:,:,.,:,::,::::::im):ttm:mim:l:t:::::t:lt:':ltmmti'/W':UMt@:::::ml'!i::/:mi':':m:m::!i:':tm:t:j'L;,:,.,:,:,:,:,:,:",.,:,:;,.,:::,:),.::;::,:,:::,:,i:U:U:U@:H@!@!i@tU:::m:::tU:t:tM@i11tlMi@ili@Wtt\Ht:m:::@:1
IItOULD ANY 01' THE ABOVE DUORIII!D POLIOIES BI! OANCll!LUD IIII!I'ORE THE
I!XPRATION DATE THEREOI'. THE ISSUING OO"'ANY WLL ENIlI!AYOR TO MAL
Mon roe Co unty . Ri s k M.n.gement 90 DAYS WRITTEN NOTICE TO THE OERTPIOATE HOLDER NAIooII!D TO THE LEI'T.
At t n : K.y M i I I e r BUT , ALUIIE TO MAL IUOH NOTICE lit ALL IIooPOII! NO GaIGlATION OR LIABLITY
5 100 Co I I ege Ro .d 01' ANY KIG W'ON THE OO"'ANY, ITS AGENTS OR REPRI!lIENT ATIVI!I.
Key Wes t. FL 33040 ~ ::::bi h., 003792007
~'!.::k~
.PiiODUCiiii.............,............ ... THIS CERTlFlCATE IS ISSUED AS A MATTER OF INFORMATlON
ONLY AND CONFERS NO RIGHTS UPON THE CERTlFlCATE
HOLDER. THIS CERTlFlCATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW.
COMPANIES AFFORDING COVERAGE
Sanger &: A1tge1t
P.O. Box 12365
San Antonio, TX 78212
(210)734-6677 Fax(210)734-6771
COMPANY
A
UNITED PACIFIC
CLEAR CHANNEL HOLDINGS, INC.
ELLER MEDIA CORPORATION
2850 E. CAMELBACK RD.,STE.300
PHOENIX AZ 85016
COMPANY
B RELIANCE NATIONAL I
"SURED
COMPANY
C
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOlWlTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NU_ER POLICY IiiFRCnvE POLICY EllPIRATION LIMITS
LTR DATE (1IIlIDD1YY) DATE (III&'DDIYY)
A GENERAL UABIUTY POUCY NO. va 8546801 04/10/97 04/10/98 GENERAL AGGREGAlE
COMMERCIAL GENERAL LIABILITY PRODUClS - COMPIOP AGG
CLAIMS MADE [i] OCCUR PERSONAL & ADV INJURY
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE
FIRE DAMAGE (MY one fire)
MED EXP (MY one person)
A AUTOIIOBILE UABIUTY POUCY NO. va 8546802 04/10/97
COMBINED SINGLE LIMIT $ 1,000,000
ANY AUTO
ALL OWNED AUTOS BODILY INJURY
(Per person) $
SCHEDULED AUTOS
HIRED AUTOS i..---' BODILY INJURY
$
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
GARAGE UABIJTY AUTO ONLY. EA ACCIDENT $
ANY AUTO OlHER lHAN AUTO ONLY:
EACH ACCIDENT
AGGREGAlE
EXCESS LIABIJTY EACH OCCURRENCE
UMBRELLA FORM AGGREGAlE
OlHER lHAN UMBRELLA FORM
B WORKERS Co.ENSATION AND POUCY NO. WD 8546800 04/10/97 04/10/98
EMPLOYERS' L1ABIUTY
lHE PROPRIETOR! X INCL
PARTNERSBCECUTIVE
OFFICERS ARE: EXCL EL DISEASE - EA EMPLOYEE
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSlVEHICLESlSPECIAL /TEllS
WITH THE EXCEPTION OF WORKERS' COMPENSATION, THE CERTIFICATE HOLDER IS
NAMED AS AN ADDITIONAL INSURED, BUT ONLY AS RESPECTS TO THEIR
INTERESTS IN THE OPERATIONS OF THE NAMED INSURED.
~g!tml"/d=:]~@;III:::::::::\:):::)::f):~):::~:::::)mmm~'::\::~~::\mmm)::=:::~::::):::::~~:m\::\::::~:~:~:~))(:.~::~~:::m):::::~:~_~'M11:mt\::mmm)))mm:::::::\\~~~~~::~~)mm:::::::::::~::~:::::~:\~~:)::::::::::::\::~::::?:~:::~:~:~~=m:::::):::::::::::::::,:.:.::.:::::::::::::
SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COW'ANY WILL ENDEAVOR TO IWL
-1L DAYS WRlTTBl NOTICE TO THE CER11FICATE HOLDER NAIlED TO THE LEFT,
~/"'L..- BUT FAURE 10 MAL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR UABIUTY
j 1 "\ '7 OF ANY KIND U THE COMPANY, ITS AGENTS OR REPRESENTA11VES.
~ (/ AUTHORIZED REPR
:=..it:.:::U.\\\:::::\m))...... ....::::......,.:.. :..:.:.:.~:.:~':~.:...,::.::::.:::::::::::::::::::''<'..:.:',.':.....,. '.' , .., ... :JitAntM:#jjlf:
MONROE COUNTY, RISK
ATTN: KAY MILLER
5100 COLLEGE ROAD
KEY WEST FL 33040
MANAGEMENT
SaDqer , Altqelt
P.O. Box 123'5
SaD ADtoDio, TX 78212
(210)734-"77 Fax(210)734-'771
1111 CERTIFICATI .. ISSUED AS A MATTlR OF IN MAllON
ONLY AND CONFIRI NO RICIHTS UPON THE CIR'I'IFICATE
HOLDER. THIS CIR11FICATI DOES NOT AMEND, IXTEND OR
AL TlR THE COYlRAGE AFFORDED IY THE POLICIII IELOW.
COMPANIES AFFORDING COVERAGE
CO/I#'/IN(
A UBITBD PACIFIC
....
CLBAR CBAKRBL BOLDINGS, INC.
ELLER KBDIA CORPORATION
2850 B. CAMELBACK RD. STE.300
PBOEJIIX AI 8501'
p/
CO/I#'/IN(
I
RELIDCB NATIONAL
CO/I#'/IN(
C
.. . . ;'$,. tllWJt; ~fk, '2t4m\AfM@111t.%t' M .!@~WY.W.-*-*tg@Wl&JWF
THIS IS TO CERTlFY THAT THE POlICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDI11ON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCles DESCRIBED HEREIN IS SUBJECT TO All THE TERMS,
EXCWSIONS AND CONDmONS OF SUCH POUCIES, UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID ClAIMS,
co T'IN OP _"Ilea I'OUCY ..... I'OUCY !I'!'I!l:nVE POLICY 1!llI'Rl1lON LIIRI
L11l ItA,. ~ ItA,. ~
A POLICY NO. VQ I54l101 04/10/98 04/10/99 GENERAL AOOREGATE
PRODUCTS - COWf'IOP AGIl
PERSONAl & N:JV INJURY
EACH OCCUIHNCE
FIlE DAMAGE (Any one lire)
MED ElCP (Any one perIOIl)
A POUCY NO. VQ8541S802 04/10/98 04/10/99 COMBIED SINGLE lIMIT 11,000,000
BOOLY INJURY $
(I'll' peflClfl)
BODL Y INJURY $
(P8r acddIInO
I'ROPBnY DAMAGE $
GARAQR LIA8UTY AUTO ONLY - EA ACCIDENT
/IN( AUTO OTHER THAN AUTO ONLY;
~J70 EACH ACClDENT
AGGfEGATE
IXCat LIA8UTY EACH OCCUfftNCE
UMIIIE..I..A FORM AGGREGATE
OlHER THAN UMIIREU.A FOIN
B WORICBlI co.IJIIAlION AJm POUCY NO. WD8541S800 04/10/98 04/10/99
IWLO'II!M' UAIIIJn'
"!HE PROPRIETORI tICL a DISEASE - POlICY lIMIT
PAR1l6lS.EllEQJT
OFFICERS NE: EXCL a DISEASE - EA EM'lOYEE
01ItER
IlUClW'IION OP OPIMno....ocATIClIII/VItICl. ITEIII
003792007
WITB BXCBPTION OF WORKERS COMPENSATION, THE CERTIFICATE BOLDER IS
NAKED AS AB ADDITIONAL INSURED BUT ONLY AS RESPECTS THE OPERATIONS OF
THE HAHBD INSURED.
MONROB COUNTY
RISK KANAGBJIBBT;ATTN: KAY MILLER
5100 COLLEGB ROAD
KEY WBST PL 33040
IIlOULD ANY 01' lItE AIIC)ft Dl!lCRIIID JIOUC8 IE <<:#_... IIfORE 1IlI!
':iI<~ili;~':>>.i1l>>':J,..,
f~~:~~:.
qg
:t:...'....A.....'.'...,'C'...w.'Ow.....'R.........:n........Il ,. ',.~~<<.:..~I~:.~~/.I~ii:I':::iit.:i!i1!lJ.::I::::::::::~:..:::.:.
~~jI:::::::}:::::::::::::::~::~~~::::::~:::::::::~':::::I~j~j~:~~*; ;~~ft~:&:{l~lffi~:::~S.~~I~j*j~jj~;:~:;;~;:~;:~l~~~~~.
PRODUCER
Sanger , Altgelt
P.O. Box 12365
San Antonio, TX 78212
(210)734-6677 Fax(210)734-6771
':t'~rT'<?~':::::' . ...:~~1111Iiii\\II!lillllll'11IjllliliJi'llillir.......DATE ~
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 POUCIES BELOW.
COMPANIES AFFORDING COVERAGE
COMPANY
A UNITED PACIFIC
IlSURED
PATRICK MEDIA GROUP
ELLER MEDIA CORPORATION
200 CONCORD PLAZA, SUITE
SAN ANTONIO TX
~o
COMPANY
B
RELIANCE NATIONAL
COMPANY
D
::Q.Q.y,~I9.~'=r:}::::f::ff:m:rr::Mfmrtfmmm:l:f::fIII:llltI:rr::r::rttrrl:::::::Iff::::::::f::ff::ff:l{{:::Immmmmmf:::lr::::r{{{{:f::::flff:::::::::m:::::::::::mml{{I{:tlllllflfIIIII:{:::::fllfI::flf:fIHlfff:{:ff::f:
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.
780
78216
COMPANY
C
CO
LTR
TYPE OF IlSURANCE
POLICY NUMBER
POLICY EFFECllVE POLICY EXPIRATION
DATE (UMIIlDIYY) DATE (MM/DDIYY)
UMlTS
A
04/10/99 04/10/00 GENERAl AGGREGAlE
PRODUClS - COMPIOP AGG
PERSONAL & AnV INJURY
EACH OCCURRENCE
FIRE DAMAGE (Anyone lite)
MED EXP (Any one person)
A GENERAL LlABLITY POLICY NO. VQ 8546801
COMMERCIAL GENERAl LIABLITY
CLAIMS MADE [i] OCCUR
OWNER'S & CONlRACTOR'S PROT
POLICY NO. VQ8546802
04/10/99 04/10/00
COMBINED SINGLE LIMIT
s 1,000,000
GARAGE LIABILITY
ANY AUTO
BODILY INJURY S
(Per person)
BODILY INJURY S
(Per eccident)
PROPERTY DAMAGE S
AUTO ONLY- EA ACCIDENT S
OTHER THAN AUTO ONLY:
EACH ACCIDENT S
AGGREGAlE S
EACH OCCURRENCE S
AGGREGAlE S
EXCESS LIABILITY
UMBRELLA FORM
OlHER lHAN UMBRELlA FORM
B WORKERS COMPENSATION AND
EMPLOYERS' LlABIUTY
POLICY NO. WD8546800
04/10/99 04/10/00
THE PROPRIETOR!
PARTNERS.EXECUTlIJE
OFFICERS ARE:
OTHER
X INCL
EXCL
DESCRIPTION OF OPERATlONSlLOCATlONSlVEHICLESISPEC....L ITEMS
003792007
CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED AS THEIR INTEREST
MAY APPEAR.
FAX TO KATHI ROTTER 305-887-9411
:~g!mmq~!!::~.~at:::::::::::::::t::,:::::::::::::::::t:::::::::::::::::::::::::::::::::t::t::::::::::::::::::tt::::::::::t::t:::::::::::::::::'::::::::::::::::::::::::t::::::::::::':::::::::::::~AN.9f.ft!nQ~::tt::::::::::::::::::t:::::::tW::::::::::::::t:::::t:::::::::::::::t:'::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::W:::::::::t:t:::;t:::::::::t::}
SHOULD ANY OF THE ABOVE DESCRIBm POLICIES BE CANCEllED BEFORE THE
MONROE COUNTY
RISK MANAGEMENTiATTN: KAY
5100 COLLEGE ROAD
KEY WEST FL 33040 DATE
.. .
::::::::::::::::::::::::::::::;:;:;:::.
:t:::::::::tttt:;:'.{:::::::tf.@~t9fi:~rp9BPQ.RA1jOt(j98ij)
;~JIT1.
:~~9R\)?~~mdIWFf:}:::::r:::::::fYtl?:::\f}}(}:r{\t::::::;..:::::::::::::::::,:
A CORDno ........_.1111111111......\.:11:.:...:1'1111.........:1111'1111.1........
DATE (UlllDDIYY)
Sanger & Altgelt
P.O. Box 12365
San Antonio, TX 78212
(210}734-6677 Fax(210}734-6771
THIS CERTlFlCATE IS ISSUED AS A MAlTER OF INFORMATlON
ONLY AND CONFERS NO RIGHTS UPON THE CERTlFICATE
HOLDER. THIS CERTlFlCATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
PRODUCER
COMPANY
A UNITED PACIFIC
INSURED
ELLER MEDIA COMPANY
PATRICK MEDIA GROUP
200 CONCORD PLAZA, SUITE 780
SAN ANTONIO TX 78216
COMPANY
B RELIANCE NATIONAL
'SJ
COMPANY
C
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOlWlTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLiCY NUMBER POLICV EFfECTIVE POLiCY EXPIRATION UMlTS
LTR I DATE (MII/DDIYY) DATE (MII/DDIYY)
A POLICY NO. VQ 8546801 04/10/00 04/10/01 GENERAL AGGREGATE
COMMERCiAl GENERAl LIABILITY PRODUCTS - COMPIOP AGG
CLAIMS MADE [i] OCCUR PERSONAl & ADV IN.AJRY
OWNER'S & CONlRACTOR'S PROT EACH OCCURRENCE
FIRE DAMAGE (Anyone fire)
MED EXP (Anyone person)
A AUTOMOBILE UABIUTY POLICY NO. VQ8546802 04/10/00 04/10/01
COMBINED SINGLE LIMIT $1,000,000
AlL OWNED AUTOS BODILY INJURY
(Per person) $
SCHEDULED AUTOS
HIRED AUTOS 'm, BODILY INJURY
$
NON-OWNED AUTOS (Per accident)
...
PROPERTY DAMAGE
GARAGE UABIUTY AUTO ONLY - EA ACCIDENT
ANY AUTO
~ L . "
$
$
EXCESS UABIUTY EACH OCCURRENCE
UMBRELLA FORM AGGREGATE
OTHER THAN UMBRELLA FORM - ~
~..~.. ---.-.-.-
B I WORKERS COMPENSATION AND POLICY NO. WD8546800 04/10/00 04/10/01
EMPLOYERS' UABIUTY
THE PROPRIETOR! X INCL EL DISEASE - POLICY LIMIT
PARTNERSiEXECUTIVE
OFFICERS ARE: EXCL EL DISEASE - EA EMPLOYEE
I OTHER
DESCRIPTION OF OPERATIONSlLOCATIONSlVEHICLESlSPECIAL ITEMS
003792007
CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED AS THEIR INTEREST
MAY APPEAR.
FAX TO KATHI RUTTER 305-887-9411
MONROE COUNTY
RISK MANAGEMENTiATTN:
5100 COLLEGE ROAD
KEY WEST FL 330~9.-rE___
Y MILLER
,.CJt!JJJ_~
SHOULD ANY OF THE ABOVE DESCRIBED POLiCIES BE CANCEllED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
R REPRESENTATIVES.
...,.'...Wi:ebijijeQa#bftkti(j~lj983
~1!~~~~~"=^~1
ONLY AND CONFERS NO RIGHTS UPON THE CERnFlCATE
HOLDER. THIS CERnFlCATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW.
COMPANIES AFFORDING COVERAGE
SANGER << ALTGELT
750 EAST MULBERRY, SUITE 500
SAN ANTONIO, TX 78212
210-734-6677/210-734-6771
COMPANY
A
KEMPER INSURANCE
llSURED
CLEAR CHANNEL HOLDINGS, INC.
ELLER MEDIA COMPANY
200 EAST BASSE
SAN ANTONIO TX 78209
COMPANY
B
COMPANY
C
COMPANY
D
9OVdiiii::::it't!:::tt:t:'t:':tmmmm:!:ittt:t!::'!:!'t!'tiI::II:::::!:!m::i:::t!::t:::::::!:!:::!:::::!'!:!:!:!'!:!",:",:::,:,!:ttttti:::i:i:!:!:::!::'i'i:t!'i:iI""::'t':'::I:!:ttt:II:i:ti'ttti::'!::::II!::::!:::::!:::!:!:!!!:!:!:!:!'i:':::i:i:!'::Ij:II::::':::j:i:i::'IiImi::i:iiII:'I'tjI:i:i:j:j:j:jij:i:i"'i:j:tj'j':'j:::i'iI:Iti:i:::::::i:t::':i:jI:j:i::'::
HTH1S IS TOHCEFlllFYHTHATTHEHpOuciES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO All THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POUCIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
co
L'm
TYPE OF IlSURAHCE
POLICY NUMBER
POLICY EFFECt1VE POLICY EXPIRATION
DA iE (YMlDDIYY) DATE (IIIWD/YY)
UIIITS
A va 8546802
04/10/00 04/10/01 GENERAL AGGREGAlE
PRODUCTS - COMPIOP AGG
PERSONAL & ADV IN.AJRY
EACH OCCURRENCE
FIRE DAMAGE (Any one lire)
MED EXP (Any one peraon)
04/10/00 04/10/01 COMBINED SINGLE LIMIT
A GENERAL UABIJTY va 8546801
COMMERCIAL GENERAL LIABILIlY
CLAIMS MADE [i] OCCUR
OWNER'S & CONTRACTOR'S PROT
$1,000,000
DATE
1- \~.O
BODILY INJURY S
(Pel pe18Clll)
BODILY INJURY S
(pel eccldenl)
PROPERTY DAMAGE S
AUTO ONLY- EA ACCIDENT S
OlHER THAN AUTO ClNL Y:
EACH ACCIDENT S
AGGREGAlE S
EACH OCCURRENCE S
AGGREGAlE S
$
GARAGE UABIJTY
ANY AUTO
INITIAL _
EXCESS UABIJTY
UMBRELLA FORM
OlHER THAN UMBRELLA FORM
A WORKERS COMPENSATION AND
EIIPLOYERI' UABIJTY
WD 8546800
04/10/00
lHE PROPRIETOR!
PARTNERSSCECUTIVE
OFFICERS ARE:
OntER
X INCL
EXCL
W'.'I,IP?'
~, ~~
.........,....
DElCRPTlON OF OI'ERATIONSILOCATIONBlVEHICLESlSPECIAL I1DIlI
003792007 RE: MIGUEL MARTINEZ, CERT. SPECIALTY ELECTRICAL CONTRACTOR,
STATE OF FL. LICENSE #00000079. WILLIAM G. HULL, CERT. ELECTRICAL
CONTRACTOR, STATE OF FL LICENSE #EC0001352. CERTIFICATE HOLDER IS NAME
AS ADDITIONAL INSURED ATIMA WITH ONLY RESPECTS. TO INSUREDS OPERATIONS.
4.I~1t:]~Mo)'t~ffiI//II::I:ti:::::t:I:i:':i:t://I;::'tttt,/:i/':I't::tmt:::':i'i':'j:::tj:::j'tj:tit:i:tj/::::::r:::ti:::i::::::m"__/:i:i:j:i/:::i:imi:::::i:j:i:i:i:i/:i::r:::ir:i:i:j:i:':i:::t:'i:t:mi:i::'i:i:::i:i'j:imti/:i::m::::i:ti/m::::i:t::i:i:j:]:::::::t:I:m;tm::Ji/:::tt
8HOULD ANY OF ntE ABOVE DElCRBED POLICES BE CANCELLED BEFORE ntE
EXPIRATION DATE ntEREOF, 11fE I8SUIIG COWANY wu. ENDEAVOR TO MAL
~ DAYS WRITTEtl NOTICE TO ntE CERTI'ICATE HOLDER NAIlED TO ntE lB'T,
IUT FALURE TO MAL IUCH NOTICE SHALL M'OSE NO OBLIGATION OR UA8LJTY
OF ANY UPON ntE COWAtIY AGIEIIn OR REl'RE8ENTA11VEI.
AUTHORIZED A'IM
MONROE COUNTY
ATTN: KAY MILLER,
5100 COLLEGE ROAD
KEY WEST FL 33040
RISK MGMT.
lR.fiil.'::fijjjj:'tt':'"""'m""':",,"'mf,,,,l:' ""m:":",,,,,mmmm:,,,,,' :'::"':""'::"frmr'"""":'::::i:",,m/:::i:i:::':':::i:"i:j:i'ti:::::::""i:"":;:::::::i::W/:i:::::;:/t::::,,,',"'""",...,
,': ,"':::"::::":"::"':'ffjjIiBl::rt'
ACORD... INSURANCE T DA'R (*DDIYY)
CERTIFICATE OF LIABILITY 03I25l2OO1
PRODUCER THIS CERnFlCATE IS ISSUED AS A MATTER OF INFORMAnON
SANGER. ALTGELT ONLY AND CONFERS NO RIGHTS UPON THE CERnFlCATE
750 EAST MULBERRY, SUITE 500 HOLDER. THIS CERnFlCATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW.
SAN ANTONIO, TX 78212
210-734-6677/210-734-6771 INSURERS AFFORDING COVERAGE
"SURED INSURER A; LUMBERMENS MUTUAL CASUAL TV CO.
CLEAR CHANNEL HOLDINGS, INC. -1' INSURER B:
ELLER MEDIA COMPANY INSURER C:
200 EAST BASSE ROAD INSURER D:
SAN ANTONIO TX 78209 INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOlWlTHSTANDING
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.
~w: TYPE OF ..SUIWlCE POLICY NUIotBER ':flfiY ~11YE ~J EXPIRATION
GENERAL UABIJTY
LMTS
A X COMMERCIAL GENERAl L1ABIlIlY 5AA 045 835 00 04110/ 01 04110/ 02
ClAIMS MADE [!] OCCUR
GENERAl AGGREGATE
PRODOC - COMPIOP AGG
lOC
COMBINED SINGLE LIMIT
A X ANY AUTO F5D 047 687 00 04110/ 01 04110/02 (Ea accident)
All OWNED AUTOS BODilY IN.AJRY
SCHEDULED AUTOS (Per person)
X HIRED AUTOS BODilY IN.AJRY
X NON-OWNED AUTOS (Per accident)
1 000 000
500 000
10000
1 000 000
000 000
000 000
$ 1,000,000
$
GARAGE UABIJTY
~Y AUTO
$
PROPERTY DAMAGE
(pe' accident)
$
DEDUCllBlE
RETENTlON $
A WORKERS COWENSATION AND
EIR.OYERS" UABIJTY
5BA 160 006 00
04110/ 01
04110/02
o ONLY - EA ACCIDENT
EA ACC
AGG
EXCESS UABIJTY
OCCUR 0 ClAIMS MADE
t' ~ ., '~'0'
EACH OCCURRENCE
AGGREGATE
OTHER
EL D
EL DISEASE - POLICY LIMIT $
1 000 000
1 000 000
1 000 000
DESCRIPTION OF 0PERA11ONSILOCATIONSlVEHICLESlEXCWSIONS ADDED BY ENDORSElENTISPECIAL PROVISIONS
003792007 RE: MIGUEL MARnNEZ, CERT. SPECIAL TV ELECTRICAL CONTRACTOR,
ST. OF FL UC. lO000OO79. WILUAM G. HULL, CERT. ELECTRICAL
CONTRACTOR, ST. OF FL UC. IECOOO1352. CERnFlCATE HOLDER IS NAMED AS
ADDmONAL INSURED AnMA WITH ONLY RESPECTS TO INSUREDS OPERAnONs.
CERTlFlCATE HOLDER ADOf11OfW. "SURED; "SURER LETTER:
CANCELLAnON
SHOULD ANY OF THE ABOVE DESCR.ED POLICES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSU..G "SURER WILL ENDEAVOR 10 MAL -L DAYS WRITTEN
N011CE 10 THE CER1I'ICATE HOLDER NAIlED 10 THE LEFT, BUT FAUlRE 10 DO SO SHALL
M'OSE NO OBLIGATION OR UABIJTY OF ANY KIlD UPON THE "SURER, ITS AGENTS OR
..,
REPRESENrA
AUTHORIZED R
PORAllON 1988
MONROE COUNTY
ATTN: KAY MILLER, RISK MANAGEMENT
5100 COLLEGE ROAD
KEY WEST FL 33040
ACORD 25-S (7"'7)
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the pOlicy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend. extend or alter the coverage afforded by the policies listed thereon.
ACORD 25-8 (7"'7)
.
ADDITIONAL INSURED -- DESIGNATED PERSON OR ORGANIZATION
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
Any person or organization as required by written contract or where certified by a Certificate of Insurance
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement.)
WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the
Schedule as an insured but only with respect to liability arising out of your operations or premises owned by or
rented to you.
THIS ENDORSEMENT MUST BE ATTACHED TO A CHANGE ENDORSEMENT WHEN ISSUED AFTER THE
POLICY IS WRITTEN.
Copyright, Insurance Services Office, Inc., 1984
CG 20 26 (Ed. 11 85)
Printed in U:S.A.
ACORQM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YY)
04/07/03
PRODUCER 1-210-299-1215 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Marsh USA, Inc. ONL Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
112 East Pecan, Suite 2625 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
San Antonio, TX 78205 INSURERS AFFORDING COVERAGE
Helen Groos
INSURED INSURER A: ACE American Insurance Company
Clear Channel Outdoor, Inc.
INSURER B: Fidelity & Guaranty Insurance Underwriters, Inc.
c/o 200 E. Basse Road i INSURER C:
San Antonio, TX 78209 ! INSURER D:
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.
II~: TYPE OF INSURANCE POLICY NUMBER I POLICY EFFECTIVE POLICY EXPIRATION LIMITS
B ~ERAL LIABILITY D064L00479 12/31/02 11/01/03 i EACH OCCURRENCE i $ 1,000,000
I X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ 1,000,000
~ CLAIMS MADE 0 OCCUR MED EXP (Anyone person) $
PERSONAL & ADV INJURY $ 1, 000, OO~.__.
U GENERAL AGGREGATE $ 2,000,000
~'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000
POLICY 1Xl~~R,: n LOC
A fmOMOBILE LIABILITY ISAHO 8003816 12/31/02 11/01/03 COMBINED SINGLE LIMIT
,X ANY AUTO (Ea accident) $ 2,000,000
!
~ ALL OWNED AUTOS I BODILY INJURY
W SCHEDULED AUTOS (Per person) $
~ HIRED AUTOS BODILY INJURY 1$
X NON-OWNED AUTOS (Per accident) ,
f-- ~~p~C fVf1b ~
X COMP/COLL - ACV nK MAN~ MENT PROPERTY DAMAGE
e-- $
(Per accident)
IJ ;V
RAGE LIABILITY l~ - _.. AUTO ONLY - EA ACCIDENT $
DATE ~fi:J. ~
ANY AUTO \,;Q --. OTHER THAN EA ACC $
t t AUTO ONLY:
AGG $
EXCESS LIABILITY ... " n..S EACH OCCURRENCE $
[JOCCUR D CLAIMS MADE 6 ~~0t~ AGGREGATE $
I $
I
,R DEDUCTIBLE I a $
, RETENTION $ I $
A WORKERS COMPENSATION AND IWLRC4350373A 12/31/02 11/01/03 X i lXf f?TAT~s i 10TH.
, T RY IMIT ER
EMPLOYERS' LIABILITY ~ka5 $ 1,000,000
I Q E.L. EACH ACCIDENT
I ' E.L. DISEASE - EA EMPLOYEE $ 1,000,000
I I E.L. DISEASE. POLICY LIMIT $1,000,000
OTHER I
I
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
The certificate holder is included as an additional insured on the GL and Auto policy, but only to
the extent of liability assumed by the Named Insured under written contract. Workers Compensation
coverage is evidenced for employees of the Named Insured only.
C- 0 ~~', ~ .~ ,^-o" {'\, c..e.....
CERTIFICATE HOLDER I Y I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
County of Monroe DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
Maria Del Rio, Risk Mgmt. Spec. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
1100 Simonton Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
Key West , FL 33040 AUTHORIZED REPRESENTATIVE
I USA ~~~
ACORD 25-S (7/97) Rache1Rodriguez
1030330
@ ACORD CORPORATION 1988
ACORD.. CERTIFICATE OF LIABILITY INSURANCE l DAn (IIII/DOIYY)
04lO6l2OO2
PRODUCER THIS CERTlFlCATE IS ISSUED AS A MAlTER OF INFORMATlON
SANGER' ALTGELT ONLY AND CONFERS NO RIGHTS UPON THE CERTlFlCATE
750 EAST MULBERRY, SUITE 500 HOLDER. THIS CERTlFlCATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW.
SAN ANTONIO, TX 78212
210-734-6677/210-734-6771 INSURERS AFFORDING COVERAGE
INSURED INSURER A:. LUMBER MENS MUTUAL CASUALTY CO.
CLEAR CHANNEL OUTDOOR, INC. INSURER B:
dba CC OUTDOOR, INC. INSURER C:
200 EAST BASSE ROAD INSURER D:
SAN ANTONIO TX 78209 INSURER E:
THE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NOlWlTHSTANDING
ANY REQUIREMENT, TERM OR CONDmON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDmONS OF SUCH
POUCIES. AGGREGATE UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
~f: TVPI! OF IlSURANCE POLICY NUMBER ~Y EFFECTIVE ~,.J ,=;w,N
GENERAL LIABILITY
-
A X COMMERCiAl GENERAl LIABILITY 5AA 045 835 00
I CLAIMS MADE [i] OCCUR
CANCELLAnON
SHOULD ANY DF 1ltE ABOVE DESCR8ED POLICIES BE CANCELLED BEFOfIE 1ltE EllJIlRA110N
DATE 1ltEREOF, 1ltE ISSUlfG If SURER W1LL ENDEAVOR 10 MAL --3lL DAYS WRITTEN
NOTICE 10 1ltE CERllFlCATE HOLDER HAlED TO 1ltE LEFT, BUT FALURE TO DO SO SHALL
M'OSI! NO OB...tA11ON OR LlABLITY ~_ AN! ~~D UPON 1ltE If SURER, ITS AGENTS OR
REPRESENT. ,. A / / / /
A viJe /{. (J/'::;~~.
I ....." "ACORD CORPDRAnDN 'OBI
COVERAGES
041101 02
LIMITS
I~
.
~
~
GENERAl AGGREGAlE .
PRODUCTS - COMPIOP AGG ~
04110103
EACH OCCURRENCE
FIRE DAMAGE (ArN one file'
MED EXP (A/1v """ NIl""'"
PERSONAl & ADV IN.AlRY
-
~'l AGGRE~ LIMIT ~ PER:
I POLICY I I 't'Ri I I LOC
~IIOBILE LIABILITY
A .lL ANY AUTO
_ ALl OWNED AUTOS
_ SCHEDUlED AUTOS
.lL HIRED AUTOS
JL NON-OWNED AUTOS
I---
041101 02
04110/03
COMBINED SINGLE LIMIT
(Ea accident)
F5D 047 687 00
BODILY INJURY
(per person)
L>o. .6YO'~ ~IlA..GEMENT
'(\'\ \.e1 ~ ~U) _
"ill:LJ )d-= -
. T
N/A~ ES
BODILY IN.AlRY
(per accident)
A
BY
PROPERTY DAMAGE
(Per accident)
GARAGE LIABILITY
R ANY AUTO
EXCESS LlABIUTY
r:r OCCUR D CLAIMS MADE
Ul'lIt; -
WAIVER
" ((2 ()
lt~[;;:'r ~
(ir"> I 'L vn ( .JL..,
(fv~ ~ij ~
.~ 1
EACH OCCURRENCE
AGGREGAlE
I AUTO ONLY - EA ACCIDENT
EA ACC
OTHER THAN
AUTO ONLY:
RDEDUCTlBlE
RETENTION
s
A WORKERS COMPENSATION AND
EMPLOYERS' LlABIUTY
I T~SI~JUi I X 10m-
EL EACH ACCIDENT I ~
E.L DISEASE - EA EMPLOYEE : ~
E.L DISEASE - POLICY LIMIT S
041101 02
5BA 160 006 01
041101 03
01ltER
DESCRPTION OF OPERA11ONM.OCA11ONSlYEHICLESlEXCWSIONS ADDED BY ENDORSElENTISPECIAL PROVISIONS
07 RE:JOSE MIEDES,JR. SPECIALTY ELECT.CONTRACTOR, FL UC.,ESOOOO277.
WILUAM G. HULL, CERT. ELECT. CONTRACTOR,FLUC.,EC0001352.EDWARD F.
LYNCH,SIGN SPECIALTY UC.,ES0000389. CERTlFlCATE HOLDER IS NAMED AS
ADDmONAL INSURED ATlMA WITH ONLY RESPECTS TO INSUREDS OPERATlONS.
CERnFlCATE HOLDER
i X I ADOmoNAL IfSURED; IlSURER LEnER: A
COUNTY OF MONROE
MARIA DEL RIO, RISK MGMT SPEC.
1100 SIMONTON STREET
KEY WEST FL 33040
ACORD 25-S (7/97)
1.000.000
500.000
10.000
1 000_000
2.000.000
2.000.000
AGG
S 2,000,000
s
S
S
I~
I.
I~
I~
I~
I.
I~
S
1 000.000
1 000.000
1 000.000
ACORD 25-S (7/97)
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
DISCLAIMER
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
IMPORTANT
ACORD", CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDIYY)
11/01/03
PRODUCER 1-210-299-1215 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Marsh USA, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
112 East Pecan, Suite 2625 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
San Antonio, TX 78205 INSURERS AFFORDING COVERAGE
INSURED INSURER A: American Home Assurance
Clear Channel Outdoor, Inc.
INSURER B: Insurance Company of the State of Pennsylvania
c/o 200 East Basse Rd. INSURER C: National Union Fire Insurance Company
San Antonio, TX 78209 INSURER D:
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~~: TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
A ~NERAL LIABILITY GL4806011 11/01/03 11/01/04 EACH OCCURRENCE $ 1000000
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ 1000000
I CLAIMS MADE 0 OCCUR MED EXP (Anyone person) $
- PERSONAL & ADV INJURY $ 1000000
- GENERAL AGGREGATE $ 2000000
n'L AGGRnE LIMIT APMS PER: PRODUCTS - COM PlOP AGG $ 1000000
POLICY ~~R,: X LOC
A ~TOMOBILE LIABILITY CA6612634 (MA) 11/01/03 11/01/04 COMBINED SINGLE LIMIT
$ 2000000
A X ANY AUTO CA6612635 (VA) 11/01/03 11/01/04 (Ea accident)
f--
A ALL OWNED AUTOS CA6612636 (TX) 11/01/03 11/01/04 BODILY INJURY
f-- $
A SCHEDULED AUTOS CA6612637 (AOS) 11/01/03 11/01/04 (Per person)
-
X HIRED AUTOS BODILY INJURY
- $
X NON-OWNED AUTOS ~y qK}i~N ~~~T (Per accident)
- APP~~
X COMP/COLL - ACV PROPERTY DAMAGE
- $
A. I (Per accident)
RAGE LIABILITY IH , AUTO ONLY - EA ACCIDENT $
ANY AUTO DATE Ib 1)-- OTHER THAN EA ACC $
-~.,_....- ,,7
. AUTO ONLY:
AGG $
EXCESS LIABILITY 'nl y '-I N f A --f--::- Y EACH OCCURRENCE $
D' OCCUR D CLAIMS MADE AGGREGATE $
$
R DEDUCTIBLE $
RETENTION $ $
B WORKERS COMPENSATION AND WC2981486 AZ,ID,MA,MD,OR,VA 11/01/03 11/01/04 X I T~r.~Tf1JU<: I TOJ~-
C EMPLOYERS' LIABILITY WC2981487 ND,OH,WA,WI,WV,WY 11/01/03 11/01/04 $ 1000000
EL. EACH ACCIDENT
A WC2981488 (AOS) 11/01/03 11/01/04 EL. DISEASE. EA EMPLOYEE $ 1000000
A *SEE BELOW 11/01/03 11/01/04 EL. DISEASE. POLICY LIMIT $ 1000000
OTHER
DESCRIPOON OF OPERATIONSILOCATIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
The certificate holder is included as an additional insured on the GL and Auto policy, but only to the extent of
liability assumed by the Named Insured under written contract. Workers Compensation coveraqe is evidenced for
employees of the Named Insured only.
c..Of~" (:'.\ "'- C\ 'f',. L-L...
CERTIFICATE HOLDER I T ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRAOON
County of Monroe DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRmEN
Maria Del Rio, Risk Mqmt. Spec. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
1100 Simonton Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
Key West, FL 33040 AUTHORIZED REPRESENTATIVE ~
I USA
ACORD 25-S (7/97) jenmar
1446475
Powered By CertificatesNow 1M
5U
@ACORD CORPORATION 1988
ACORQ. CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDIVY)
10/26/04
PRODUCER 1-210-299-1215 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Marsh USA, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
112 East Pecan, Suite 2625 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
San Antonio, TX 78205 INSURERS AFFORDING COVERAGE
INSURED INSURER A: American Home Assurance
Clear Channel Outdoor, Inc.
INSURER B: Insurance Company of the State of Pennsylvania
c/o 200 East Basse Rd. INSURER CoNational Union Fire Insurance Company
San Antonio, TX 78209 INSURER D:
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.
II~-M TYPE OF INSURANCE POLICY NUMBER PRHSY EFFECTIVE POLICY EXPIRATION LIMITS
A ~NERAL LIABILITY GL5548724 11/01/04 11/01/05 EACH OCCURRENCE $ 1000000
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ 1000000
I CLAIMS MADE 0 OCCUR MED EXP (Anyone person) $
f-- PERSONAL & ADV INJURY $ 1000000
f-- GENERAL AGGREGATE $ 2000000
n'L AGGRnE LIMIT AP~S PER: PRODUCTS - COM PlOP AGG $ 1000000
POLlCy~~R,: X LOC
A ~TOMOBILE LIABILITY CA1914480 (MA) 11/01/04 11/01/05
COMBINED SINGLE LIMIT $2,000,000
A X ANY AUTO CA1914479 (VA) 11/01/04 11/01/05 (Ea accident)
f--
A ALL OWNED AUTOS CA1914481 (TX) 11/01/04 11/01/05 BODILY INJURY
f-- $
A SCHEDULED AUTOS CA1914482 (AOS) 11/01/04 11/01/05 (Per person)
f--
~ HIRED AUTOS BODILY INJURY
$
X NON-OWNED AUTOS (Per accident)
-
X COMP/COLL -ACV n ' ,,::N' PROPERTY DAMAGE
- ~ 'r(\ i-J :.::" $
,\ ,')l (Per accident)
~AGE LIABILITY \ \ ..... \..\ 11.t\1 ~.._.' AUTO ONLY - EA ACCIDENT $
ANY AUTO BY :J ~ I' l DC OTHER THAN EA ACC $
..,_.....-
DATE -'-" , AUTO ONLY: AGG $
EXCESS LIABILITY t'f". '~".!rl!'" ~ ~"( 117 _ EACH OCCURRENCE $
:::J' OCCUR D CLAIMS MADE
AGGREGATE $
->-', ~rr -h $
==l DEDUCTIBLE ' ~O 1.--' I '=.... $
RETENTION $ $
B WORKERS COMPENSATION AND WC5898904 AZ,ID,MA,MO,OR,VA 11/01/04 11/01/05 X 1 T"X'6~T ~W~ 1 IOJJ;l-
C EMPLOYERS' LIABILITY WC5898905 ND,OH,WA,WI,WV,WY 11/01/04 11/01/05 $ 1000000
E.L. EACH ACCIDENT
A WC5898906 (AOS) 11/01/04 11/01/05 E.L. DISEASE - EA EMPLOYEE $ 1000000
A *SEE BELOW 11/01/04 11/01/05 E.L. DISEASE - POLICY LIMIT $ 1000000
OTHER
$
$
$
DESCRIPTION OF OPERATlONSlLOCATlONSlVEHICLESlEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
The certificate holder is included as an additional insured on the GL and Auto policy, but only to the extent of
liability assumed by the Named Insured under written contract. Workers Compensation coverage is evidenced for
employees of the Named Insured only.
C. 0 f> ~ '. ~ ~ \".. O..d\.~c.. e.-
CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
County of Monroe DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
-
Maria Del Rio, Risk Mgmt. Spec. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
1100 Simonton Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
Key West, FL 33040 AUTHORIZED REPRESENTATIVE ~
I USA
ACORD 25-5 (7/97) maribethking
2194514
@ACORD CORPORATION 1988
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