Certificates of Insurance
ACORDN CERTIFICATE OF LIABILITY INSURANC~~o~~l I DATE (MM/DDIYY)
12/29/00
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Roger Bouchard Insurance, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
101 Starcrest Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PO Box 6090 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Clearwater FL 33758-6090 INSURERS AFFORDING COVERAGE
Phone: 727-447-6481 Fax:727-449-1267 i
INSURED , INSURER A: FCCI INSURANCE CO
INSURER B:
DL Porter Construction, Inc INSURER c:
DL Porter Constructors Inc.
6574 Palmer Park Circle INSURER D:
Sarasota FL 34238
I INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I~f: TYPE OF INSURANCE POLICY NUMBER LIMITS
, GENERAL LIABILITY
: I COMMERCIAL GENERAL LIABILITY
ltJ W,., "'" iJ OCC",
GEN'L AGGREGATE LIMIT APPLIES PER:
rr8i LOC
~OMOBILE LIABILITY
W ANY AUTO
Ij~ ALL OWNED AUTOS
I SCHEDULED AUTOS
i : HIRED AUTOS
r~ '0'<0'"<0 ^"ro,
I GARAGE LIABILITY
r=j ANY AUTO
r~ ,. - r.
( c
i EXCESS LIABILITY
~J OCCUR 0 CLAIMS MADE
L DEDUCTIBLE
i RETENTION $
i WORKERS COMPENSATION AND I
A i EMPLOYERS' LIABILITY . 4 0 2 6 6
01/01/01
01/01/02
I OTHER
I dd/asst
EACH OCCURRENCE $
FIRE DAMAGE (Anyone fire) $
MED EXP (Anyone person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
, PRODUCTS - COMP/OP AGG $
COMBINED SINGLE LIMIT $
(Ea accident)
BODILY INJURY $
(Per person)
BODILY INJURY i$
(Per accident)
PROPERTY DAMAGE i$
(Per accident)
AUTO ONLY. EA ACCIDENT $
OTHER THAN EA ACC $
AUTO ONLY: AGG $
EACH OCCURRENCE $
AGGREGATE $
$
x
E.L. DISEASE - EA EMPLOYEE $ 10 0 0 0 0 0
E.L. DISEASE - POLICY LIMIT $ 1000000
DESCRIPTION OF OPERATIONSlLOCATlONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER IS ADDITIONAL INSURED ON ALL PHASES OF INSURANCE EXCEPT
WORKERS COMPENSATION ATTN: ANN MYTNIK
CERTIFICATE HOLDER
ADDITIONAL INSURED; INSURER LETTER:
CANCELLATION
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY
5100 COLLEGE RD
KEY WEST FL 33040
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO
DATE THEREOF, THE ISSUING INSURER 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
REPRESENT TIVES.
BOARD 0
ACORD 25-5 (7/97)
@ ACORD CORPORATION 1988
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endDrsed. A statement
on this certificate dDes not cDnfer rights tD the certificate hDlder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain pDlicies may
require an endDrsement. A statement Dn this certificate dDes not confer rights tD the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side Df this fDrm does not constitute a contract between
the issuing insurer(s), authorized representative Dr producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the cDverage affDrded by the policies listed thereon.
ACORD 25-5 (7/97)