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Certificates of Insurance::::::::::::.MM DD::::::::..... 5 :;:; :::2:::: :;: .... i:::::::;::::: r ::>:;:;? :::: ' ::::::: :;::; :'3::::>::is i ;:::::::::::: ; ;:: ` ::;:::: >:::: ::: '`'' ::'::: :> ; I�:R:t::::: ;:`;';::?:; ::::: `:%:':?:::::::::t::'::?::::: DATE ::. ACORD .:::. :."".".:..:..1L"fi':>:::::::.::::::.:::::::.::::::::::.>:::.:::;:.: 1a 06 96 ::.::::.::.::.:::::.::.::.::.::.:::.::.::::.::.:::::.::.>:.::::::::::::::.:::::::::::................................ . PRODUCER 2 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Sid Banack Insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2045 - 14th Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 130 COMPANIES AFFORDING COVERAGE Vero Beach, FL 32961 COMPANY A OWNERS INS CO INSURED COMPANY Dade Restaurant & Repair Inc. B AUTO -OWNERS INS CO 201-05 W 27th St COMPANY Hialeah, FL 33010 C EMP-SIF COMPANY DADERE D THIS IS TO CERTIFY THAT THE POLICIES 11 OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE (MM/DD/YY) DATE (MM/DD/YY) A GENERAL LIABILITY 912312-20516094-96 07/17/96 107/17/97 GENERAL AGGREGATE $ 500000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FX] OCCUR OWNER'S & CONTRACTOR'S PROT X PREMISES/OPERATION B AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 920212 20260778 1 07/17/96 1 07/17/97 PRODUCTS - COMP/OP AGG $ 500000 PERSONAL & ADV INJURY $ 500000 EACH OCCURRENCE $ 500000 FIRE DAMAGE (Any one fire) $ 50000 MED EXP (Any one person) $ 5000 COMBINED SINGLE LIMIT $ 300000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: ANY AUTO EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ UMBRELLA FORM $ OTHER THAN UMBRELLA FORM C WORKERS COMPENSATION AND 0830 06577 04/01/96 04/01/97 WC STATU- OTH- TORYLIy/ITc.X ER EL EACH ACCIDENT $ 100000 EMPLOYERS' UABIUTY EL DISEASE - POLICY UMIT $ 5000001 THE PROPRIETOR/ INCL EL DISEASE - EA EMPLOYEE $ 100000 PARTNERS/EXECUTIVE OFFICERS ARE: RX EXCL OFFICERS ARE: EXCL OTHER AP'r'P0'TD y �iC;!%1��/�+, �•�C4ecr T DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS n' TF.._— CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED ON AUTO AND GENERAL LIABILITY POLICY REF:PREVENTIVE MAINTENANCE OF KITCHEN EQUIPMENT STOCK ISLAND DETENTION FACILITY COUNTY OF MONROE MONROE COUNTY RISK MANAGEMENT 5100 COLLEGE ROAD KEY WEST` FL 33040 cc - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE HALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMP Y, Ir AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE -11"j— RHG I PRODUCER 2 Sid Banack Insurance 2045 - 14th Avenue P.O. Box 130 Vero Beach, FL 32961 INSURED Dade Restaurant & Repair Inc. 201-05 W 27th St Hialeah, FL 33010 ::<:::::;: DATE MM/DD /YY) E `. '' ::::sirs::":;;:;''EEii:'`:'•:::12/06/96 Rw 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. COMPANY A OWNERS INS CO COMPANY B AUTO -OWNERS INS CO COMPANY C EMP-SIF COMPANY D C1fiCIFfALt�>�.7 :.. . THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERT OD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTA TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/VVI DATE (MM/DD/YY) A GENERAL LIABILITY 912312 2 16094-96 07/17/96 07/17/97 GENERAL AGGREGATE $ 500000 X COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG $ 500000 CLAIMS MADE a OCCUR PERSONAL & ADV INJURY $ 500000 OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 5 0 0 0 0 0 X PREMISES/OP$RATIO flI FIRE DAMAGE (Any one fire) a 50000 7 MED EXP (Any one person) $ 5000 B AUTOMOBILE LIABILITY 12 20260778 07/17/96 07/17/97 COMBINED SINGLE LIMIT $ 300000 $ ANY AUTO ALL OWNED AUTOS o BODILY INJURY $ (Per person) SCHEDULED AUTOS Jam/ �� T�� a - - / BODILY INJURY y HIRED AUTOS (Per accident) NON -OWNED AUTOS PROPERTY DAMAGE $ GARAGE LIABILITY I ANY AUTO EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE OFFICERS ARE: X E)(CL OTHER 0630 06577 04/01/96 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED ON AUTO AND GENERAL LIABILITY POLICY REF:PREVENTIVE MAINTENANCE OF KITCHEN EQUIPMENT STOCK ISLAND DETENTION FACILITY COUNTY OF MONROE MONROE COUNTY RISK MANAGEMENT 5100 COLLEGE ROAD KEY WEST_ FL 33040 Cc '-/ AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT S AGGREGATE $ EACH OCCURRENCE S AGGREGATE $ 04/01/97 TO '�_l�nT� I X. I co I EL EACH ACCIDENT S 100000 EL DISEASE - POLICY LIMIT S 500000 EL DISEASE - EA EMPLOYEE $ 10 0 0 0 0 ! aPPRn.ro By F � n r TF —_—L -/o =- - - — SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE HALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMP Y, 1p AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE z dw z RHG INNSURED DATE M D) � (M /D ::::<i;••:::::Y'•y:'•:;n•:::'.:�:::::;::::::.::.::::.�::•:.:':r:.+:r"�'::r�r::;r:.:r:.:.:.::::::.r::x:»,;,;:;::.>r:.::i:;.r: ��YMMYY11:: ...:::::::::::: Y.: r::.::: ::::::.:;•,•,.•:•,•,•�•,,.,.,,.#IIIFrx•'.<..r•.:;:::::::rr:.::•.r:.r:.rr:.>:.r•'.:.r:.r:.r:;.: 2 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE Dade Restaurant & Repair Inc. 201-05 W 27th St Hialeah, FL 33010 COMPANY A OWNERS INS CO COMPANY B AUTO -OWNERS INS CO COMPANY C Employers Self Insurers COMPANY D THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER DATE (MWDD/YV) DATE (POUCYEFFECTIVE MM/DD/YV)N LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE ®OCCUR OWNER'S & CONTRACTOR'S PROT PREMISES/OPERATIO 912312-20516094-96 07/17/96 07/17/97 GENERAL AGGREGATE $ 500000 X PRODUCTS - COMP/OP AGG $ 500000 PERSONAL & ADV INJURY $ 500000 EACH OCCURRENCE S 500000 X FIRE DAMAGE (Any one fire) S 50000 MED EXP (Any one person) $ 50001 B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 920212 20260779 JIPPR�E= BY �1 C 07/17/96 AGFMFNT 07/17/97 COMBINED SINGLE LIMIT $ 300000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accldenq $ PROPERTY DAMAGE $ GARAGE LIABILITY ANY AUTO WA IVFR; N/A VS AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT S AGGREGATE S EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM I uG 04/O1/98 EACH OCCURRENCE $ AGGREGATE $ $ C WORKERS COMPENSATION AND EMPLOYERS LIABILITY THE PROPRIETOR/ INCL PARTNERSIEXECUTIVE OFFICERS ARE: X EXCL OTHER 0830 06577 P n (�(Q 04/01/97 oRYunni� X .....OER s: EL EACH ACCIDENT S 10 0 0 0 0 EL DISEASE - POLICY LIMIT $ 500000, EL DISEASE - EA EMPLOYEE $ 100000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED ON AUTO AND GENERAL LIABILITY POLICY REF:PREVENTIVE MAINTENANCE OF KITCHEN EQUIPMENT STOCK ISLAND DETENTION FACILITY COUNTY OF MONROE MONROE COUNTY RISK MANAGEMENT 5100 COLLEGE ROAD KEY WEST, FL 33040 (( l'A SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE( COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE r RHGI 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. COI TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE (MM/DO—, DATE (MM/DDNY) A GENERAL LIABILITY 912312-20516094-97 07/17/97 07/17/98 GENERAL AGGREGATE $ 500000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X❑ OCCUR OWNER'S & CONTRACTOR'S PROT XjPREMISES /OPERATION B LAUTOMOBILE LIABILITY X :ANY AUTO —�i ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS III GARAGE LIABILITY ^' ANY AUTO EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE OFFICERS ARE: IX EXCL OTHER 920212 20260778 BY WAIVER: N/A / srov �VY*A d 0830 06577 07/17/97 107/17/98 PRODUCTS - COMP/OP AGG $ PERSONAL & ADV INJURY $ EACH OCCURRENCE $ FIRE DAMAGE (Any one fire) $ MED EXP (Any one person) $ COMBINED SINGLE LIMIT 1 $ BODILY INJURY $ ENT (Per person) BODILY INJURY $ (Per accident) I YES -- 04/01/97 04/01/98 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS MONROE COUNTY BOARD OF COUNTY COMMISSIONER IS ADDITIONAL INSURED FOR GENERAL LIABILITY AND AUTO LIABILITY. PROPERTY DAMAGE I $ AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EACH OCCURRENCE $ AGGREGATE $ $ TQRY I IMITS X OFR EL EACH ACCIDENT $ EL DISEASE - POLICY LIMIT $ EL DISEASE - EA EMPLOYEE $ 500000 500000 500000 50000 5000 5000001 100000 500000 100000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE MONROE COUNTY BOARD OF EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL COUNTY COMMISSIONERS 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 5100 COLLEGE ROAD BUT FAILURE TO MAI SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY KEY WEST, FL 33040 OF ANY KIND UP N TH COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTAT - / 1'f+�=a PRODUCER 2 05/06/98 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Sid Banack Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2045 - 14th Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE P.O. Box 130 COMPANY Vero Beach, FL 32961 A OWNERS INS CO INSURED COMPANY Dade Restaurant Repair Inc. I B AUTO -OWNERS INS CO 201 W. 27th St. COMPANY Hialeah, FL 33010-1511 C BRIDQZFIZLD EMPLOYERS INSURANC COMPANY DADERZ D THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE 0111110DIVY) POLICY 004MTM DATE PUMXWM LIMITS A GENERAL LIABILITY 912312-20SI6094-97 07/17/97 07/17/98 GENERAL AGGREGATE i 500000 X PRODUCTS - COMP/OP AGG S 500000 COMMERCIAL GENERAL LIABILITY CLAIMS MADEFx OCCUR PERSONAL & ADIV INJURY S 500000 EACH OCCURRENCE i 500000 OWNERS & CONTRACTORS PROT X FIRE DAMAGE (Any one We) $ 50000 PRZKISZS/OPZRATION MED EXP Wry orw pwoon) $ 5000 B AUTOMOBILE LIABILITY ANY AUTO 920212 20260779 07/17/97 07/17/99 COMBINED SINGLE LIMIT $ 500000 X BODILY INJURY rK P—) ALL OWNED AUTOS SCHEDULED AUTOS — — BODILY INJURY rK 8001cle" $ HIRED AUTOS NON -OWNED AUTOS 00 — PROPERTY DAMAGE $ ey ;; GARAGE LIABILITY MTE AUTO ONLY - EA ACCIDENT S OTHER THAN AUTO ONLY: .......... ............... ............ .......... .......... .................. ................. .......... -- ......... .......... ................... ........ ......................... ANY AUTO EACH ACCIDENT AGGREGATE S EXCESS LL#JWUrFY EACH OCCURRENCE AGGREGATE UMBRELLA FORM OTHER THAN UMBRELLA FORM C WOWMIS COMPENSATION AND 0930 06S77 04/01/99 04/01/99 � A ... % 'X FR ... ................................. .. ............................ ................................... ................... .............. . ....................................... .......................... ....... .... EMPLOYER5'UABIUTY EL EACH ACCIDENT $ 100000 THE PROPRIETOR/ INCL PARTNERSAD(ECUTIVE RX EL DISEASE - POLICY LIMIT S 500000 EL DISEASE - EA EMPLOYEE S 100000 OFFICERS ARE: EXCL OTHER DESCRIPTION OF ITEMS MONROE COUNTY BOARD OF COUNTY COMMISSIONER IS ADDITIONAL INSURED FOR GENERAL LIABILITY AND AUTO LIABILITY. ....... I ... MO.-% . . . . . . .............. 'Row .............. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE MONROE COUNTY BOARD OF EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL COUNTY COMMISSIONERS 2k__ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 5100 COLLEGE ROAD BUT FAILURE 110 SUCHNOTICE SHALL IMPOSE NO OBLIGATION ON UAINUTY KEY WEST, FL 33040 DATE. INITIAL OF ANY KIND :;E 22rw. ITS OR REPRESENTATIVES. ZLI KLH .. • :::.. ......:...:.::. w:::::::::::::::;;:.; .; . .. CORD .:?.}. PRODUCER 3 •••: nYii::• iSii>ii: fin;{.•.w::..... v::::r......:::::: •}}::::::::::::::::::::::::::::::::::::::.... . x: v: :.:'%tiw::':'/:•:'r"::'•,''::%::;;;: DATE (MMroDM) 05 12 98 / THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION Sid Banack Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2045 - 14th Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE P.O. Box 130 COMPANY Vero Beach, FL 32961 A OWNERS INS CO INSURED COMPANY Dade Restaurant is Repair Inc. / B AUTO -OWNERS INS CO COMPANY 201 W. Z 7 th St. f/ Hialeah, FL 33010-1511 v C BRIDGSFISLD EMPLOYERS INSURANC COMPANY DADERE D vv n4?^::::}::i{}>::C::i:}•':iii::isi::i::i::?•C:iiii:':i?isii}}}}<i�:}:iiti:iiiiiviiitiifiiiiiifi::iii`ii}i'riiii?i:�iiiiJiiji}i'r?}i. . . •rit�f�f :}}::>ijiii'iY••::3.: :::.v}} :??v.�::::::::. �:::::v::.�::::::::}}:.�:::::::}}}}:;.}•{•}:.}:4:??{?�'y%}•}}+••'•.•::: }::•.ti•}'ti:•}: }: }}: Y:•..:•}:{{{::i?i:::: ..x .. f.. n.,.,.•..........? ...?.}}:??L:•}:4:•}:L;•}:4:•}:•}:{{•}:O:v:•; .........n:..........Y ..x.rr .....r ... rr......r yr .:?... . ..............................................v....:....vv ..v .: ........ .. ..:........r..n................................ r. 4....v�:....:...........:....v.....:...........v.r...............:...v....r.......}.....................................................::: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MWDD/YY) POLICY EXPIRATION DATE ONAMD/YY) LIMITS A GENERAL LIABILITY 912312-20516094-97 07/17/97 07/17/99 GENERAL AGGREGATE S 500000 PRODUCTS - COMP/OP AGG $ 500000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE ® OCCUR PERSONAL & ADV INJURY 9 500000 EACH OCCURRENCE $ 500000 OWNER'S & CONTRACTOR'S PROT FIRE DAMAGE (Any one fire) $ 50000 X PRENISES/OPERATIC MED EXP (Any one person) $ 5000 B AuTOMOBILELIABILITY 920212 20260779 07/17/97 07/17/98 ANYAUTO COMBINED SINGLE LIMIT $ 500000 X BODILY INJURY ��^) S ALL OWNED AUTOS SCHEDULED AUTOS ADa ED AGFM NT BODILY INJURY $ HIRED AUTOS NON -OWNED AUTOS BY --' _ ` PROPERTY DAMAGE $ n4TE GARAGE LIABILITY N/ YES AUTO ONLY - EA ACCIDENT S OTHER THAN AUTO ONLY: ANY AUTO EACH ACCIDENT S AGGREGATE $ EXCESS LIABILITY UMBRELLA FORM ( `G" EACH OCCURRENCE $ AGGREGATE $ $ OTHER THAN UMBRELLA FORM C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 0930 06577 04/01/98 04 O1/99 TORY MI X ER ........... EL EACH ACCIDENT $ 100000 THE PROPRIETOR/ INCL PARTNERS/EXECUTWE RX EL DISEASE - POLICY LIMIT 6 500000 EL DISEASE - EA EMPLOYEE $ 100000 OFFICERS ARE: EXCL OTHER DESCRIPTION OF OPERATIONSA.00ATIONS/VEHICUESWECULL ITEMS MONROE COUNTY BOCC IS ADDITIONAL INSURED FOR GENERAL LIABILITY AND AUTO LIABILITY. s: }. : •.',......:::.:.::•.:......................................................................... �-.r>��:iiii:;iiii;;:iiiiiiiiiiii:iii::::ii;;i:• ................................................. .... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE MONROE COUNTY BOARD OF EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL COUNTY COMMISSIONERS 2.,9_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 5100 COLLEGE ROAD KEY WEST, FL 33040 DATE BUT FAILURE TO L SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND E COMP , ITS jTTS OR REPRESENTATIVES. A unioro�DPRE!rTM RLH :.• Acam CERTIFICATE OF LIABILITY INSURANCE DEC 1099 I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFUKMAIIUN UNIT SID BANACK INSURANCE AGENCY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 045 14TH AVE. CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE 2 2 4 BOX 130 AFFORDED BY THE POLICIES BELOW. VERO BEACH FL 32961 PHONE: 561-562-3369 COMPANIES AFFORDING COVERAGE FAX: 561-562-3466 COMPANY A: BRIDGEFIELD INSURANC INSURED DADE RESTAURANT & REPAIR INC. COMPANY B: OWNERS INSURANCE CO 201 W. 27TH ST. COMPANY C: AUTO OWNERS INSURANCE CO HIALEAH FL 33010-1511 - `Y COMPANY D: COMPANY E: t,,VvrMmurza TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY THIS IS NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO PERIOD INDICATED, 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. WSR TYPE OF INSURANCE �— POLICY NUMBER T—POLICY EFFECTIVE DATE (MWDD/YY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS LTR GENERAL LIABILITY 912312-20516094-99 JUL 17 99 JUL 17 00 EACH OCCURRENCE $ 500,000 FIRE DAMAGE (Any One Fire) $ 50,000 COMMERCIAL GENERAL LIABILITY .—X CLAIMS MADE OCCUR MED. EXP (Any One Person) $ 5,000 PERSONAL & ADV INJURY $ 500,000 B GENERAL AGGREGATE $ 500,000 I PRODUCTS-COMP/OP AGG. $ 500,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 7PRO- LOC JECT LIABILITY 95-424-609-00 JUL 17 99 JUL 17 00 COMBINED SINGLE LIMIT $ 500,000 [AUTOMOBILE (Ea accident) ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ C X HIRED AUTOS �r (Per accident) X NON -OWNED AUTOS kl�r-;: PROPERTY DAMAGE $ „Y GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO G -- "-� $ /AUTO YCr; ONLY: AGG EXCESS LIABILITY , EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE7 b is f(' 4 li2k $ DEDUCTIBLE li `� $ RETENTION $ D_0,gL_- WORKERS COMPENSATION AND 1 0830 06577 APR 1 99 APR 1 00 WC STATU- OTH LIMIT _R EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 100,000 A,I E.L. DISEASE -EA EMPLOYEE $ 100,000 E.L. DISEASE -POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED ON GENERAL LIABILITY AND THE AUTOMOBILE POLICY MONROE COUNTY BOARD OF COUNTY COMMISSIONERS 5100 COLLEGE ROAD KEY WEST, FL 33040 � / OATF. _,..— SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. il AUTHORIZED REPRESEN Attention: FAXED TO: 305,295�$64 _ ACORD 25-S (7/97) Certmcate IF 1b3Z5 C �rT7� DATE (MM/DD/YY) _ ",."INS, 1�E APR 2199 ".... .. ,.. .. _ - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRODUCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE SID BANACK INSURANCE AGENCY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2045 14TH AVE. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. VERO BEACH FL 32961 PHONE: 561-562-3369 COMPANIES AFFORDING COVERAGE FAX: 561-562-3466 COMPANY A BRIDGEFIELD INSURANCE CO INSURED DADE RESTAURANT & REPAIR INC. % COMPANY B OWNERS INSURANCE CO — COMPANY C AUTO OWNERS INSURANCE CO 201 W. 27TH ST. / HIALEAH FL 33010-1511 L// COMPANY D COVERAGES;.:.a .. 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. t R --- --. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE 04MlDD/YY) POWCY B7�[RATION DATE 04"D/YY) LIMITS GENERAL LIABILITY 912312-20516094-98 JUL 17 98 JUL 17 99 GENERAL AGGREGATE $ 5 r PRODUCTS-COMP/OP AGG. $ 500,000 X COMMERCIAL GENERAL LIABILITY PERSONAL & ADV INJURY $ 500,000 B CLAIMS MADE a OCCUR OWNER'S &CONTRACTOR'S TROT EACH OCCURRENCE $ 500,000 r-- — FIRE DAMAGE (Any One Fire) $ 50,000 S 5,000 MED. EXP (Any One Person) AUTOMOBILE LIABILITY ANY AUTO 95424-609-00 JUL 17 98 JUL 17 99 COMBINED SINGLE LIMIT $ $00,000 BODILY INJURY (Per person) C -- ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS S $ BODILY INJURY (Per accident) -- NON -OWNED AUTOS - ..... r :." , , • , r (� FMv �'.,�� ._._ W.L Ak PROPERTY DAMAGE $ GARAGE LLABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT -------- $ t r'r r'r " tr o. :, .' . , vG5 -- S — 1 -- AGGREGATE EXCESS LIABILITY UMBRELLA FORM (� f l�Lu T _ ( `fjl� EACH OCCURRENCE $ — - - AGGREGATE OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND 0830 06577 APR 199 APR 100 WC SrATU• OTH TORY I IMIIiF EACH ACCIDENT $ 100,000 11 EMPLOYERS' LIABILITY A THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE OFFICERS ARE: EXCL DISEASE -POLICY LIMIT $ 500,000 DISEASE -EACH EMPLOYEE $ 100,000 OTHER: I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS RE: PREVENTATIVE MAINTENANCE KITCHEN EQUIPMENT STOCK ISLAND DETENTION FACILITY FAX TO: 305-2954364 CERTIIrICpTF:, QI:DER CAN4Ei'L'ATIQN' COUNTY OF MONROE, RISK MANAGEMENT 5100 COLLEGE ROAD KEY WEST FL 33M SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZE REPRESENTATIVE DATE Attention: INITIAL 4 7 0 ACORD 25-S (V95) : w' w Certificate # 10150 ;::::::::......................::::.x•;•::;>::.:>:.:::::::::::::::::::.;;.:>:..................;............... ��!111!11.►►l!:..::::::::::::::::.;:.;:.:;:.;:.;:.;:.:::.::.>:.;:.;:.;:.;: DATE (MM/DD/YY) A CORD '+.%:GYM :::::: :::::: ::: ::? :..... ::::::<: ::: ;::: ::' X. PRODUCER a THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Sid Banack Insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2045 - 14th Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 130 COMPANIES AFFORDING COVERAGE Vero Beach, FL 32961 COMPANY A OWNERS INS CO INSURED COMPANY Dade Restaurant & Repair Inc. B AUTO -OWNERS INS CO 201 W. 27th St. I COMPANY Hialeah, FL 33010-1511 / C BRIDGEFIELD EMPLOYERS INSURANC VVV COMPANY �+ DADERE D XX THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POUCY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE (MM/D-uiY)r) DATE (MMiDDA A GENERAL LIABILITY 912312-20516094-98 07/17/98 07/17/99 GENERAL AGGREGATE $ 500000 X COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG $ 500000 CLAIMS MADE Fx_1 OCCUR PERSONAL & ADV INJURY $ 500000 OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 500000 X PREMISES/OPERATION FIRE DAMAGE (Any one flre) $ 50000 MED EXP (Any one person) $ 5000 $ AUTOMOBILE LIABILITY 95-424-609-00 07/17/98 07/17/99 COMBINED SINGLE UMIT $ 500000 X ANY AUTO ALL OWNED AUTOS BODILY INJURY $ (Per person) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS t` R RI ' ' ' .M:. (PeraccidenU JY — ^ ^ � A PROPERTY DAMAGE $ GARAGE LIABILITY ANY AUTO r,gTE _ cc - AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ �.-yE� ?, AGGREGATE $ IF] EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ UMBRELLA FORM WC STATU- OTH- TORYUMITS XI ER $ C OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND 0830 06577 04/01/98 04/01/99 EL EACH ACCIDENT $ 100000 EMPLOYERS' LIABILITY EL DISEASE - POLICY LIMIT $ 500000 THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE OFFICERS ARE: RX E (CLEL OFFICERS ARE: E)(CL DISEASE - EA EMPLOYEE $ 100000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED ON AUTO AND GENERAL LIABILITY POLICY REF:PREVENTIVE MAINTENANCE OF KITCHEN EQUIPMENT STOCK ISLAND DETENTION FACILITY COUNTY OF MONROE MONROE COUNTY RISK MANAGEMENT 5100 COLLEGE ROAD KEY WEST, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 3_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE C MPANY, ITS AGENTS a REPRESENTATIVES, AUTHORIZED REPRESENTATIV . _ ff zZA. - _ RHG ACORD CERTIFICATE OF LIABILITY INSURANCE DATE ( AUG 2 2 000YY) 0 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND SID BANACK INSURANCE AGENCY CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE 2045 14TH AVE. DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE P O BOX 130 POLICIES BELOW. VERO BEACH FL 32%1 PHONE: 561-562-3369 COMPANIES AFFORDING COVERAGE FAX: 561-562-3466 - — ---- - COMPANY A: OWNERS INSURANCE CO. INSURED DADE RESTAURANT & REPAIR INC. COMPANY B: AUTO OWNERS INSURANCE CO. 201 W. 27TH ST. - — - - I COMPANY C: BRIDGEFIELD EMPLOYERS INS. CO. HIALEAH FL 33010-1511 _ +n u Y" COMPANY D: COMPANY E: C:O VEI IKAUE' J 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 OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS MAY BE ISSUED OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR _ - _ _ --- --_-� -- TYPE OF INSURANCE POLICY NUMBER EFFECTIVE POLICY EXPIRATION--- POLICY DATE (MM/DD/YY) DATE (MM/DD/YY) I LIMITS LTR GENERAL LIABILITY 912312-20516094-00 JUL 17 00 JUL 17 01 EACH OCCURRENCE $ 1,000,000 X I COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any One Fire) $ _ 50,000 - CLAiS?S MADE X-� OCCUR MED. F.XP (Any One Person) $ 5.000 A ' --- -' - - - PERSONAL & ADV INJURY $ 1,000,000 - - - _ GENERAL AGGREGATE- iS 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG. Is 1,000,000 POLICY --- PROJECT LOC AUTOMOBILE LIABILITY 95424-609-00 JUL 17 00 JUL 17 01 COMBINED SINGLE LIMIT $ 5000 X ANY AUTO (Ea accident) ,00 - -_1 ALL OWNED AUTOS BODILYINJURY i$ I(Per person) SCHEDULED AUTOS X ''.. HIRED AUTOS •� -` BODILY INJURY (Per accident) X NON -OWNED AUTOS - •• q•r ,," (- I I$ t PROPERTY DAMAGE $ GARAGE LIABILITY _ AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ �C? AUTO ONLY: AGG $_--- -- EXCESS LIABILITY EACH OCCURRENCE is OCCUR [ CLAIMS MADE 4r AGGREGATE S I i DEDUCTIBLE � J --.-- - - $ X RETENTION $ WORKERS COMPENSATION AND 0830 06577 APR. 1 (NI APR 1 01 WC STATU- OTHER TURY-LIMLI'5_. EMPLOYERS' LIABILITY E.L. EACH ACCIDENT i is100,000 C E.L. DISEASE -EA EMPLOYEE I$ 100,000 E.L. DISEASE -POLICY LIMIT I$ 500,000 OTHER: DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED ON GENERAL LIABILITY AND THE AUTOMOBILE POLICY l;l.�.x 11r 11,A FIG nvLLl'.x •,••••• ••�•, �•�� a�••••••••••••••• 1.t11\{..GLLLf 11V1\ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAI 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY MONROE COUNTY BOARD OF COUNTY COMMISSIONERS OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. 5100 COLLEGE ROAD AUTHORIZED REPRESENTATIVE KEY WEST, FL 33040 Attention: FAXED TO: 305 2954364 ACORD 25-S (7/97) Certificate # 16325 Frank E. Bein DATE MAY 1 01 g9QBD CERTIFICATE OF LIABILITY INSIURANCE AS A MAIrER OFINF:HOLDER.ATHON SONLY AND CERTIFCATE T PRODUCER CONFERS NO RIGHTS UPON THE CERTIFICATE SID gANACK INSURANCE AGENCY DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE 2046 14TH AVE. POLICIES BELOW. p O BOX 130 COMPANIES AFFORDING COVERAGE VERO BEACH FL 32961 PHONE: 661-662-3369 COA: BRIDGEFIELD INSURANCE CO cot INSUREDOMPANY B: OWNERS INSURANCE CO DADE RESTAURANT &REPAIR INC.NCtp COMPANY C: AUTO OWNERS INSURANCE CO 201 W. 27TH ST. FL 33010-1611 COMPANY D: HIALEAH COMPANY E: CT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. NDITION OF ANY CONTRACT BEEN OTH ER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISS jED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. BE I THIS IS TO TERM OR C NOTWITHSTANDING ANY REQUIREMENT, MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT LIMITS LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFFECTIVE POLICY EXPIRATION $ 1,000,000 POLICY NUMBER EACH OCCURRENCE iNSR TYPE OF INSURANCE JUL 17 00 JUL 17 01 60,000 GENERAL LIABILITY 912312-20616094-00 FIRE DAMAGE (Any One Fire) $ 6,000 MED. EXP (Any One Person) $ X COMMERCIAL GENERAL LIABILITY 1,000,000 CLAIMS MADE I� OCCUR PERSONAL & ADV INJURY $ I 1,000,000 GENERAL AGGREGATE $ 1,000,000 B PRODUCTS-COMP/OP AGG. $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PROJECT LOC JUL 17 00 JUL 17 01 COMBINED SINGLE LIMIT $ 600,000 AUTOMOBILE LIABILITY 96-424-609-00 (Ea accident) X ANY AUTO BODILY INJURY $ (Per person) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ C h� (Per accident) X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE $ AUTO ONLY - EA ACCIDENT $ GARAGE LIABILITY OTHER THAN EA ACC $ AUTO ONLY: AGG $ ANY AUTO $ EACH OCCURRENCE AGGREGATE $ EXCESS LIABILITY $ OCCUR ❑ CLAIMS MADE / Is DEDUCTIBLE — 1J OTHER X RETENTION $ APR 1 02 WC STATLL 0830 06677 APR 101 100,000 E.L. EACH ACCIDENT $ WORKERS COMPENSATION AND 100,000 EMPLOYERS' LIABILITY E.L. DISEASE -EA EMPLOYEE $ A 600,000 E.L. DISEASE -POLICY LIMIT $ OTHER: PECIAL ITEMS DESCRIPTION OF CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED ON GENERAL (ABILITY AND THE AUTOMOBILE POLICY ADDITIONAL INSURED; INSURER LETTER: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS 6100 COLLEGE ROAD KEY WEST, FL 33040 Attention: FAXED TO. 306 296-4364 ACORD 25S (7I97) .r.r... �. -- HE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED DAYS BEFORE WRI30 TTEN THEREOF THENOTICE ONTDHETCERTIFICATE HOLDERING NAMED TO THE LEFT,BCOMPANY WILLIUTFAILURE OMAIL SUCH NOTICE ITS AGENTS OR REPRESENTATIVES.O OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPA Certificate # 16325 REPRESENTATIVE Frank E. Bein DATE (MWDDNY) AVjWD CERTIFICATE OF LIABILITY INSURANCE JUN2801 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND PRODINSURANCE AGENCY CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE SID UCER ANA DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE SODS AYE. P O BOX 130 VERO BEACH FL 32961 PHONE: 561-662-3369 INSURED DADE RESTAURANT & REPAIR INC. 201 W. 27TH ST. HIALEAH FL 33010-1511 COMPANIES AFFORDING COVERAGE COMPANY A: OWNERS INSURANCE CO. COMPANY B: AUTO OWNERS INSURANCE CO. COMpANy C: BRIDGEFIELD EMPLOYERS INS CO. COMPANY D: COMPANY E: AT HE POLICIES OF THIS IS TO CERTIFY INSURANCE LISTED BELOW HAVE BEEN ISSUED TO HE INSURED NAMED ABOVE FOR HE POLICY PERIOD INDICATED, MAY ITHSTPERTAAN,DHE INSURANCE AFFORD ERBYOTHE POLICIES DESCRIBED HEREIN IS LIMITSSUBJECT TOR OTHER ALLHE TERMS. EXCLUSIONS NT WITH RESPECT ( AND CONDITIONS OF SUCH POLICH THIS CERTIFICATE MAY BE CIES. OR LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY NUMBER POLICY EFFECTNE POLICY EXPIRATION LIMITS NSR TYPE OF INSURANCE EACH OCCURRENCE $ 1,000,000 GENERAL LIABILITY 912312-20516094-01 JUL 17 01 JUL 17 02 FIRE DAMAGE Any One Fire) $ 50,000 X COMMERCIAL GENERAL LIABILITY MED. EXP (Any One Person) $ 5,000 CLAIMS MADE OCCUR PERSONAL & ADV INJURY $ 1,000,000 A GENERAL AGGREGATE $ 1,000,000 PRODUCTS-COMP/OP AGG. $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PROJECT LOC 95-024-609-00 JUL 17 01 JUL 17 02 BINEDnt) SINGLE LIMIT $ COMBINED 600,000 AUTOMOBILE LIABILITY ccid X ANY AUTO BODILY INJURY ALL OWNED AUTOS (Per person) $ SCHEDULED AUTOS B BODILY INJURY $ X HIRED AUTOS (Per accident) X NON -OWNED AUTOS K��'E!. CIS PROPERTY DAMAGE $ GARAGE LIABILITY t AUTO ONLY - EA ACCIDENT $ EA ACC $ h OHER THAN ANY AUTO AUTO ONLY: AGG $ I AL. EACH OCCURRENCE $ EXCESS LIABILITY AGGREGATE $ OCCUR CLAIMS MADE $ DEDUCTIBLE $ X RETENTION $ WORKERS COMPENSATION AND 0830 06577 APR 1 01 APR 102 ^/0 ST"N OT"ER $ 100,000 EMPLOYERS' LIABILI rY E.L. EACH ACCIDENT C E.L. DISEASE -EA EMPLOYEE $ 100,000 E.L. DISEASE -POLICY LIMIT $ 600,000 OTHER: DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESISPECIAL ITEMS STOCK ISLAND DETENTION FACILITY FAX TO: 305-296 4364 RE: PREVENTATIVE MAINTENANCE KITCHEN EQUIPMENT X FADDITIONAL INSURED; INSURER LETTER: _ CANCELLATION MONROE COUNTY, OFFICE OF RISK MANAGEMENT 6100 COLLEGE ROAD KEY WEST FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION TO HE CERTIFICATE HOLDER ISSUING NAMED TO THE LEFTAUT FAILUREANY WILL MAIL 30 DTO MAIL WRITTENAYS NOTICE SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON HE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Attention: ACORD 2" (7197) Certificate # 10150 Frank E. Bein DATE (MMIDDNY) OF LIABILITY INSURANCE JUN2801 Aww. CERTIFICATE PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND SID BANACK INSURANCE AGENCY CONFERS NO DOES NOT AMEND, S UPON THE EXTEND CERTIFICATE RTIFICATE EXTEND ORA TERTHE COVERAGE AFFOR ED BY THE 2045 14TH POLICIES BELOW. P O BOX 130 VERO BEACH FL 32961 COMPANIES AFFORDING COVERAGE PHONE: 561-562-3369 COMPANY A: OWNERS INSURANCE CO. INSURED DADE RESTAURANT 8r REPAIR INC. COMPANY B: AUTO OWNERS INSURANCE C 201 W. 27TH ST. COMPANY C: BRIDGEFIELD EMPLOYERS INS CO. HIALEAH FL 33010-1511 COMPANY D: COMPANY E: COVERAGES - HIS IS TO CERTIFY THAT HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO HE INSURED NAMED ABOVE FOR HE POLICY PERIOD INDICATED, OTHER DOMENT WITH RESPECT TO ES. NOTWITHSTNING ANY REQUIREMENT, TEM OR CONDITION OF ANY MAY P R AAIN,DHE INSURANCE AFFORDEDRBY HE POLICIES DESCRIBED NHEREIN IS SUBJECT TTOCUALL HE TERMS, EXCLUSIONS IAND CONDITIONS OF SUCH POLIISSUEDCH THIS CERTIFICATE MAY BE OR LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. JTR INSRrAGGREGATE NSURANCE Y POLICY NUMBER 912312-20516094-01 DATF l wnol NE JUL 17 01 roucn—mnrvviEXPIRATO JUL 17 02 LIMITS EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any One Fire) $ 50,000 L GENERAL LIABILITY MADE OCCUR MED. EXP (Any One Person) $ S,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 A E LIMIT APPLIES PER:PROJECT PRODUCTS-COMP/OP AGG. $ 1,000,000 LOC AUTOMOBILE LIABILITY 95.424-609-00 JUL 17 01 JUL 17 02 COMBINED t, INGLE LIMIT $ 600,000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED AUTOS B SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ,.•r,�•. �^ Gl'- ij " ,.tp,:' Y. ' —� //) 'U'[/S, / BODILY INJURY (Per accident) $ X X U PROPERTY DAMAGE $ _ _-- AUTO ONLY - EA ACCIDENT $ GARAGE LIABILITY ANY AUTO OHERTHAN EA ACC AUTO ONLY: AGG $ o• �vr� -- $ EACH OCCURRENCE $ EXCESS LIABILITY OCCUR El CLAIMS MADE AGGREGATE $ $ $ DEDUCTIBLE X RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 0830 06577 APR 101 APR 102 WC STATLL OTHER $ 100,000 ___ E.L. EACH ACCIDENT E.L. DISEASE -EA EMPLOYEE $ 100,000 C E.L. DISEASE -POLICY LIMIT $ 600,000 OTHER: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED ON GENERAL LIABILITY AND THE AUTOMOBILE POLICY CERTIFICATE HOLDER X I ADDITIONAL INSURED; INSURER LETTER: _CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE HEREOF, THE ISSUING COMPANY WILL MAIL 30 DAYS WRITTEN NOTICE TO HE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE 5100 COLLEGE ROAD KEY WEST, FL 33040 Attention: FAXED TO: 306 295-0364 ACORD 25S (7/97) Certificate # 16325 Frank E. Bein ACORD ) DATMAY CERTIFICATE OF LIABILITY INSURANCE 22 3 TM. PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION SID BANACK INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2045 14TH AVE. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O BOX 130 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. VERO BEACH FL 32961 PHONE: 772-562-3369 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: OWNERS INSURANCE CO. DADE RESTAURANT & REPAIR INC. INSURER B: AUTO OWNERS INSURANCE CO. 201 W. 27TH ST. INSURER C: BRIDGEFIELD EMPLOYERS INS CO. HIALEAH FL 33010-1511 — - - — -- r INSURER D. INSURER E: rnvcoAr_cc THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REOUIREMENT, 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. INS LT TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD POLICY EXPIRATION DATE MWDD LIMITS GENERAL LIABILITY 912312-20516094-01 JUL 17 02 JUL 17 03 EACH OCCURRENCE Is 1,000,000 DAMAGE TO RENTED PREMISES a occurence $ 50,000 X COMMERCIAL GENERAL LIABILITY MED. EXP (Any One Person) $ 5,000 CLAIMS MADE IX] OCCUR PERSONAL & ADV INJURY $ 1,000,000 A GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG. $ 1,000,000 POLICY AUTOMOBILE LIABILITY X ANY AUTO 95-424-609-00 JUL 17 02 JUL 17 03 COMBINED SINGLE LIMIT (Ea accident) $ 500,000 BODILY INJURY T ALL OWNED AUTOS B - SCHEDULED AUTOS (Per person) $ — BODILY INJURY— (Per accident) - _ -- — - $ I $ X HIRED AUTOS X NON -OWNED AUTOS 1 pp �AN&NMEI � - PROPERTY DAMAGE - --- i 1 GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO ATE OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS / UMBERELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR El CLAIMS MADE C C DEDUCTIBLE X RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 830-06577 APR 1 03 APR 1 04 TORY LIM TS OTHER E.L. EACH ACCIDENT $ 100,000 C ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MeMBER EXCLUDED? E.L. DISEASE -EA EMPLOYEE $ 100,000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ 500,000 OTHER: DESCRIPTION OF OPERATIONS/LOCATIONIVEHICLES/EXCLUSIONS ADDED ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED ON GENERAL LIABILITY AND THE AUTOMOBILE POLICY rl GLn C / =MG 101f-ATM ue%i ncn I I ADDITIONAL INSURED: INSURER LETTER: (`AN[`FI I ATInN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS INSURER, ITS AGENTS OR REPRESENTATIVES. 1100 SIMONTON ST., RM #268 AUTHORIZED REPRESENTATIVE KEY WEST, FL 33040 Attention: FAXED TO: 305 295-4364 ACORD 25 (2001/08) Certificate # 54517 I-ranK c. beln ACOCERTIFICATE OF LIABILITY INSURANCE DATE CT o 02 RD PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND SID BANACK INSURANCE AGENCY CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE 2045 14TH AVE. DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE P O BOX 130 POLICIES BELOW. VERO BEACH FL 32961 PHONE: 772-562-3369 COMPANIES AFFORDING COVERAGE INSURED COMPANY A: OWNERS INSURANCE CO. DADE RESTAURANT & REPAIR INC. COMPANY B: AUTO OWNERS INSURANCE CO. 201 W. 27TH ST. COMPANY C: BRIDGEFIELD EMPLOYERS INS CO. HIALEAH FL 33010-1511 COMP_ANY D: BRIDGEFIELD EMPLOYERS INSURANCE CO COMPANY E: COVERAQFS 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. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS A �IGU GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY 7 CLAIMS MADE II� OCCUR - 912312-20516094-01 JUL 17 02 JUL 17 03 EACH OCCURRENCE $ 1, 00 FIRE DAMAGE (Any One Fire) 5,000 $ 0,000 MED. EXP (Any One Person) $ 6,000 PERSONAL & ADV INJURY $ 1,000,000 - - 'L AGGREGATE LIMIT APPLIES PER: 1 POLICY PROJECT LOC GENERAL AGGREGATE $ 1,000,000 PRODUCTS-COMP/OPAGG. $ 1,000,000 _ AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS -_ - _-_--__-- --_- 95-424-609-00 aeeS u , 56t, JUL 17 02 MA UL JUL 17 03 COMBINED SINGLE LIMIT (Ea accident) :B�ODILYJURY person) $ 500,000 — - $ BODILY INJURY (Per accident) $ $ PROPERTY DAMAGE GARAGE LIABILITY - - ANY AUTO BY DA.r fl V AUTO ONLY - EA ACCIDENT $ $ $ OTHER THAN EA ACC AUTO ONLY: AGG EXCESS LIABILITY ] OCCUR i � CLAIMS MADE DEDUCTIBLE X RETENTION $ VVAIVt:hEACH � rl C - OCCURRENCE $ AGGREGATE $ $ -.- .— $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 830-06677 APR 102 APR 1 03 WC STATU- OTHER E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE -EA EMPLOYEE $ 100,000 E.L. DISEASE -POLICY LIMIT 1 $ 600,000 OTHER: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED ON GENERAL LIABILITY AND THE AUTOMOBILE POLICY MONROE COUNTY BOARD OF COUNTY COMMISSIONERS 5100 COLLEGE ROAD KEY WEST, FL 33040 Attention: FAXED TO: 305 296-4364 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, IT,'S AGENTS OR REPRESENTATIVES. REPRESENTATIVE ACORD 25-S (7/97),,, Certificate # 54517 rranK t. bein �G ACORDDATE (MM1DD/YYj �r TM. CERTIFICATE OF LIABILITY INSURANCE OCT 2803 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION SID BANACK INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2045 14TH AVE I HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O BOX 130 VERO BEACH FL 32961 PHONE: 772-562-3369 INSURED DADE RESTAURANT & REPAIR INC. 201 W. 27TH ST. HIALEAH FL 33010-1511 INSURERS AFFORDING COVERAGE INSURER A: OWNERS INSURANCE CO. INSURER B: AUTO OWNERS INSURANCE CO. INSURER C_ BRIDGEFIELD EMPLOYERS INS CO. INSURER D: INSURER E: COVERAGE5 BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING THE POLICIES OF INSURANCE LISTED 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. INS -- - - - -- TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVEPODCY DATE MMIDD EXPIRATION DATE MMIDD/YY LIMITS LT GENERAL LIABILITY 912312-20516094-03 JUL 17 03 JUL 17 04 EACH OCCURRENCE DAMAGE TO RENTED PREMISES Ee oNcurenu $ 50 000 -- X� COMMERCIAL GENERAL LIABILITY MED. EXP (Any One Person) $ 5,000 CLAIMS MADE " OCCUR PERSONAL & ADV INJURY $ 1,000,000 A 1 GENERAL AGGREGATE $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG. $ - 1,000,000 POLICY AUTOMOBILE k--• LIABILITY 95-424-609-0� JUL 17 02 JUL 17 03 COMBINED SINGLE LIMIT $ 500,000 X ANY AUTO Ea accident BODILY INJURY ALL OWNED AUTOS (Per person) $ B SCHEDULED AUTOS APR Y' SK M A EME T X � X� HIRED AUTOS NON -OWNED AUTOS o BY BODILY INJURY (Per accident) $ '^y 0 SATE PROPERTY DAMAGE $ GARAGE LIABILITY WAI /ER N/A YES AUTO ONLY - EA ACCIDENT $ — -- OTHER THAN EA ACC ANY AUTO $ -j AUTO ONLY: AGG $ EXCESS / UMBERELLA LIABILITY r EACH OCCURRENCE $ AGGREGATE ]OCCUR n CLAIMS MADE $ DEDUCTIBLE $ X RETENTION $ $ WORKERS COMPENSATION AND 830-06577 APR 1 03 APR 1 04 ATU uM 7s OTHER _TORS E.L. EACH ACCIDENT EMPLOYERS' LIABILITY $ 100,000 ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MeMBERE%CLUDEDI -- - - 100,000 — -- ON E.L. DISEASE -EA EMPLE$ E.L. DISEASE -POLICY LIMIT tl yes, describe under SPECIAL PROVISIONS below $ 500,000 OTHER: DESCRIPTION OF OPERATIONS/LOCATION/VEHICLES/EXCLUSIONS ADDED ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED ON GENERAL LIABILITY AND THE AUTOMOBILE POLICY. FAX TO: 305-292-4564 C— G P".3 '. (::� -- C.. h C 4 ADDITIONAL IN5UKW; INSUKCK LC I I CK: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS 1100 SIMONTON ST., RM #268 KEY WEST, FL 33040 Attention: MARIA SLAVIK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ^ ACORD 25 (2001/08) Certificate # 54517 MODUIL n. JOIICS ACORD TM. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) PRODUCER SID BANACK INS./A HILB ROGAL & HOBBS CO. JUL 14 04 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 2045 14TH AVE. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P O BOX 130 VERO BEACH FL 32961 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURED DE RESTAURANT & REPAIR INC. NAIC # INSURER A: OWNERS INSURANCE CO. - - -- --- 201 W. 27TH ST. i-. _ AUTOt - INSURER B: AUTO OWNERS INSURANCE CO. HIALEAH FL 33010-1511 INSURER C: — -- - EMPLOYERS INS CO.. ------------ INSURER D: - - - — -- - -- - --- - --- --- -f INSURER E: -- - - THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR ADD'L TYPE OF INSURANCE ---------- — --- LTR.INSR POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION --- - - - -- - -- -- - GENERAL LIABILITY 912312-20516094-03 DATE MM/DD/YY JUL 17 04 DATE I LIMITS COMMERCIAL1GEE LIABILITI� XGENERAL JUL 17 05 EACH OCCURRENCE_ _ $_ � 1,000,000 C GIB, I nn OCCUR DAMAGE TO RENTED Pfl^ F jEa nre) i- — - -- ti 000 A MED EXP (Any one person) $ - 5 000 PERSONAL & ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE ..-.- $ 1 OOO,OOO POLICY LOCI' PROJECT ' PRODUCTS-COMP/OPAGG. - -- -- - $ 1,000,000 -- 'AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED AUTOS B SCHEDULED AUTOS X HIRED AUTOS X ! NON -OWNED AUTOS i I GARAGE LIABILITY ANY AUTO EXCESS / UMBRELLA -LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE X I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY C I ANY PROPRIETOR/PARTNER/EXECUTIVE OFFiCER/MEMBER EXCLUDED? It yes, describe under SPECIAL PROVISIONS below OTHER: i 95-424-609-00 JUL 17 04 I AP P v yy�� L MAMNISEMENT BY:� WAIVER 1 l , 1 1.�► 0830-06577 JUL 17 05 COMBINED SINGLE LIMIT (Ea accident) $ 500,000 BODILY INJURY - - - (Per person) I $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (Per accident) AUTO ONLY - EA ACCIDENT �$ OTHER THAN EA ACC $ AUTO ONLY: I$ EACH OCCURRENCE $ ,AGGREGATE $ I$ $ APR 1 OS OTHER _ _-ILORY-UWT& I- E.L. EACH ACCIDENT - - _ - - - i $ - 100,000 E.L. DISEASE -EA EMPLOYEE ; $ 100,000 E.L. DISEASE -POLICY LIMIT �$ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED ON GENERAL LIABILITY PER POLICY TERMS AND CONDITIONS WITH RESPECT TO OPERATIONS OF THE NAMED INSURED. FAX TO: 305-292-4564 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS 1100 SIMONTON ST., RM #268 KEY WEST, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, IT'S AGENTS OR REPRESENTATIVES. Attention: MARIA SLAVIK Y, ` ACORD 25 (2001f08) , Robert rs G-G Certificate # 78960 © ACORD CORPORATION 1988 - ACORD CERTIFICATE OF LIABILITY INSURANCE DATE/YYYY) TM. JUL 19 04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION SID BANACK INSURANCE/A HILB ROGAL & HOBBS CO. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2045 14TH AVE. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O BOX 130 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. VERO BEACH FL 32961 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: OWNERS INSURANCE CO. DADE RESTAURANT & REPAIR INC. INSURER B: AUTO OWNERS INSURANCE CO. 201 W. 27TH ST. - HIALEAH FL 33010-1511 1 INSURER C: BRIDGEFIELD EMPLOYERS INS CO. INSURER D: INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE LTR INSR 1 POLICY EXPIRATION LIMITS DATE MMIDDIYY DATE MMIDDlYY GENERAL LIABILITY X COMMERCIAL GENERAL L —' 912312-20516094-03 JUL 17 03 JUL 17 04 EACH OCCURRENCE $ DAMAGE To RENTED $ 1,000,000 0,000 RN X OCCUR CLAIMS MADE(_- , PREMISES (Ea_occurence) _ MED. EXP (Any one person) $ 5,000 Ai PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 GEN 'L AGGREGATE LIMIT APPLIES PER:' PRODUCTS-COMP/OPAGG $ 1,000,000 POLICY PROJECT LOC AUTOMOBILE LIABILITY 95-424-609-00 JUL 17 03 JUL 17 04 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $ 500,000 � , ALL OWNED AUTOS BODILY INJURY I SCHEDULED AUTOS (Per person) $ BI I X HIRED AUTOS X NON -OWNED AUTOS `I ` i fiu) Ai:�E[r1'i BODILY INJURY $ (Per accident) i APP�.( _;et 1 �E$ Y _�ERT (Per accident) GARAGE LIABILITY DATE '""-"""'" y AUTO ONLY - EA ACCIDENT $ ANY AUTO ! i YES OTHER THAN EAACC $ WAIVED �N/A ^ -,.'�„^.�`-, ',AUTO ONLY: $ EXCESS / UMBRELLA LIABILITY \ 1 EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ X RETENTION $ WORKERS COMPENSATION AND 0830-06577 APR 1 04 EMPLOYERS' LIABILITY APR 1 05 WC STATU- OTHER TORY LIMITS C ANY PROPRIETORIPARTNERIEXECUTIVE E.L. EACH ACCIDENT $ 100,000 OFFICERIMEMBER EXCLUDED? If yes, describe under E. L. DISEASE -EA EMPLOYEE $ 100,000 SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ 500,000 (OTHER: DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED ON GENERAL LIABILITY AND AUTO LIABILITY PER POLICY TERMS AND CONDITIONS WITH RESPECT TO OPERATIONS OF THE NAMED INSURED. FAX TO: 305-292-4564 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS 1100 SIMONTON ST., RM #268 KEY WEST, FL 33040 Attention: MARIA SLAVIK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ^ \]j�� (� +`u'"�a\ K - Robert s ACORD 25 ( 01lC8) Certificate # 79072 GC �Lta.tic.c�- © ACORD CORPORATION 1988 ACORD TM. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) OCT 28 04 PRODUCER SID BANACK INS./A HILB ROGAL & HOBBS CO. 2045 14TH AVE. P O BOX 130 VERO BEACH FL 32961 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. INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: OWNERS INSURANCE CO. DE RESTAURANT &REPAIR INC. 201 W. 27TH ST. HIALEAH FL 33010-1511 - INSURER B: AUTO OWNERS INSURANCE CO. - - --- INSURER C: BRIDGEFIELD EMPLOYERS INS CO. INSURER D: INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. --- ILT RBI ADD L T LTR INSRd TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS 11 DATE MMIDDNY DATE MWDD/YY GENERAL LIABILITY 1 912312-20516094-04 JUL 17 04 JUL 17 05 EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY! - DAMAGE TO RENTED $ S 0,000 CLAIMS MADE X OCCUR _ I ' ]- - _ MED. EXP (Anyone person) $ 5,000 A �PERSONAL 8 ADV INJURY $ 1,000,000 - - — - GENERAL AGGREGATE $ 1,000,0000 GENT L AGGREGATE LIMIT APP LIES - - - PRODUCT $ 1,000,000 --_- - ---- -- POLICY PROJECT PROJECT LOC AUTOMOBILE LIABILITY 95-424-609-00 JUL17 04 JUL 17 05 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $ 500,000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ B X HIRED AUTOS - p AP BODILY INJURY --- X NON -OWNED AUTOS {Oj! �/ , f� ; .'J -�e (Per accident) $ i PROPERTY DAMAGE $ (Per accident) LIABILITY GARAGEOTHER ANY WA � t�.E(- AUTO ONLY - EA ACCIDENT $ - - -- - THAN AUTO - ': EA ACC AUTO ONLY: AQQ $ EXCESS / UMBRELLA_ _LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE --- I - - $ X RETENTION $ - - - WORKERS COMPENSATION AND 0830-06577 EMPLOYERS' LIABILITY APR 1 04 APR 1 05 WC STATU- OTHER __ - 1SDRy—S C ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? EDISEASE-EAEME� PLOY$ If yes, describe under .L. 100000 _ - ._ E.L. DISEASE -POLICY LIMIT 1$ _ _ -., _ --- 500,000 SPECIAL PROVISIONS below OTHER: DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED ON GENERAL LIABILITY AND AUTO LIABILITY PER POLICY TERMS AND CONDITIONS FOR ONGOING OPERATIONS WITH RESPECT TO OPERATIONS OF THE NAMED INSURED. FAX TO: 305-295-4364 C o P L ; �1 VS- q v%--,C 2.-_ MONROE COUNTY BOARD OF COUNTY COMMISSIONERS 1100 SIMONTON ST., RM #268 KEY WEST, FL 33040 Attention: MARIA SLAVIK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. h R`obert s tf %,emTIcate s blbbi U ACORD CORPORATION 1988 ACORD CERTIFICATE OF LIABILITY INSURANCE DATEMAY 3 05YYY) TM. MAY 3 05 PRODUCER SID BANACK INS./A HILB ROGAL & HOBBS CO. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2045 14TH AVE. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O BOX 130 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. VERO BEACH FL 32961 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: OWNERS INSURANCE CO. DADE RESTAURANT & REPAIR INC. INSURER B: AUTO OWNERS INSURANCE CO. I 201 W. TH ST. HIA EAH FL 33010-1511 INSURER C: BRIDGEFIELD EMPLOYERS INS CO. INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTNE POLICY EXPIRATION LIMITS LTR DATE M. DATE MMIDD GENERAL LIABILITY 912312-20516094-04 JUL 17 04 JUL 17 05 I EACH OCCURRENCE _ _ $ 1,000,000 COI COMMERCIAL GENERAL LIABILITY !, DAMAGEFCO RENTED $ 50,000 CLAIMS MADE' X OCCUR �Pg IFe��r,��p� MED. EXP (Any one person) -...__. _._. $ 5,000 A PERSONAL & ADV INJURY L$ 1,000,000 - GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: I PRODUCTS-COMP/OP AGG. $ 1,000,000 POLICY PROJECT LOC AUTOMOBILE LIABILITY 95-424-609-00 JUL 17 04 JUL 17 05 COMBINED SINGLE LIMIT X ANY AUTO ! I (Ea accident) $ 500,000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ B - - X HIRED AUTOS BODILY INJURY $ X NON -OWNED AUTOS �A EMENII (Per accident) APPROVE BY ail - - — �q r PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ DATE -- ANY AUTO V L �� """ OTHER THAN EA ACC $ - _j" AUTO ONLY: EXCESS ! UMBRELLA_ LIABILITY EACH OCCURRENCE $ OCCUR --]CLAIMS MADE AGGREGATE I$ 4 $ \ DEDUCTIBLE - X RETENTION $ WORKERS COMPENSATION AND 0830-06577 APR 1 05 APR 1 06 WC STATU- OTHER EMPLOYERS' LIABILITY ! ! 1- - -LTA-UMLTS.- - - `+ ANY PROPRIETOR/PARTNER/EXECUTIVE I I _ E.L. EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? E.L. DISEASE-EAEMPLOYEE $ 100,000 If yes, describe under -- - - -- - - - - - SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ 500,000 ,OTHER: DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED ON GENERAL LIABILITY AND AUTO LIABILITY PER POLICY TERMS AND CONDITIONS FOR ONGOING OPERATIONS WITH RESPECT TO OPERATIONS OF THE NAMED INSURED. FAX TO: 305-295-3179 Lm V4 1 e S '. . r, a. +n C. Q..,. MONROE COUNTY BOARD OF COUNTY COMMISSIONERS P.O. BOX 1026 KEY WEST, FL 33041-1026 Attention: MARIA SLAVIK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. REPRESENTATIVE ��, X h Robert s AL:UKU Lb ("LUU9/Ut$) Certificate # 86316 (0 ACORD CORPORATION 1988 TM. CERTIFICATE OF LIABILITY PRODUCER HILB ROGAL & HOBBS OF FLA. INC./SID BANACK INS. 2045 14TH AVE. P O BOX 130 VERO BEACH FL 32961 INSURANCE DATE (MM/DD N-fYY) DEC 20 05 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. INSURERS AFFORDING COVERAGE NAIC # INSURED DADE RESTAURANT REPAIR SHOP, INC. INSURER A: OWNERS INSURANCE CO 1 W. 27TH ST. INSURER B. AUTO OWNERS INSURANCE CO! 09703 HIALEAH FL 33010-1511 INSURER C. BRIDGEFIELD EMPLOYERS INSURANCE CO — -- - ------—-- INSURERD: -- NSURER 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 MAY PERTAIN, WHICH THIS CERTIFICATE MAY BE ISSUED OR THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. OF SUCH INSR ADDL TYPE OF INSURANCE LTR INSR POLICY NUMBER _ ___ _ _ _ PO`LICYIE EFFECTIVE POLICY EXPIRATION GENERAL LIABILITY 912312-20516094-06 DATE MnvoDn'Y LIMITS JUL 17 05 1 X COMMERCIAL GENERAL LIABILI JUL 17 O6 EACH occuRRENCE $ 1,000,000 CLAIMS MADE OCCUR I I DAMAGE To RENTED $ 5Q000 A MED. EXP (Any one person) $ 5,000 _ [PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 1,000,000 POLICY PROJECT LOC PRODUCTS-COMP/OPAGG $ 1,000,000 -- - AUTOMOBILE LIABILITY 95-424-609-00 JUL 17 05 X ANY AUTO JUL 17 06 COMBINED SINGLE LIMIT ALL OWNED AUTOS i (Ea accident) $ 500,000 SCHEDULED AUTOS B BODILY INJURY (Per person) X HIRED AUTOS I $ ---- - X NON -OWNED AUTOS r BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY t. (Per accident) ANY AUTO �M� EAACCIDAUTO ONLY - LY - BMW �OUHOER AACC !$ THAN —I AUTO ONLY: — EXCESS /UMBRELLA LIABILITY OCCUR CLAIMS MADE Idz EACH OCCURRENCE Is v - AGGREGATE g DEDUCTIBLE X RETENTION $ -. L — 7$ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 0830-06577 WC STATU_ APR 1 05 APR 1 06TORY oTlieR $ (�` ANYPROPRIETORIEXCLUDElEXECUTIVE OFFICERIMEMSER EXCLUDED? E L. EACH ACCIDENT $ 100,000 Myes, describe under SPECIAL PROVISIONS bNow EL DISEASE -EA EMPLOYEE $ 100,000 _' -. -_ OTHER: _ E.L. DISEASE -POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED ON GENERAL LIABILITY AND AUTO LIABILITY PER POLICY TERMS AND CONDITIONS FOR ONGOING OPERATIONS WITH RESPECT TO OPERATIONS OF THE NAMED INSURED. FAX TO: 305-295-3179 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS P.O. BOX 1026 KEY WEST, FL 33041-1026 Attention: MARIA SLAVIK ACORD 25 (2001/018) Certificate # 91670 CG SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Robert S © ACORD CORPORATION 1988 ACORD CERTIFICATE OF LIABILITY INSURANCE DATAP' R2506 TM. PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HILB ROGAL 8r HOBBS OF FLA. INC./SID BANACK INS. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2045 14TH AVE. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O BOX 130 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. VERO BEACH FL 32961 INSURERS AFFORDING COVERAGE NAIC # INSURED c"R--=-� YERS INSURANCE CO -- — -- - DADE RESTAURANT REPAIR SHOP, INC. INSUR 201-205 W. 27TH ST. — -- — HIALEAH FL 33010-1511 SURER D: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TH INSUR Y PERI DINDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHE DOCU THISCE IFICATE MAY BE ISSUED OR �Irr� MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED EREIN IS , EXCLU ONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAI CLAIMS. INSR' ADD'L. TYPE OF INSURANCE POLICY NUMBER LTRINSR POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE MMIDD DATE MMIDDIYY GENERAL _EACH OCCURRENCE $ - — * -- - - COMMABILIT GENERAL LIABILITY ERCIAL DAA GE TO RENTED $ ISES_(Ea.ocr.ne I CLAIMS MADE OCCUR pl MEO MED. EXP tAny cn parson) g PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG. $ POLICY PROJECT F ' LOCI AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ - -- -- ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS i HIRED AUTOS I BODILY INJURY $ (Per accident) _ NON -OWNED JJJ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY - AUTO ONLY - EA ACCIDENT $ _ ANY AUTOOTHER THAN EA ACC'$ AUTO ONLY:AGG $ EXCESS LIABILITY EACH OCCURRENCE $ — - L OCCURUMBRELLA CLAIMS MADE AGGREGATE $ $ owl A - DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND 830-06577 WC STATU- OTHER j APR 1 06 APR 1 07 CRY„�,T� _- EMPLOYERS' LIABILITY E.L. EACH ACCIDE'N I _ $ 100,000 A ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? ---- ---- - E.L. DISEASE -EA EMPLOYEE $ III •. - 100,000 --_ II If yes, describe under SPECIAL PROVISIONS below -_- __.__ E.L. DISEASE -POLICY LIMIT $ 500,000 OTHER: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BYIENDORSEMENT/ SPECIAL PROVISIONS MONROE COUNTY BOARD OF COUNTY COMMISSIONERS ARE HEREBY NAMED AS ADDITIONAL INSURED WHEN REQUIRED BY CONTRACT MONROE COUNTY RISK MANAGEMENT 1100 SIMONTON STREET KEY WEST, FL 33040 Attention: c c-' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, IT'S AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Robert s ACORD 25 (2001108) Certificate # 94323 W AL UKU 1,Ul VILIKA I IUN I yaa ACORD- CERTIFICATE OF LIABILITY INSURANCE OP ID DATE IMM DD YY) PRODUCER DAD 0B 15 06 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Stuart Insurance, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 3070 S W Ma pp HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Palm City FL 34990 1 ( 0 , f( ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Phone: 772-286-4334 Fax: 772-286938 j INSURED "- --- ",fMSURERS AFFORDING COVERAGE NAIC # Dade Restaurant Repair INSURER A to Owners Insurance Co 18988 Shop Inc AUG 8 Nelson Fleches ' INI6URER B: Bridgatlald mPlvyvv xva. Cv. 14042 N.W. 82nd Avenue j Miami Lakes FL 33016 L••-•---�.,.._.___. INSURER d: j INSURER 0: i THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. �R NSR TYPE OF INSURANCE POLICY NUMBER ,...�, GENERAL LIABILITY A I $ X I COMMERCIAL GENERAL LIABILITY 20685410 CLAIMS MADE 1K OCCUR GENT AGGREGATE LIMIT APPLIES PER: TXNON-OWNED PRO- JECT LOC LIABILITY 9542460900 ED AUTOS ED AUTOS TOS ED AUTOS GARAGE LIABILITY 7 ANY AUTO EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE HE IENTION $ WORKERS COMPENSATION AND B EMPLOYERS' LIABILITY ANY PROPRIETOWPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? It v.-, dncrnne •..ne. A Motor Cargo - ••••^-•••• nic mm,uurvY LIMITS EACH OCCURRENCE $ 1000 07/17/06 07/17/07 PREMISESEaoccurence) $5000 MEDEXP(Anyoneperscn) $5000 PERSONALBADV INJURY $1000 GENERAL AGGREGATE $ 1000 PRODUCTS-COMP/OP AGG $ 1000 07/17/06 07/17/07 (Ea acccdeDISINGLE LIMIT $500,000 BODILY INJURY (Per person) $ BODILY INJURY $ (PeraccidenU PROPERTY DAMAGE $ (PeraccidenU AUTO ONLY - EA ACCIDENT $ U OTHER THAN EA ACC $ AUTO ONLY: AGO $ EACH OCCURRENCE $ /^- AGGREGATE $ 8/ $ 08300657700001061 •- IURYUMITS ER 07/17/06 07/17/07 E.L.EACHACCIDENT $100000 E.L. DISEASE - EA EMPLOYEE $ 100000 E.L. DISEASE -POLICY LIMIT $500000 v 2051609506 I 07/17/06I 07/17/071 Motor 20,000 ------- •-••••-��..,.v nuucu er ENDORSEMENT / SPECIAL PROVISIONS - Appliances -Commercial CERTIFICATE HOLDER IS A NAMED INSURED WITH RESPECTS TO GENERAL LIABILITY AND AUTO LIABILITY. - c- C• L / BIrxa-!L4 MONRC- 4 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO MONROE COUNTY BOARD OF COUNTY DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN COMMISSIONERS NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Room #268 - Marie IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1100 SIMONTON ST REPRESENTATIVES. KEY WEST FL 33040 ADmnmvcE -..-. _..._ . ACORV. CERTIFICATE OF LIABILITY INSURANCE OF ID DATE(MMIDDIYYYY) DADER-1 04 09 07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Stuart Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 3070 S W Mapp . ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Palm City FL 34990 I r \, 1 Phone:772-286-4334 Fax:772-286F9389 INSURERS AF�ORDING COVERAGE NAIC# - INSURED INSI IRER AAntc Owners Insurance Cc 1 18988 Dade Restaurant Repair ! , INSURER B: BrfdSs>`iald imPlaYe=a Ive. Co. Shop Inc Nelson Fleches I-INSURERC: 14042 N.W. 82nd Avenue wsuRER D'. Miami Lakes FL 33016 -- 9N URER E' 1 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR'NSR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDD/YY DATE MM/DD/Y7 LIMITS GENERAL LIABILITY EACH OCCURRENCE $1000000 PREMISE (Ea occurence) $ 300000 A - X X . COMMERCIAL GENERAL LIABILITY 72685410 07/17/07 07/17/08 MED EXP(Any one person) $ 10000 CLAIMS MADE X❑ OCCUR PERSONAL B ADV INJ U RV $1000000 GENERAL AGGREGATE $ 1000000 PRODUCTS - COMP/OP AGG $1000000 -- GEN'L AGGREGATE LIMIT APPLIES PER: _-- POLICY PRO- LOC ECT AUTOMOBILE LIABILITY A X 'ANY AUTO 9542460901 07/17/07 07/17/08 COMBINED SINGLE LIMIT (Ea accident) $500,000 BODILY INJURY (Per person) - $ X ALL OWNED AUTOS —~ SCHEDULED AUTOS BODILY INJURY (Per accident) $ 'X HIREDAUTOS X NON -OWNED AUTOS I PROPERTY DAMAGE (Per accident) _ $ 1 GARAGE LIABILITY I ->J-� AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTOONLY: qGG - $ ANY AUTO $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ Imo_ OCCUR C' CLAIMS MADE AGGREGATE $ $ I L �i DEDUCTIBLE S RETENTION $ _ $ WORKERS COMPENSATION AND X ITORY E EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? 08300657700001061 04/01/07 04/01/08 EL EACH ACCIDENT $lOOOOO E.L. DISEASE - EA EMPLOYEE $100000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT I $ 500000 OTHER A Motor Cargo 20685410 07/17/06 07/17/07 Motor 20,000 Cargo DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS - Appliances -Commercial - CERTIFICATE HOLDER IS A NAMED INSURED WITH RESPECTS TO GENERAL LIABILITY AND AUTO LIABILITY. - CL, �nance� MONROE COUNTY BOARD OF COUNTY COMMISSIONERS Room #268 - Marie 1100 SIMONTON ST KEY WEST FL 33040 MONRC-4 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 4410zl itUlal _V ©ACORD ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID $ DATE (MM/DD/Y07 DARER-1 07 13 07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE _ Stuart Insurance, Inc. '--- - --- ,€R. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 3070 S W Mapp I �{ ��'' ^ (1; „'f ALTER Y"HE COVERAGE AFFORDED BY THE POLICIES BELOW. Palm City FL 34990--- --- Phone:772-286-4334 Fax:772-286-9389 INSURERSAFFORDING COVERAGE NAIC# INSURED INSURER A: Auto Owners Insurance CO 18988 Dade Restaurant Repair INSURER B: Bridgefisid Xapioyere Ina. Co. Sho NelsonnFlechee I-_ _R INSU ERQ ) 14042 N.W. 82nd AV9nu6 Miami Lakes FL 33016 iy��"a;i�[ �,l"i-e INSU ERD: j \ vv=l Uco THE POLICIES OF INSURANCE LISPED 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. LTRINSRE TYPEOFINSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/VY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A X X COMMERCIALGENERAL LIABILITY 72685410 07/17/07 07/17/08 PREMISES Eaoc.rence) $ 300000 CLAIMS MADE [X] OCCUR MED EXP (Any one person) $ 10000 PERSONAL B ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO $2000000 POLICY PR LOC A X AUTOMOBILE LIABILITY ANY AUTO 9542460901 07/17/07 07/17/08 (Eaami ent)ED LE LIMIT (Ea accitlenq $ 500 000 , X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY " AUTO ONLY - EA ACCIDENT $ OTHER THAN EAACC $ ANY AUTO $ - AUTO ONLY: AGO EXCESS/UMBRELLA LIABILITY OCCUR F—ICLAIMS MADE< �/ .. _, -'-" EACH OCCURRENCE 4 AGGREGATE $ $ $ DEDUCTIBLET� n $ RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS- LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE +( 08300657700001061 04/01/07 04/01/08 X TORY LIMIT$ ER E.L. EACH ACCIDENT $100000 E.L. DISEASE - EA EMPLOYEE $ 100000 OFFICER/MEMBER EXCLUDED" If yes, tlesaibe Under SPECIAL PROVISIONS b 1.w E.L. DISEASE -POLICY LIMIT $500000 OTHER A Motor Cargo 20685410 07/17/07 07/17/08 Motor 20,000 Cargo DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS - Appliances -Commercial - CERTIFICATE HOLDER. IS A NAMED INSURED WITH RESPECTS TO GENERAL LIABILITY AND AUTO LIABILITY.. -- C-. C . 1 1 (i Q. VI Q� MONRC - 4 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN MONROE COUNTY BOARD OF COUNTY NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL COMMISSIONERS Room #268 - Marie IMPOSE NO OBUGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR � 1100 SIMONTON ST REPRESENTATIVES. KEY WEST FL 33040 AUTHORIZE EVE/ 7 d ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID S DATE(MM ODM'YY) PRODUCER DADER-1 07 13 07 IFICATE IS ISSUED AS A MATTER OF INFORMATION Stuart Insurance, Inc . CONFERS NO RIGHTS UPON THE CERTIFICATE 3070 S W Ma HIS CERTIFICATE DOES NOT AMEND, EXTEND OR PP E COVERAGE AFFORDED BY THE POLICIES BELOW. Palm City FL 34990Phone:772-286-4334 Fax:772-286 9389 JALTER F RDING COVERAGEINSURED NAIC #A Restaurant Repair Shop Inc Fleches 14042 N.W. 82nd Avenue Miami Lakes FL 33016 JUL to Owners Insurance Co 18988Dade Br .[i.la Raploy.r. in.. co.Nelson COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSU ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CEIRTIIFI DIC MAY BETWITHSISSUED NOTWITHSTANDING 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. IN LTR NSR TYPE OF INSURANCE GENERAL LIABILITY POLICY NUMBER DATE MM/DD/YY DATE MM/DD/YY LIMITS A X X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR 72685410 07/17/07 07/17/08 EACH OCCURRENCE $ 1000000 PREMISES Eaoccurence $ 300000 MED EXP(Any on a pe.n) $ 10000 PERSONAL S ADV INJURY $ 1000000 GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2000000 PRODUCTS-COMP/OP AGG s2000000 POLICY JEC' LOC AUTOMOBILE LIABILITY A X X ANY AUTO ALL OWNED AUTOS 9542460901 07/17/07 07/17/08 COMINED (Ea aaatlent)INGLELIMIT $500,000 BODILY INJURY (Per person) $ SCHEDULED AUTOS HIRED AUTOS X BODILY INJURY (Per accident) $ X NON -OWNED AU OS PROPERTY DAMAGE (Paraccident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG EACH OCCURRENCE $ EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE _ ----"-"" $ $ AGGREGATE $ DEDUCTIBLE. $ RETENTION $ WORKERS COMPENSATION AND $ B EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE 08300657700001061 OFFICER/MEMBER EXCLUDED? X TORY LIMITS ER 04/01/07 04/01/08 E.L. EACH ACCIDENT g1Q0000 I(yes, describe under SPECIAL PROVISIONS below / j+ \ !I_ E.L. DISEASE - EA EMPLOYEE $ 100000 C_ _". OTHER I E.L. DISEASE -POLICYLIMIT $500000 A Motor Cargo 20685410 07/17/07 07/17/08t Motor 20,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Car O - Appliances -Commercial - CERTIFICATE HOLDER IS A NAMED INSURED WITH RESPECTS TO GENERAL LIABILITY AND AUTO LIABILITY. - MONROE COUNTY BOARD OF COUNTY COMMISSIONERS Room #268 - Marie 1100 SIMONTON ST KEY WEST FL 33040 MONRC-4 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR ACORD 25 (2001/01 CC DATE (MM/DD/YYYY) OP ID S CERTIFICATE OF LIABILITY INSURANCE DADER-1 03 26 08 AcoRD IS ISSUED AS A MATTER OF INFORMATION THIS CERTIFICATE CONFERS NO RIGHTS UPON THE CERTIFICATE PRODUCER ONLY AND THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Inc. HOLDER. AFFORDED BY THE POLICIES BELOW. Stuart Insurance, ALTER THE COVERAGE 3070 S W Mapp_--- Palm City FL 34990 ppr- R '�'`' NAIC# 6N hjjS14SAFFORDI GCOVERAGE Phone:772-286-4334 Fax:772-286-938 - Cc 18988 INSURER A: Auto Owners Insurance INSURED Dade Restaurant Repairo. AA❑❑ (r�Fil N URER B'. Byldgaflld Enployaxa Iac. c Shop Inc I N RA'C:' Nelson Fleches INSURER D: Miami Lakas8FLd33016ue ---.-' COVERAGES PI°�.., •. {_�.. '. _. _ _.. ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING OR THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH ANY SUBJECT TO INSURANCE POLICIES. AMAY GGREGATE LIMITS SHOWN MAD HAVE BEEN RIEDUCED BY PAID CLAIMS. LIMITS LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DDM/ DATE MMIDDIYY EACH OCCURRENCE 51000000 GENERAL LIABILITY 07/17/07 07/17/08 PREMISES oaw $ 3000 A X X COMMERCIAL GENERAL LIABILITY 72685410 MED EXP (AnyonneePawn) $ 10000 CLAIMS MADE [�(] OCCUR PERSONAL B ADV INJURY $ 1000000 GENERAL AGGREGATE $ 1000000 PRODUCTS. COMPIOP AGO $ 1000000 GEN'L AGGREGATE LIMIT APPLIES PER'. POLICY PR LOC JEC COMBINED SINGLE LIMIT $500 000 AUTOMOBILE LIABI 07 07 07/17/08 (Eaaccitlenl) 17 / / A X ANY AUTO 9542460901 BODILY g X ALL OWNED AUTOS Person) (Per person) (Per SCHEDULED AUTOS BODILY INJURY g X HIRED AUTOS (Per accident) X NON -OWNED AUTOS PROPERTY DAMAGE $ (Per accident) AUTO ONLY - EA ACCIDENT $ GARAGE LIABILITY !. EAACC $ OTHER THAN ANY AUTO ' ( _ -` AUTO ONLY: AGO $ EACH OCCURRENCE $ EXCESS/UMBRELLA LIABILITY r'""" " -"� AGGREGATE $ OCCUR CLAIMS MADE �')ir.{:i„j� NIA t ict - $ DEDUCTIBLE RETENTION $- X TORY LIMITS ER WORKERS COMPENSATION AND B EMPLOYERS' LIABILITY 0830065770000 04/O1/OS 04/O1/09 E.L. EACH ACCIDENT $ OFFANYICE ME ER PARTNE EXCLUDED9 ECUTIVE �// E. L. DISEASE -EA EMPLOYEE 8 DI E.L. DISEASE -POLICY LIMIT $ OTHER A Motor Cargo 20685410 07/17/07 07/17/08 Motor 20,000 Cargo - Appliances -Commercial - CERTIFICATE HOLDER IS A NAMED INSURED WITH RESPECTS TO GENERAL LIABILITY AND AUTO LIABILITY. - MONROE COUNTY BOARD OF COUNTY COMMISSIONERS Room #268 - Marie 1100 SIMONTON ST KEY WEST FL 33040 MONRC.•- 4 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, RS AGENTS OR OP ID SB DATE(MM/DDNYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE DARER-1 07 17 08 PRODUCER 3ER HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION NLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Stuart Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 3070 S W Mapp LTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Palm City FL 34990 NAIC#Phone:772-286-4334 Fax:772-286- 389 3i1RERS AFF RIDING COVERAGEIINSURED URER A:' An o Owners Insurance Co18988Dade Restaurant Repair RB. Bri yefield Employere Ine. Co. Shop Inc R c:Nelson Fleches 14042 N.W. 82nd Avenue SURER D.Miami Lakes FL 33016RER E: COVERAGES I nlan'"11Aeovlxla POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING THE REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR ANY MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDD/YY DATE MM/DDIYY N LIMITS $LOUD DDD GENERAL LIABILITY 72685410 07/17/08 07/17/09 EACH OCCURRENCE PREMISES (Ea occurenos) $ 300000 A X X COMMERCIAL GENERAL LIABILITY MED EXP(Any one Person) $10000 CLAIMS MADE aOCCUR PERSONAL S ADV INJURY $1000000 GENERAL AGGREGATE $ 1000000 PRODUCTS - COMPIOP AGG $ 1000000 GEN'L AGGREGATE LIMIT APPLIES PER. POLICY JE�f LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ x ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS HIRED AUTOS - BODILY INJURY (Per accident) $ NON -OWNED AUTOSPROPERTY DAMAGE $ - - - _ (Per accident) ""'--- AUTO ONLY - EA ACCIDENT $ GARAGE LIABILITY EA ACC $ ANY AUTO _ "^-- OTHER THAN AUTO ONLY. AGG 8 EACH OCCURRENCE $ EXCESSIUMBRELLA LIABILITY ✓ AGGREGATE $ OCCUR C CLAIMS MADE $ 1 ` $ DEDUCTIBLE $ RETENTION 9 X TORV LIMITS ER WORKERS COMPENSATION AND EMPLOYERS'LIABILITY 0830065770000 04/01/08 04/01/09 E.L. EACH ACCIDENT $100000 E.L. DISEASE - EA EMPLOYEE $ 100000 B ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? If describe under E. L. DISEASE - POLICY LIMIT $500000 yes, SPECIAL PROVISIONS below OTHER 20685410 07/17/08 07/17/09 Motor 20,000 A Motor Cargo Cargo DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS - Appliances -Commercial - CERTIFICATE HOLDER IS A NAMED INSURED WITH RESPECTS TO GENERAL LIABILITY AND AUTO LIABILITY. - LATION CERTIFICATE HOLDER CANCEL MONRL.-4 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN MONROE COUNTY BOARD OF COUNTY NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL COMMISSIONERS IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Room #268 - Marie REPRESENTATIVES. 1100 SIMONTON ST AUTHORIZED EgIT VE Q KEY WEST FL 33040 - 1 / ,p ACORD 25 GC CERTIFICATE OF LIABILITY INSURANCE OP ID MK DATE(MM/DD/YYYY) ACORDDADER-1 03 31 09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY A D CONFERS NO RIGHTS UPON THE CERTIFICATE Stuart Insurance, Inc. HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 3070 S W Mapp ALTER T E COVERAGE AFFORDED BY THE POLICIES BELOW. Palm City FL 34990 Phone : 7 7 2- 2 8 6- 4 3 3 4 Fax : 7 7 2- 2 8 6- 9 3 8 9 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Auto Ot mers Insurance Co 18988 Dade Restaurant Repair INSURERB: Bridgefield Employers Ins. Co. Shop Inc Nelson Fleches , INSURERG: 14042 N.W. 82nd Avenue INSURERD: Miami Lakes FL 33016 L. THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PI=RIOdINDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WH CH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DDIYY EXN LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 10 0 0 0 0 0 PREMISES (Ea occurence) $ 300000 A X X COMMERCIAL GENERAL LIABILITY 72697785 0 7/ 17 / 0 8 0 7/ 17 / 0 9 MED EXP (Any one person) $ 10000 CLAIMS MADE 7 OCCUR PERSONAL & ADV INJURY $ 10 0 0 0 0 0 GENERAL AGGREGATE $ 10 0 0 0 0 0 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1000000 POLICY PRO LOC JECT X AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ �. C GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ EA ACC OTHER THAN $ ANY AUTO $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ �- $ DEDUCTIBLE ` L $ RETENTION $ WORKERS COMPENSATION AND X TORY LIMITS ER B EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE .0830065770000 0 4/ 01 / 0 9 0 4/ 01 / 10 E.L. EACH ACCIDENT $ 10 0 0 0 0 E.L. DISEASE - EA EMPLOYEE $ 10 0 0 0 0 OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 5 0 0 0 0 0 OTHER A Motor Cargo 20685410 07/17/08 07/17/09 Motor 20,000 Cargo DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT ! SPECIAL PROVISIONS - Appliances -Commercial CERTIFICATE HOLDER IS A NAMED INSURED WITH RESPECTS TO GENERAL LIABILITY AND AUTO LIABILITY. - CERTIFICATE HOLDER CANCELLATION MONRC — 4 SHOULD AN OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THER OF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN MONROE COUNTY BOARD OF COUNTY NOTICE TO 11HE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL COMMISSIONERS Room #268 - Marie IMPOSE NO 6BLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 1100 S IMONTON ST REPRESENTATIVES. AUTHORIZED T VE KEY WEST FL 33040 ACORD 25 (2001 Y8) _ W AL;UKU cuKPUKA I wN 1 Vt$t$ C C c.0 1UUV tKA"t, THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FXJ OCCUR POLICY NUMBER 72697785 DATE MM/DDT g— 07/17/09 POLICY EXPIRATION DATE MWDD/YY 07/17/10 LIMITS EACH OCCURRENCE $ lOOOOOO A X PREMISES (Ea occurence) $ 300000 MED EXP (Any one person) $ 10000 PERSONAL & ADV INJURY $ 1000000 GENERAL AGGREGATE $ 1000000 PRODUCTS - COMP/OP AGG $ 1000000 GEN'L AGGREGATE LIMIT APPLIES PER: PPRO LOC POLICY JECT X AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ _ $ EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ } " EACH OCCURRENCE $ AGGREGATE $ $ $ B WORKERS COMPENSATION AND EM-PLOYERS'LIAMLIT'f ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 0830065770000 04/01/09 04/01/10 QTH_ X TORY LIMITS ER E.L. EACH ACCIDENT $ 100000 E.L. DISEASE - EA EMPLOYEE $ 100000 E.L. DISEASE - POLICY LIMIT $ 5 0 0 0 0 0 A OTHER Motor Cargo 20685410 07/17/08 07/17/09 Motor 20,000 Cargo DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS - Appliances -Commercial N CERTIFICATE HOLDER IS A NAMED INSURED WITH RESPECTS TO GENERAL LIABILITY AND AUTO LIABILITY. - VCn I IrIVM 1 G fl\JLVGr% MONROE COUNTY BOARD OF COUNTY COMMISSIONERS Room #268 - Marie 1100 SIMONTON ST KEY WEST FL 33040 MONRC-4 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRAT101 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTA iA Amon t`noDnl?ATIANI 1QRR ACORD 25 (200008).-- c. c. C !,Pb'9 CERTIFICATE OF LIABILITY INSURANCE OP ID SB DADER-1 DATE (MM/DD/YYYY) 03/26/10 PRODUCER Stuart Insurance Inc . Y 1 f.... 3070 S W Mapp r - - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION VC0�tFE NO RIGHTS UPON THE CERTIFICATE ii I . THIS CER IFICATE DOES NOT AMEND, EXTEND OR i .-i ALTE HE OVE GE AFFORDED BY THE POLICIES BELOW. f Palm City FL 34990 Phone : 772-286-4334 Fax : 772-286-938 #4WRfAg AFF�ORDI COVERAGE NAIC # INSURED INSURER A: A' to qwners Insurance Co 18988 INSURER B: Brdgefie d Employers Ins. Co. Dade Restaurant Repair Shop Inc Nelson Fleches IN§UkEk D 14042 N.W. 82nd Avenue - -• �---_ �_ . Miami Lakes FL 33016 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DDT DATE POLICYEXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 10 0 0 0 0 0 A X X COMMERCIAL GENERAL LIABILITY 72697785 0 7/ 17 / 0 9 0 7/ 17 / 10 PREMISES (Ea occurence) $ 3 0 0 0 0 0 CLAIMS MADE Fx_1U OCCUR , MED EXP (Any one person) $ 10 0 0 0 PERSONAL & ADV INJURY $ 10 0 0 0 0 0 F1GENERAL AGGREGATE $ 2 0 0 0 0 0 0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2 0 0 0 0 0 0 7 POLICY[-] PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ x ANY AUTO (Ea accident) BODILY INJURY $ ALL OWNED AUTOS SCHEDULED AUTOS (Per person) BODILY INJURY $ HIRED AUTOS NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO EA ACC OTHER THAN $ $ AUTO ONLY: AGG EXCESS / UMBRELLA LIABILITY 7 EACH OCCURRENCE $ FIOCCUR F-ICLAIMS MADE AGGREGATE $ t• $ $ DEDUCTIBLE L4 $ RETENTION $A/Vt WORKERS COMPENSATION X TO_RY_LIMITS ER AND EMPLOYERS' LIABILITY Y/ N B ANY PROPRIETOR/PARTNER/EECUTIV 830065770000 0 4/ 01 / 10 0 4/ 01 / 11 E.L. EACH ACCIDENT $ 10 0 0 0 0 OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 10 0 0 0 0 (Mandatory in NH) If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 5 0 0 0 0 0 OTHER A Motor Cargo 72697785 07/17/09 07/17/10 Motor 20000 Cargo DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS - Appliances -Commercial CERTIFICATE HOLDER IS A NAMED INSURED WITH RESPECTS TO GENERAL LIABILITY AND AUTO LIABILITY.0�1 - rza e7 C_ C. CERTIFICATE HOLDER CANCELLATION MONROE COUNTY BOARD OF COUNTY COMMISSIONERS Room #268 - Marie 1100 SIMONTON ST KEY WEST FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION MONRC— 4 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REMErtENTATIVE f /? ACORD 25 (2009/011 88-2009 ACORtYCaWORATION. "All rights reserved. The ACORD name and logo are registered marks of ACORD �vRv CERTIFICATE OF LIABILITY INSURANCE OP ID S$ DATE(MM/DD/YYYY THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER• HIS 5 10 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORthe certl Icate o der Is an ADDITION A N ,the pollcy(ies must a endorsed. R A '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(sl- Stuart Insurance, Inc. ac, No, Ext : _ (A/C, No): 3070 S W Mapp DRESS: Palm City FL 34990 RECEIV Phone:772-286-4334 Fax:772 86- -- ---- sTo RID a: DADER-1 INSURED INSURER(S) AFFORDING COVERAGE NAIC # Dade Restaurant Repair J�� O URERA: Llto Owners Insurance CO 18988 Shop Inc _2 11 RER B: idgefield Employers Ina. co. Nelson Fleches INSURER 14042 N.W. 82nd Avenue Miami Lakes FL 33016 URER WNR�E C0.U. R� kl'ri1gNtVT11 MURERE: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORT INDICATED. POLICY PERIOD NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT CERTIFICATE TO WHICH THIS MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO EXCLUSIONS ALL THE TERMS, AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE GENERAL LIABILITY INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS EACH OCCURRENCE $ 1000000 A X COMMERCIAL GENERAL LIABILITY 72697785 PREMISES (Ea occurrence) $ 300000 CLAIMS -MADE Fx� OCCUR 07/17/10 07/17/11 _ MED EXP (Any y one person) $ 10000 X PERSONAL BADVINJURY $ 1000000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2000000 PRODUCTS- COMP/OP AGG $ 2000000 POLICY JRO LOC AUTOMOBILE LIABILITY $ COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) $ HIRED AUTOS PROPERTY DAMAGE (Per accident) $ NON -OWNED AUTOS $ UMBRELLA LIAB OCCUR n �� EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE t f DEDUCTIBLE AGGREGATE r' l _ RETENTION $ $ $ WORKERS COMPENSATION $ AND EMPLOYERS' LIABILITY Y / N 04/01/1 04/01/11 X TORY ANY PROPRIETOR/PARTNER/EXECUTIV LIMITS ER E.L. EACH ACCIDENT $ 100000 OFFICER/MEMBEREXCLUDED? t (Mandatory in NH) /A E.L. DISEASE - EA EMPLOYEE $ 100000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $500000 A Motor Cargo 72697785 07/17/11 Motor 20000 07/17/10 Car O DESCRIPTION - Appliances OF OPERATIONS / LOCATIONS / VEHICLES -Commercial - (Attach ACORD 701, Additional Remarks Schedule, if more ace is P required) CERTIFICATE AUTO HOLDER IS A NAMED LIABILITY. - INSURED WITH RESPECTS TO GENERAL LIABILITY AND CERTIFICATE HOLDER CANCELLATION MONRC-4 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN MONROE COUNTY BOARD OF COUNTY ACCORDANCE WITH THE POLICY PROVISIONS. COMMISSIONERS ROOM #268 - Marie AUTHORIZED REPRESENTATIVE 1100 SIMONTON ST Y WEST FL 33040 ACORD 25 200� 09 © 88-2009 AC RATION. All rights reserved. ( :� The ACORD name and logo are registered marks of ACORD Cc. D�® DATE (MM/DD/YYYY) 4 A CERTIFICATE OF LIABILITY INSURANCE OP ID SB 03 30 11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an orsed. if SU ROGATION IS WAIVED, subject to the terms and conditions of the policy, certain polici ay regllj�@Cf�t. A state ent on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). l�L►+++ j-"" Stuart Insurance, Inc. 3070 S W Mapp Palm City FL 34990 Phone:772-286-4334 Fax:772-28 INSURED Dade Restaurant Repair Shop Inc Nelson Fleches 14042 N.W. 82nd Avenue Miami Lakes FL 33016 rnveowi±oe 389 ('GRTICI('ATF NI IMRFR- APR rrt"V. CUSTOMER ID #: D ER-1 INS RER(S) AFFORDING COVERAGE Owners Insurance Co INSURER B: Hridgefield Employers Ina. Co. INSURER C : INSURER D : INSURER E : INSURER F : REVISION NUMBER: NAIC # 18988 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE AUUL INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/1'YYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 PREMISES (Ea occurrence) $ 300000 A X COMMERCIAL GENERAL LIABILITY 72697785 07/17/10 07/17/11 MED EXP (Any one person) $ 10000 CLAIMS -MADE CJ OCCUR PERSONAL & ADV INJURY $ 1000000 X GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OPAGG s2000000 $ POLICY jE LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED AUTOS _ SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X J/ 1 PROPERTY DAMAGE (Per accident) $ $ 1 0 $ UMBRELLA LIAB OCCUR �? waft — EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEDUCTIBLE RETENTION $ $ l' ijz/ /� $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) 830065770000 04 01/11 04/01/12 X TORYLIMITS ER E.L.EACHACCIDENT $ 100000 E.L. DISEASE - EA EMPLOYEE $ 100000 E.L. DISEASE -POLICY LIMIT $ 500000 If yes, describe under DESCRIPTION OF OPERATIONS below A Motor Cargo 72697785 07/17/10 07/17/11 Motor 20000 Cargo DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) - Appliances -Commercial - CERTIFICATE HOLDER IS A NAMED INSURED WITH RESPECTS TO GENERAL LIABILITY AND AUTO LIABILITY. - - rFRTIFICATF MAI_nFR CANCELLATION C C C %_CA.1 l / SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE �"'C� MONRC-4 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. MONROE COUNTY BOARD OF COUNTY COMMISSIONERS AUTHORIZED REPRESENTATIVE Room #268 - Marie 1100 SIMONTON ST Y WEST FL 33040 © 88-2009 AC RATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD �Ro® CERTIFICATE OF LIABILITY INSURANCE OP ID SB =DATEDD/Y112/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMP the certificate holder Is an ADDITIONAL INSURED, the po icy(les) must be endorsed. 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). PRODUCER NAME: PHONE FAX JAJC, No, Ext : (A/C, No): Stuart Insurance, Inc. ADDRESS: 3070 S W Mapp CUSTOMERID#: DADER-1 Palm City FL 34990 INSURER(S) AFFORDING COVERAGE NAIC# Phone:772-286-4334 Fax:772-286-9 INSURED Dade Restaurant Repair ; Shop Inc p !kJ ERA: to Owners Insurance Co 18988 INSURER B: Biidgefield Employers Ina. Co. INSURERC: Nelson Fleches 14042 N.W. 82nd Avenue Miami Lakes FL 33016 JUL 1 4 1 RERD: INSURER E : INSURER F COVERAGES CERTIFICATE $UMBER: MONROE COUNTY I REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTE ED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F_x� OCCUR X 72697785 r 07/17/11 07/17/12 EACH OCCURRENCE $ 1000000 PREMISES(Ea occurrence) $ 300000 MED EXP (Any one person) $ 10000 PERSONAL BADVINJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY D PROJECT 7 LOC PRODUCTS - COMP/OPAGG s2000000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X / �) COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE If � _ EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 04/01/11 o4/oi/12 X A - TORY LIMITS ER E.L. EACH ACCIDENT $ 100000 E.L. DISEASE - EA EMPLOYEE $ 100000 E.L. DISEASE - POLICY LIMIT $ 500000 A Motor Cargo 1 1 72697785 1 07/17/11 07/17/12 Motor 20000 T Cargo DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) - Appliances -Commercial CERTIFICATE HOLDER IS A NAMED INSURED WITH RESPECTS TO GENERAL LIABILITY AND AUTO LIABILITY. - CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MONRC-4 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. MONROE COUNTY BOARD OF COUNTY COMMISSIONERS Room #268 - Marie 1100 SIMONTON ST KEY WEST FL 33040 riahts reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD