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HomeMy WebLinkAboutCertificates of InsuranceGEICO GENERAL INSURANCE COMPANY Certificate of Insurance One GEICO Center Macon, GA 31295-0001 Named Insured and Address: Aim I z4 PO BOX 500333 MARATHON FL 33050-0333 Date of Certificate: 07-09-15 Policy Number: 0403-89-08-09 Policy Period: 06-04-15 to 12-04-15 (12:01 A.M. Local Time) (12:01 A.M. Local Time) Name and Address: MONROE COUNTY RISK MANAGEMENT 4WAl */A 1100 SIMINTON STKEY WEST FL 33040 C/ (This Certificate of Insurance does not amend, extend, or alter the coverage afforded by this policy.) During the term of coverages provided, the Company and the insured shall be bound by the provisions of the policy (or policies) of insurance in current use by the Company in the state. This is to certify that the captioned policy includes the limits specified herein for each person and for each occurrence under the Bodily Injury Liability Coverage; the limits specified herein for each occurrence under the Property Damage Liability Coverage; and limits specified herein for each person and for each occurrence for Bodily Injury under the Mir Uninsured Motorists Coverage. Description of Vehicle: 13 FORD 1FTFW1CFXDFD93779 Description of Vehicle: COVERAGE LIMITS OF COVERAGE LIMITS OF COVERAGE Bodily Injury Liability $100 M and $300 M $ M and $ M (Each Person) (Each Occurrence) (Each Person) (Each Occurrence) Property Damage Liability $ 50M $ (Each Occurrence) (Each Occurrence) Uninsured Motorists $ M and $ M $ M and $ M (Bodily Injury) (Each Person) (Each Occurrence) (Each Person) (Each Occurrence) INTERESTED PARTY We agree to provide you with written notice of termination in the event this policy becomes cancelled. Notice provided may be more than ten (10) days, but not less than ten (10) days. 0 0 8 8 8 0 00 Cl) 0 q U99 (9-07) 0 0 8 ADDITIONAL INSURED ENDORSEMENT 0 0 0 0 0 0 0 0 Named Insured and Address: Effective Date of Endorsement 01-03-02 ANTHONY D AND ANGELA D CULVER Policy Number 403-89-08 PO BOX 500761 MARATHON FL 33050-0761 Policy Period 11-16-01 (12:01 A.M. Standard Time) This policy includes coverages for which limits are shown below. Description of Car #1: 01 GMC 2GTEC19V911157825 Description of Car #2: Description of Car #3: COVERAGE Bodily Injury Liability M Property D mage Liability ri Uninsured Motorist (Bodily Injury) i� Personal Injury Protection CAR #1 $ 100 M and $ 300 M (each person) (each occurrence) $ 50M (each occurrence) $ 100 M and $ 300 M (each person) (each occurrence) $ BASIC LIMITS OF COVERAGE CAR #2 $ M and $ M (each person) (each occurrence) (each occurrence) $ M and $ M (each person) (each occurrence) $ to UNTIL TERMINATED (12:o1 A.M. Standard Time) JAN 1 5 2002 CAR #3 $ M and $ M (each person) (each occurrence) (each occurrence) $ M and $ M (each person) (each occurrence) ADDITIONAL INSURED These coverages also apply to the Additional Insured; but the limit of our liability is not increased by the inclusion of the Additional Insured. We will give the Additional Insured written notice in the event of any: 1. Cancellation; or 2. Material change in the liability coverages during the term of the policy. Name and Address of Additional Insured: BOARD OF CO COMMSIONERS 3583 SOUTH ROOSEVELT BLVD KEY WEST FL 33040 6Y S NgGEMENT AP BY DATE WAIVER NIA YES UE-30-A (3-91) Countersigned by Authorized Representative (X) 1996 Edition MONROE COUNTY, FLORIDA Request For Waiver of Insurance Requirements It is requested that the insurance requirements, as specified in the County's Schedule of Insurance Requirements, be waived or modified on the following contract. Contractor: (/Q-y I Contract for: tj -y SZ- r i 5 L L Address of Contractor: C) r7 6 f Phone: Scope of Work: Reason for Waiver: Policies Waiver will apply to: Signature of Contractor: �0� ) rI�t2- 9aC, -Say-L C e. S I N C It,, -A to q Al ka C.QSSAJ-U pp(1 e,s aKT) J,u`(�MQ-/J V2a,u-I r-> Fdt-yo�- -vA6'S riA� -JAr- t< V--A+ i-1 v N. S R l_ 6 u -fie ' y . VP 1), c Risk Management U rd Date County Administrator appeal: Approved: Not Approved: Date: Board of County Commissioners appeal: Approved: Not Approved: Meeting Date: Administration Instruction #4709.2 103 ACOR ,,M CERTIFICATE OF LIABILITY INSURANCE D/ 09/119/11/2002001 PRODUCER (305) 743-0494 FAX (305) 743-0582 Keys Insurance Agency, Inc. P.O. Box 500280 Marathon, FL 33050-0280 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 INSURED Anthony Culver PO BOX 500761 Marathon, FL 33050-0761 INSURER A: Terra Nova Ins Co INSURERB: CNA Surety Companies INSURERC: 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EF TIVE DATE MM/DD/YY LI Y N DATE MM/DD/W LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE D OCCUR NGL000531 07/05/2001 07/05/2002 EACH OCCURRENCE $ 300,0001 FIRE DAMAGE (Any one fire) $ 50,0001 MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ included GENERAL AGGREGATE $ 600,00 GENT AGGREGATE LIMIT APPLIES PER: PRO- POLICY LOC JECT PRODUCTS - COMP/OP AGG $ 300,00 AUTOMOBILE LIABILITY ANY AUTO Q M� 1`� COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS D Y A BODILY INJURY (Per person) $ HIRED AUTOS NON -OWNED AUTOS BY G YE A1V �� NI A BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY w " '1"' AUTO ONLY - EA ACCIDENT $ ANY AUTO �/ I��„� A J II' OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS LIABILITY OCCUR a CLAIMS MADE ! / ! EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY STA TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ BFidelity O.TIJER Bond 68634853 07/30/2001 07/30/2002 $10,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ertificateholder is additional insured with respect to liability as their interest may appear Monroe County Board of County Commissioners 5100 College Road Key West, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED EXPIRATION DATE THEREOF, THEZTE 10 DAYS WRI EN NOTICE T BUT FAILURE': MI SUCH NOTI OF ANY KIND UPON THE CUM —PAS ITS AUTHORIZED REPRESENTATIVE ICIES BE CANCELLED BEFORE THE O PANY WILL ENDEAVOR TO MAIL IFICATE HOLDER NAMED TO THE LEFT, IMPOSE NO OBLIGATION OR LIABILITY SITS OR REPRESENTATIVES. ACORDM CERTIFICATE OF LIABILITY INSURANCE ioiz9izooi PRODUCER (305) 743-0494 FAX (305) 743-0582 Keys Insurance Agency, Inc. P.O. Box 500280 Marathon, FL 33050-0280 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 INSURED Anthony Culver PO Box 500761 Marathon, FL 33050-0761 INSURER A: T.H.E. Insurance Company INSURER B: Western Surety Company INSURERC: 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATI N DATE MM/DD/YY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE M OCCUR OOM2SB4345 08/30/2002 08/30/2003 EACH OCCURRENCE $ 300,000 FIRE DAMAGE (Any one fire) $ 50,000 MED EXP (Any one person) $ Excluded PERSONAL & ADV INJURY $ 300,000 GENERAL AGGREGATE $ 600,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC JECT PRODUCTS - COMP/OP AGG $ 300,000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS APP Y�RISKr BY DATE NAGEMENT 1) // COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO / WAIVER N/A r AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT 1 $ B OT E T cej i ty Bond 8634853 07/30/2002 07/30/2003 $10,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ertificateholder is Loss Payee with respect to Liability as their interst may appear on the Bond ertificateholder is additional insured with respect to liability as their interest may appear. CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Monroe County Board of County Commissioners 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Attn Risk Management BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 1100 Simonton Street OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. Key West, FL 33040 AUTHORIZED REPRESENTATIVE Derek Martin-Veaue / /Z' 1h /'4 ACORD 25-S (7/97) ACORD. CERTIFICATE OF LIABILITY INSURANCE DA72972002 10/29/2002 PRODUCER (305) 743-0494 FAX (305) 743-0582 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Keys Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 500280 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Marathon, FL 33050-0280 INSURED Anthony Cu I ver PO Box 500761 Marathon, FL 33050-0761 INSURERS AFFORDING COVERAGE INSURERA: T.H.E. Insurance Compa INSURER B: Western Surety Company INSURER C: 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MWDD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS GENERAL LIABILITY OOM2SB4345 08/30/2002 08/30/2003 EACH OCCURRENCE $ 300,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE I OCCUR FIRE DAMAGE (Any one fire) $ 50,000 MED EXP (Any one person) $ Excluded A PERSONAL & ADV INJURY $ 300,000 GENERAL AGGREGATE $ 600,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY PROJECT LOC PRODUCTS - COMP/OP AGG $ 300,000 AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ HIRED AUTOS NON -OWNED AUTOS APP B K Mj MENT BODILYINJURY $ BY PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT $ $ GARAGE LIABILITY ANY AUTO WAIVER NIA ES OTHER THAN EA ACC $ $ AUTO ONLY: AGG EXCESS LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ! t� TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ e o•Tc�E i i el ty Bond 8634853 07/30/2002 07/30/2003 $10,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ertificateholder is additional insured with respect to liability as their interest may appear. Monroe County Board of County Commissioners Attn Risk Management 1100 Simonton Street Key West, FL 33040 SHOULD ANY OF THE ABOVE EXPIRATION DATE THEREO 10 DAYS WRIT EN N I BUT FAILURE TO MAI SU OF ANY KIND UPON THE C M AUTHORIZED REPRESENTATIVE :SCRIB POLICIES BE CANCELLED BEFORE THE ISSUICOMPANY WILLENDEAVOR TO MAIL O TH ERTIFICATE HOLDER NAMED TO THE LEFT, SHALL IMPOSE NO OBLIGATION OR LIABILITY NY, ITS AGENTS OR REPRESENTATIVES. (7/97) C G • e�cwwC�C. TION 1 ACORD,.. CERTIFICATE OF LIABILITY INSURANCE 10/15i2002 PRODUCER (305) 743-0494 FAX (305) 743-0582 Keys Insurance Agency, Inc. P.O. Box 500280 Marathon, FL 33050-0290 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 INSURED Anthony Culver PO Box 500761 Marathon, FL 33050-0761 INSURER A: T.H.E. Insurance Company INSURERB: Western Surety Company INSURER C: 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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATIONLTR LIMITS GENERAL LIABILITY BINDER 08/30/2002 08/30/2003 EACH OCCURRENCE $ 300,000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any one fire) $ 50,000 CLAIMS MADE D OCCUR MED EXP (Any one person) $ Exclude PERSONAL & ADV INJURY $ include A GENERAL AGGREGATE $ 600,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 300,000 POLICY PRO LOC JECT 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) $ t��Am A - GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ ANY AUTO WAIVER N/A YES _�.�... $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE U AGGREGATE $ $ DEDUCTIBLE � ) $ $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY C U- O - TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E. L. DISEASE -POLICY LIMIT $ Bond 8634853 07/30/2002 07/30/2003 $10,000 B [Ide)ity DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ertificateholder is additional insured as their interest may appear 1 u 12. 2 j C .. F,y -E-b�4,. I cm I Irl{iN I G nwa wv m I I ADDITIONAL INSURED: INSURER LETTER: %IMMICL -M i IVIY Monroe County Board of County Commissioners 1100 Simonton Street Key West, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN N ICE TO E CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SU H NOTICE HALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE C MFA Y, AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATI ACORD 25-S (7/97) ACORD�, CERTIFICATE OF LIABILITY INSURANCE 09/12/2002 PRODUCER (305) 743-0494 FAX (305) 743-0582 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Keys Insurance Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 500280 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Marathon, FL 33050-0280 INSURERS AFFORDING COVERAGE ,INSURED Anthony Cu I ver PO Box 500761 Marathon, FL 33050-0761 INSURER A: T.H.E. Insurance INSURER B: INSURER C: INSURER D: INSURER E: GOVtKAULb 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. INTR A TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 7X OCCUR POLICY NUMBER BINDER 020830 POLICY EFFECTIVE A I 08/30/2002 POLICY EXPIRATION D M Y 08/30/2003 LIMITS EACH OCCURRENCE $ 300,000 FIRE DAMAGE (Any one fire) $ 50,000, MED EXP (Any one person) $ Excluded PERSONAL & ADV INJURY $ included GENERAL AGGREGATE $ 600,000 PRODUCTS - COMP/OP AGG $ 300,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC JECT AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS APPrff ov K MIAGEMENT COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO %) DATE WAIVER AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Wks- C EACH OCCURRENCE $ AGGREGATE $ $ WC STATU- TORY LIMITS ER O H- $ _ E.L. EACH ACCIDENT _ $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ertificateholder is additional insured as their interest may appear 1 - SHOULD ANY OF THE ABOVE BED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THER F, THE ISS ING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WE TE NOTICE TO T CERTIFICATE HOLDER NAMED TO THE LEFT, Monroe County Board of County Commissioners BUT FAILURE TOI SUCHNOTIC HALL IMPOSE NO OBLIGATION OR LIABILITY 3 583 S Roosevelt Blvd OF ANY KIND UP E C Y, ITS AGENTS OR REPRESENTATIVES. Key West, FL 33040 AUTHORIZEDREPRESE TATIV A 111[�WIPYAI TION 1988 ACORDM CERTIFICATE OF LIABILITY INSURANCE 11/13/2 0 ' PRODUCER (305) 743-0494 FAX (305) 743-0582 Keys Insurance Services, Inc. P.O. Box 500280 Marathon, FL 33050-0280 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 Anthony Culver DBA: Culver's Cleaning Co P . o . Box 500761 Marathon, FL 33050-0761 INSURERA: Bankers Insurance Company INSURERB: Western Surety Company INSURER C: INSURERD: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDINI 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 DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVIDDIYYIE POLICY EXPIRATION DATE IMM113DIYYI LIMITS GENERAL LIABILITY 090004892905300 08/30/2003 08/30/2004 EACH OCCURRENCE $ 300,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 50 000 CLAIMS MADE OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 300,000 A GENERAL AGGREGATE $ 600,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 300,000 POLICY PRO- LOC JECT AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ A �l ,� MANAIG&AUT PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY G yy •.... --- AUTO ONLY - EA ACCIDENT $ ANY AUTO DATE OTHER THAN EA ACC $ $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY '• k E. EACH OCCURRENCE $ OCCUR CLAIMSMADE AGGREGATE $ DEDUCTIBLE $ $ RETENTION $ WORKERS COMPENSATION AND WC STATU- OTH- TORY LIMITS EEL EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE (/� - E.L. DISEASE - EA EMPLOYEE $ OFFICER/MEMBER EXCLUDED? If yes, describe under rC'J` E.L. DISEASE - POLICY LIMIT $ SPECIAL PROVISIONS below B O,T E i ce�l i ty Bond 68634853 07/30/2003 07/30/2004 $10,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES ! EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS ertificateholder is additional insured with respect to liability, as their interest may appear. Monroe County Board of County Commissioners 1100 Simonton Street Key West, FL 33040 SHOULD ANY OF THE ABOVE DES EXPIRATION DATE THEREOF, THE 10 DAYS WRITTE OTICE T BUT FAILURE TO MAIL UCH NOTI OF ANY KIND UPON THE URE14 AUTHORIZED REPRESENTATIVE 'IES BE CANCELLED BEFORE THE �CER WILL ENDEAVOR TO MAIL ATE HOLDER NAMED TO THE LEFT, 'OSE NO OBLIGATION OR LIABILITY OR REPRESENTATIVES. ACORD 25 (2001/08) GG / ©ACORD CORPORATION 1988 DATE (MM/DD/YYYY ACORDM CERTIFICATE OF LIABILITY INSURANCE 1 09/29/2 0 PRODUCER (305) 743-0494 FAX (305) 743-0582 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Keys Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 500280 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Marathon, FL 33050-0280 INSURERS AFFORDING COVERAGE NAIC # INSURED Anthony Culver INSURERA: Bankers Insurance Company DBA: Culver's Cleaning Co INSURERS: Western Surety Company P . o . Box 500761 INSURER C: Marathon, FL 33050-0761 INSURERD: INSURER E: _AVFRAnPA THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIN, 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 DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDDIYYI POLICY EXPIRATION DATE (MM/DD/YY1 LIMITS GENERAL LIABILITY 090004892905300 08/30/2004 08/30/2005 EACH OCCURRENCE $ 1,000,009 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 50 00 CLAIMS MADE a OCCUR MED EXP (Any one person) $ S,000 A X PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000 POLICY`F_j PROJECT LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ DILY INJURY r person) $ ALL OWNED AUTOS SCHEDULED AUTOS lip GEM HIRED AUTOS NON -OWNED AUTOS A� F+ ` ..... `1v p T ...._---- v ""` ILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY r) I AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO �� $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND WC STATU- OTH- EEL EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ oT E i ty Bond 68634853 07/30/2004 07/30/2005 $10,000 e i �7el DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ertificateholder is additional insured as their interest may appear. ZVI. VI) �..,. Monroe County Board of County Commissioners 1100 Simonton Street Key West , FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING I ER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOT E TO THE RTIFI ATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH OTICE S LL I OSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INS ER, ITS S REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001108) ©ACORD CORPORATION 1988 1996 Edition MONROE COUNTY, FLORIDA Request For Waiver of Insurance Requirements It is requested that the insurance requirements, as specified in the County's Schedule of Insurance Requirements, be waived or modified on the following contract. Contractor: Contract for: Address of Contractor: TO, boy 5gl&i jv r I�NrA-1 % FI cv. 6&)a-- 0333 Phone: "705' q`isi- Le Scope of Work: 1 Reason for Waiver: P i k4t. PN , - V2h;Cle. n4 LL>-Y. ! owe"niti Policies Waiver PQr,S,, -i flW will apply to: Signature of Contractor: Approved ed Not Approved Risk Management Date -C)-'�3 County Administrator appeal: Approved: Not Approved: Date: Board of County Commissioners appeal: Approved: Not Approved: Meeting Date: Administration Instruction #4709.5 102 ACORD,a CERTIFICATE OF LIABILITY INSURANCE oiiis%z 0 ' PRODUCER (305)743-0494 FAX (30S)743-OS82 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Keys Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 500280 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR RECEIVE E COVERAGE AFFORDED BY THE POLICIES BELOW. Marathon, FL 33050-0280 ERS FFORDING COVERAGE NAIC # INSURED Anthony Culver INSUR RA: Bunkers Insurance Company 33162 DBA: Culver's Cleaning Company JUL 2 3 Jl SUR RB: PO Box 500761 INSUR R c: Marathon, FL 330SO-0761 D: r!n"dRnF COUNT INSURERE' 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. INSRADD- TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE imminintyyI LIMITS GENERAL LIABILITY 090004892905303 08/30/2006 08/30/2007 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS WOE � OCCUR DAMAGE TO RENTEDre, $ ZOO, OO $ 5,00 MED EXP (Any one person) A X PERSONAL S ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,00 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,00 POLICY PRO- ECIf E LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTO:i SCHEDULED AUTOS BODILY persorINJURY (Per person) $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Par accitlant) $ PROPERTY DAMAGE (Psraccident) $ " _ GARAGE LIABILITY �.� �Z�l AUTO ONLY - EA ACCIDENT $ ANY AUTO ,.. '. _. _..____. J OTHER THAN EA ACC $ - AUTO ONLY: AGO $ EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ $ DEDUCTIBLE I CI (�% $ RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY / L WC STATTOLIMU- OTH- E.L. EACH ACCIDENT $ ANY PROPRIETOWPARTNEWEXECUTWE OFFICERAMEMBER EXCLUDED? If yes. a under E.L. DISEASE - EA EMPLOYEE $ E. L. DISEASE -POLICY LIMIT I $ SPECIAALL PROVISIONS EeIow OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ertificateholder is additional insured as their interest may appear Monroe County Board of County Commissioners Attn: Risk Management 1100 Simonton Street Key West, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INS ER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NI(p TICE TO THE CE IFI ATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SU¢H NOTICE SH L IMP BE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE I Y RER ITS G QN REPRESENTATIVrx. AUTHORIZED REPRESENTATIVE Lourdes Montane AI VKV ZA(ZUUI/UV) OACORD CORPORATION 1988 ACORDM CERTIFICATE OF LIABILITY INSURANCE 07/18/z 0 ) PRODUCER (305) 743-0494 FAX (30S) 743-0582 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Keys Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE OLDER.-7 IS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 500280 -1 C F1LTER TH COVERAGE AFFORDED BY THE POLICIES BELOW. Marathon, FL 33050-0280 R,E( DIV INSURED DBA: Culver's Cleaning Co P.D. Box 500761 Marathon, FL 33050-0761 ______— N UR LJUL 2 3 : NSURER RER NSURER. RS AFFORDING COVERAGE MONROE COU ,..JF"nANAOFM RfURER E'. NAIC # 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 - KM TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION118. LIMITS GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE OCCUR $ MED UP (Any one person) PERSONAL S ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMI F APPLIES PER PRODUCTS - COMP/OP AGG $ POLICYPRO- ECT OC AUTOMOBILE LIABILITY ANY AUTO (Ea accident51NGLE LIMIT $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANV AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY OCCUR ❑ CLAIMS MADE �. 1^ 999y j11 EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE — ... _. $ RETENTION $ $ WORKERS COMPENSATION AND "' WC STATUCRY LIM - I OTH- EMPLOYERS' LIABILITY 1 E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED'! If yea, tlesmbe under L E. L. DISEASE -EA EMPLOYE $ E. L. DISEASE -POLICY LIMIT $ SPECIAL PROVISIONS below A OTH R mp oyee Dishonesty 68634853 07/30/2007 D7/30/2008 $10, 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, HE IS/HETI ER WILL ENDEAVOR TO MAIL Monroe County Board of County Commissioners lO DAYS WRITTEN NOTI TO ICATE HOLDER NAMED TO THE LEFT, Attn: Risk Management BUT FAILURE TO MAIL SUCH OTICEOS OOBLIGATION OR LIABILITY 1100 Simonton Street OF ANV HIND UPON THEINS RERITO EPRESENTATIVES. Key West, FL 33040 AUTHORIZED REPRESENTATIVE Al Umu ZO �l�UUI/UO) CACORD CORPORATION 1988 cc / ,_ GEICO GENERAL INSURANCE COMPANY Certificate of Insurance P.O. BOX 33040 Lakeland, FL 33807-3040 1 CI Named Insured and Address: ANTHONY D AND ANGELA D CULVE - PO BOX 500333 p, MARATHON FL 33050-0333 _ Name and Address: MONROE COUNTY RISK MANAGEMENT BOARD OF COUNTY COMMISSIONERS 1100 SIMONTON ST KEY WEST FL 33040 Date of Certificate: 12-24-07 Policy Number:0403-89-08-09 Policy Period:12-04-07 to 06-04-08 (12:01 A.M. Local Time) (12:01 A.M. Local Time) (This Certificate of Insurance does not amend, extend, or alter the coverage afforded by this policy.) During the term of coverages provided, the Company and the insured shall be bound by the provisions of the policy (or policies) of insurance in current use by the Company in the state. This is to certify that the captioned policy includes the limits specified herein for each person and for each occurrence under the Bodily Injury Liability Coverage; the limits specified herein for each occurrence under the Property Damage Liability Coverage; and limits specified herein for each person and for each occurrence for Bodily Injury under the Uninsured Motorists Coverage. Description of Vehicle: 06 FORD 1FTRW12W36KB23026 Description of Vehicle: COVERAGE LIMITS OF COVERAGE Bodily Injury Liability Property Damage Liability Uninsured Motorists (Bodily Injury) $ 100 M and $ 300 M (Each Person) (Each Occurrence) $50M (Each Occurrence) $ M and $ M (Each Person) (Each Occurrence) INTERESTED PARTY LIMITS OF COVERAGE $ M and $ M (Each Person) (Each Occurrence) $ (Each Occurrence) $ M and $ M (Each Person) (Each Occurrence) We agree to provide you with written notice of termination in the event this policy becomes cancelled. may be more than ten (10) days, but not less than ten (10) days. U99 (9-071 A Notice provide C f�j �4CO ,,M CERTIFICATE OF LIABILITY INSURANCE i1/28/200 ) PRODUCER (305) 743-0494 FAX (305) 743-0582 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Keys -insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 500280 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Marathon, FL 33050-0280 INSURERS AFFORDING COVERAGE NAIC # INSURED Anthony Cu ver WSURERA: Bankers Insurance Company 33162 DBA: Culver's Cleaning Company INSURER B. PO Box 500761 INsuRER c Marathon, FL 330SO-0761 NsuRERD: INSURER E'. GOVtKA 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. INSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS BM GENERAL LIABILITY 0900048929OS304 08/30/2007 08/30/2008 EACH OCCURRENCE s 1,000,000 DAMAGETORENTED $ lOO,000 X COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $ 5,000 CLAIMS MADE O OCCUR PERSONAL 8 A" INJURY $ 1,000,000 A A GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 1,000,000 POLICY PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) S HIREDAUTOS NOWOWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO r - AUTO ONLY -EA ACCIDENT $ OTHER��(�{ ACC EAAUTO III $ ONLY: AGG EXCESSIUMBRELLA LIABILITY -- _ EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE ` _ ---` DEDUCTIBLE $ $ RETENTION $ WC STATU- OTH- WORKERS COMPENSATION AND / p E.L. EACH ACCIDENT $ EMPLOYERS' LIABILITY '� q l ANY PROPRIETORIPARTNEWEXECUTIVE OFFICERIMEMBER EXCLUDED9 ` E.L. DISEASE - EA EMPLOYEE $ E. L. DISEASE - POLICY LIMIT $ It yes, describe undor SPECIAL PROVISIONS below Ix)� OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Monroe County BOCC PO Box 1026 Key West, FL 33041 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER 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 INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Acnan iR nnnvnm FAX: (305)295-3179 C C :_rµ-c�c. ©ACORD CORPORATION 1988 -ACOWTTM CERTIFICATE OF LIABILITY INSURANCE 10/21/20 s) PRODUCER (30S) 743-0494 FAX (305) 743-0582 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Keys Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 500280 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Marathon, FL 33050-0280 INSURERS AFFORDING COVERAGE NAIC # INSURED Anthony Culver INSURER A: Bankers Insurance Company 33162 DBA: Culver's Cleaning Company INSURERS: Western Surety PO Box 500333 INSURER Marathon, FL 33050-0761 INSURER D: NSURER E: VERA 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 MIRM TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATIOMWOGIYY3N LIMITS GENERAL LIABILITY 09000489290530S 08/30/2008 08/30/2009 EACH OCCURRENCE $ 1,000,00 DAMAGE TO RENTED $ 100,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR $ S,000 MED EXP (Any one person) PERSONAL BADVINJURY $ 1,000,00 A X GENERAL AGGREGATE $ 2,000,00 GEN1 AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000 POLICY PRJECOT 7 LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) BODILY INJURY $ ALL OWNED AUTOS SCHEDULED AUTOS (Par person) BODILY INJURY $ HIRED AUTOS NON -OWNED AUTOS (Per accident PROPERTY DAMAGE $ —.__.—_,�...__._.... ,.. (Per amident GARAGE LIABILITY ._ - AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE $ $ DEDUCTIBLE 1, (� RETENTION $ \ $ WORKERS COMPENSATION AND WC STATU- OTM- E.L. EACH ACCIDENT $ EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE E. L. DISEASE - EA EMPLOYE $ OFFICER/MEMBER EXCLUDED? 1 E.L. DISEASE -POLICY LIMIT 1 $ If yyes, describe under SPECIALPROVISIONS belm �- LOTH R 686348S3 07/30/2008 07/30/2009 10,000 mplloyee Dishonesty B ^l 0W DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CEIVEDV102008 FN Monroe County BOCC 3583 S. Roosevelt Blvd Key West, FL 33040 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 MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATWE ACORD 25 (2001I08) FAX: (305)Z95-3179 CACORD CORPORATION 1988 TM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 10/21/2008 PRODUCER (305) 743-0494 FAX (305) 743-0582 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Keys Insurance Services, Inc. P.O. Box 500280 Marathon, FL 33050-0280 I R C �_ ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ^� ERAGE AFFORDED BY THE POLICIES BELOW. 1) _ INWRERSIAFF DING COVERAGE NAIC # INSURED Anthony Culver DBA : Cul ver' s Cleaning Company E E B INSURERA: anke s Insurance Company 33162 ' IN B: Weste n surety PO Box 500333 INSURER C: Marathon, FL 33050-0761 - — - - -- 4NSURF_RD: . R 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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY 090004892905305 08/30/2008 08/30/2009 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,000 CLAIMS MADE M OCCUR MED EXP (Any one person) $ 51000 A X PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000 POLICY 7 PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) AGE LIABILITY AUTO ONLY - EA ACCIDENT $ANY OTHER THAN EA ACC $ AUTO P $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR F] CLAIMS MADE AGGREGATE $ DEDUCTIBLE _ � , 7 $ $ RETENTION $ WORKERS COMPENSATION AND �_� WC STATU- I OTH- TORY LIMITS ER EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYE $ OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER 68634853 07/30/2008 07/30/2009 10,000 Employee Dishonesty B DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Monroe County BOCC 1100 Simonton Street Key West, FL 33040 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 MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Lourdes Montagne ACORD 25 (2021/08) FAX: (305)295-3179 ©ACORD CORPORATION 1988 ec DATE ACORD-, CERTIFICATE OF LIABILITY INSURANCE 8/2oi2o 9 PRODUCER (305) 743-0494 FAX: (305) 743-0582 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Keys Insurance Services, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 5800 Overseas Hwy #43 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 500280 Marathon FL 33050-0280 INSURERS AFFORDING COVERAGE NAIC # INSURED IINSURER A: Bankers Insurance Co 33162 Anthony Culver, DBA: Culver's Cleaning Company PO Box 500333 Marathon FL 33050-0761 INSURER B: Western surety INSURER C: INSURER D: INSURER E: OVERAGES 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. A R A LIMITSMAY AVE E REDUCED PAID I POLICY EFFECTIVE POLICY EXPIRATION INSR ADD'L TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/YY LIMITS A X GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE � OCCUR 090004892905306 8/30/2009 8/30/2010 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES a occurrence $ 100,000 MED EXP An one person)$ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS- MP/ P A $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (Per accident) $ NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO } OTHER THAN A A AUTO ONLY: AGG $ $ EXCESS/UMBRELLA LIABILITY EACH OCCURRFNQF $ AGGREGATE $ OCCUR El CLAIMS MADE $ $ DEDUCTIBLE ' RETENTION WORKERS COMPENSATION AND Y 'TORY WC STATU- OTH- LIMITS -1 ER E.L. EACH ACCIDENT $ EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ If yes, describe under SPECIAL PROVISIONS below , B OTHER Bond 68634853 7/30/ 009 7/30/2010 gio,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER uAM#r_LLJ% I IVN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Monroe County Risk Management EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Board of County Commissioners 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT 1100 Simonton Street FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE Key West, FL 33040 INSURER, ITS AGENTS OR REPRESENTATIVES. FL UTHORIZED REPRESENTATIVE ourdes Montagne ., A^non ^f%00 OAT! ki 4ORR ACORD 25 (2001/08) INS025 (otoe).wa Page 1 of 2 AC"R" CERTIFICATE OF LIABILITY INSURANCE 9i�i2olo ) PRODUCER (305) 743-0494 FAX: (305) 743-0582 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Keys Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 5800 Overseas Hwy #43 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 500280 Marathon FL 33050-0280 INSURERS AFFORDING COVERAGE 1 NAIC # INSURED INSURER A Bankers Insurance Co 33162 Anthony Culver, DBA: Culver's Cleaning Company INSURERB:Western Surety PO Box 500333 INSURER C: INSURER D: .Marathoq FL 33050-0761 INSURERE: rnVFRAf.FR 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 OFSUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR- -DD' -- -- ----- _ - -- ---_- _-- _-_- _r- -- -POLICYEFFECTIVE ) POLICY EXPIRATION -- --_--- --_--- --- -- - - -- TR N R TYPE OF INSURANCE POLICY NUMBER DATE MM DD DATE IMMIDDfYYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE _�i $ 1,000,00.0 XCOMMERCIAL GENERAL LIABILITY � DAMAGE TO RENTED _PREMISES (Ea occurrences $ 100,00_ MED EXP (Any one person) '} $ 5, 000 A X I CLAIMS MADE I X-'.. OCCUR 090004892905307 8/30/2010 8/30/2011 PERSONAL & ADV INJURY $. 1, 000, 000 _. -. _PER: GENERAL AGGREGATE $ 2,000,000 GE N'L AGGREGATE LIMIT APPLIES PER:' PRODUCTS - COMP/OP AGG $ 11 OOO OOO r X POLICY —�PRO- JECT LOC I , AUTOMOBILE LIABILITYI COMBINED SINGLE LIMIT $ - ANY AUTO i, I, (Ea accident) _ ALL OWNED AUTOS BODILY INJURY _ SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ 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 OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ --- - - -. DEDUCTIBLE r $ RETENTION $ C $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N . - TORY LIMN____. J.. ER ANY PRO(Mandatory IETO i E.L. EACH ACCIDENT $ j/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ In E.L. DISEASE - EA EMPLOYEC; $ If yes, describe under,`- li - - -- _ - --- _ - - - -- SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ B OTHER 68634853 07/30/10 07/30/11 1 $10,000 Employee Dishonesty Bond DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS Monroe County Risk Management Board of County Commissioners 1100 Simonton Street Key West, FL 33040 L,ANL,r-LLA I IVn 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 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Lourdes Montagne AL;UKU 25 (ZUU9/U1) 01988-2009 ACORD CORPORATION. All rights reserved. INS025(200901) The ACORD name and logo are registered marks of ACORD ® DATE (MMIDDACO /YYYY) CERTIFICATE OF LIABILITY INSURANCE 9/7/2010 PRODUCER (305) 743-0494 FAX: (305) 743-0582 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION QN�Y._AdTHIS ERS NO RIGHTS UPON THE CERTIFICATE Keys Insurance Services, Inc. _ .44 C RTIFICATE DOES NOT AMEND, EXTEND OR 5800 Overseas Hwy #43 R LlFXX HE COVE GE AFFORDED BY THE POLICIES BELOW. P.O. Box 500280 _.____..__ _ __ 1 Marathon FL 33050-0280 INSURERS AFOORDI G COVERAGE NAIC # INSURED S�� INS EFL A ; n @rs nsuranCe CO 33162 Anthony Culver, DBA: Culver's Cleani g C pany INSURERS: _ PO Box 500333 NSNRERE: --- D;-r Marathon FL 3 3 0 5 0- 0761 — INsrtRERE vTHE 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. IN SR DD'L NSRD TYPELTR OF INSURANCE POLICY NUMBER POLICY EFFECTIVE T POLICY EXPIRATION LIMITS GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 PREM SES Ea occu ence $ 100,000 MED EXP (Any one person) __ $ 5,000 A X CLAIMS MADE �X OCCUR 090004892905307 8/30/2010 8/30/2011 PERSONAL & ADV INJURY _ $ 1,000,000 _J GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000 X POLICY PRO LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ( J 1 111 AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ _ AGGREGATE $ OCCUR El CLAIMS MADE $ 1 $ DEDUCTIBLE ! $ F RETENTION $ " WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORWARTNER/EXECUTIVE � OFFICERIMEMBER EXCLUDED? (Mandatory in NH) o� _7 1//J� L f �� (�� (J✓ WC STATT- OTRH- - - - E.L. EACH ACCIDENT EA E E.L. DISEASE EA EMPLOYE - $ - - $ E.L. DISEASE - POLICY LIMIT $ If yes, describe under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS GCK I IFI6A I r- rIVLUCK %,AIYVCLLA I IVIY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Monroe County Risk Management DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Board of County Commissioners NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 1100 Simonton Street Key West, FL 33040 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED REPRESENTATIVE Lourdes Montagne ACORD 25 (2009101) C 1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200901) The ACORD name and logo are registered marks of ACORD GEICO P.O. BOX 9105 Macon, GA 31208-9105 INSUR Certificate=�'kftlle.-- Named Insured and Address: ANTHONY D AND ANGELA D CULVER PO BOX 500333 MARATHON FL 33050-0333 Name and Address: MONROE COUNTY RISK MANAGEMENT BOARD OF COUNTY COMMISSIONERS 1100 SIMONTON ST KEY WEST FL 33040 Date of Certificate: 10-21-10 Policy Number:0403-89-08-09 Policy Period:12-04-10 to 06-04-11 (12:01 A.M. Local Time) (12:01 A.M. Local Time) (This Certificate of Insurance does not amend, extend, or alter the coverage afforded by this policy.) During the term of coverages provided, the Company and the insured shall be bound by the provisions of the policy (or policies) of insurance in current use by the Company in the state. This is to certify that the captioned policy includes the limits specified herein for each person and for each occurrence under the Bodily Injury Liability Coverage; the limits specified herein for each occurrence under the Property Damage Liability Coverage; and limits specified herein for each person and for each occurrence for Bodily Injury under the Uninsured Motorists Coverage. Description of Vehicle: 06 FORD 1FTRW12W36KB23026 Description of Vehicle: COVERAGE LIMITS OF COVERAGE Bodily Injury Liability $ 100 M and $ 300 M (Each Person) (Each Occurrence) Property Damage Liability $50M (Each Occurrence) Uninsured Motorists $ M and $ M (Bodily Injury) (Each Person) (Each Occurrence) INTERESTED PARTY LIMITS OF COVERAGE $ M and $ M (Each Person) (Each Occurrence) $ (Each Occurrence) $ M and $ M (Each Person) (Each Occurrence) We agree to provide you with written notice of termination in the event this policy becomes cancelled. Notice provided may be more than ten (10) days, but not less than ten (10) days. CG� U99 (9-07) DATE (MM/DD/YYYY) AC" CERTIFICATE OF LIABILITY INSURANCE 9/2/2011 R OF INFORMATION ONLIS THIS CERTIF ISSUED AS A MATTRMAT VEl_YEOR NEGATIVELY AMEND, EXTEND OR ALTER TAND CONFERS NOIHE GHTS COVERAGE AFFORDEDUPON THEATE BY THE POLICIES CERTIFICATE DOES NOT A BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZE REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. st be endorsed. If SUBROGATION IS WAIVED, subject to IMPORTANT: If the certificate holder is an A P rsement. statement on this certificate does not confer rights to the the terms and conditions of the policy, certain olicies m certificate holder in lieu of such endorsement( ). ON ACTLo rdes Montagne - PRODUCER NAME: -- (305)793-0582 PHONE 305)743-0494 _ �Fac Keys Insurance Services, Inc. C No Ext : --- -MAIL 1 ntagne@keysinsurance com- S ADDRESS: - - 5800 Overseas Hwy #43 PRODUCER 00005060 C T MER ID - - - P.O. Box 500280 - _ - INSURER(S) AFFORDING COVERAGE NAIC # Marathon _-_ FL 33050- 280 MONROE _ - T _ RISK MANAGEM WXURERA:B nkers Insurance Co - - �33162 INSURED - INSURERB _ ---- - -.- Anthony Culver, DBA.: Culver, s Cleaning Company INSURER C — — - PO Box 500333- INSURER E : _ -- -- -- Marathon FL 33050-0761 INSURER F: COVERAGES CERTIFICATE NUMBER:Master REVISION NUMBER: 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 AID CLAIMS. POLICY E DUCEDBY PPOLI Y E P LIMITS INSR AD L B POLICY NUMBER MM/DDIYYYY MM/DD/YYYY LTR TYPE OF INSURANCE 1 OOO 000 GENERAL LIABILITY EACH OCCURRENCE $ —! _! -- DAMAGE TO RENTED 100,000 PRE MISES(Ea occurrence)- X COMMERCIAL GENERAL LIABILITY 8/30/2011 8/30/2012 MED EXP (Any one person) $ - 5,000 1 090004892905308 A '- CLAIMS -MADE [X� OCCUR X I PERSONAL S ADV INJURY $ 1,000,000 -- I --__ GENERAL AGGREGATE �$— 2 , OOO , OOO PRODUCTS - COMP/OP AGG $ 2,000 , 000 GENT AGGREGATE LIMIT APPLIES PER: $ �X POLICY PRO LOC COMBINED SINGLE LIMIT $ AUTOMOBILE LIABILITY (Ea accident) 1 ANY AUTO BODILY INJURY (Per person)-� $ ALL OWNED AUTOS BODILY INJURY (Per accident) $- - SCHEDULED AUTOS PROPERTY DAMAGE $ r (Per accident) HIRED AUTOS —� NON -OWNED AUTOS �, $ AGGREGATE $ UMBRELLA LIAB OCCUR — $ EXCESS LIAB I � I --- ' - - - - - CLAIMS-MADE1 r 1 - �— �- �-- EACH OCCURRENCE � $ _ - It DEDUCTIBLE WC STATU- OTH- $ RETENTION $ WORKERS COMPENSATION L- - TRY LIMITAND EMPLOYERS' LIABILITY E.L. EACH I ACCIDENT $ Y!N r E.L. I 11 ANY PROPKIETORlPARTNER/EXECUTIVE N / A �i ^���-� I ---- OFFICER/MEMBER EXCLUDED? �_L,'r' . ISEASE_ - EA EMPLOYEE) $ (Mandatory in NH) I I I y_ /� If ves, describe under �.j'j I p A Lj�j/ ISEASE -POLICY LIMIT j $ DESCRIPTION OF OPERATIONS I LOCATIONS ! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, ifmore space is required) LC , r ! , ex �-e— SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County Risk Management Board of County commissioners AUTHORIZED REPRESENTATIVE 1100 Simonton Street Key West, FL 33040 Lourdes Montagne/XM ACORD 25 (2009109) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200909) The ACORD name and logo are registered marks of ACORD GEICO GEPERAL I C rtificate off Insurance P.O. BOX 9105 Macon, GA 31208-9105 Named Insured and Address: ANTHONY D AND ANGELA D CULVER PO BOX 500333 MARATHON FL 33050-0333 Name and Address: MONROE COUNTY RISK MANAGEMENT BOARD OF COUNTY COMMISSIONERS 1100 SIMONTON ST KEY WEST FL 33040 OCT 2 5 ?flil Date of Certificate:10-21-11 Policy Number: 0403-89-08-09 Policy Period: 12-04-11 to 06-04-12 (12:01 A.M. Local Time) (12:01 A.M. Local Time) (This Certificate of Insurance does not amend, extend, or alter the coverage afforded by this policy.) During the term of coverages provided, the Company and the insured shall be bound by the provisions of the policy (or policies) of insurance in current use by the Company in the state. This is to certify that the captioned policy includes the limits specified herein for each person and for each occurrence under the Bodily Injury Liability Coverage; the limits specified herein for each occurrence under the Property Damage Liability Coverage; and limits specified herein for each person and for each occurrence for Bodily Injury under the . Uninsured Motorists Coverage. Am) `ISK Description of Vehicle: 06 FORD 1 FTRW12W36KB23026WA Description of Vehicle: W YES — COVERAGE LIMITS OF COVERAGE LIMITS OF COVERAGE Bodily Injury Liability $100 M and $ 300 M $ M and $ M (Each Person) (Each Occurrence) (Each Person) (Each Occurrence) Property Damage Liability $ 50M $ (Each Occurrence) (Each Occurrence) Uninsured Motorists $ M and $ M $ M and $ M (Bodily Injury) (Each Person) (Each Occurrence) (Each Person) (Each Occurrence) INTERESTED PARTY We agree to provide you with written notice of termination in the event this policy becomes cancelled. Notice provided may be more than ten (10) days, but not less than ten (10) days. c—c. U99 (9-07) GEICO GE � i D One GEICO Center Macon, GA 31295-0001 APR 1 r; 2012 Named Insured and Address: MONROE COUNTYRISK MANAGEMENT ANTHONY D AND ANGELA D CULVER f" Date of Certificate: 04-21-12 PO BOX 500333 Policy Number: 0403-89-08-09 MARATHON FL 33050-0333 Policy Period: 06-04-12 to 12-04-12 (12:01 A.M. Local Time) (12:01 A.M. Local Time) Name and Address: MONROE COUNTY RISK MANAGEMENT BOARD OF COUNTY COMMISSIONERS gAYPPRO E 1100 SIMONTON ST W KEY WEST FL 33040 . Jt7 �iCj . � (,f� 1./ w, (This Certificate of Insurance does not amend, extend, or alter the coverage afforded by this policy.) During the term of coverages provided, the Company and the insured shall be bound by the provisions of the policy (or policies) of insurance in current use by the Company in the state. This is to certify that the captioned policy includes the limits specified herein for each person and for each occurrence under the Bodily Injury Liability Coverage; the limits specified herein for each occurrence under the Property Damage Liability Coverage; and limits specified herein for each person and for each occurrence for Bodily Injury under the Uninsured Motorists Coverage. Description of Vehicle: 06 FORD 1 FTRW12W36KB23026 Description of Vehicle: COVERAGE LIMITS OF COVERAGE Bodily Injury Liability $100 M and $ 300 M (Each Person) (Each Occurrence) Property Damage Liability $ 50M (Each Occurrence) Uninsured Motorists $ M and $ M (Bodily Injury) (Each Person) (Each Occurrence) INTERESTED PARTY LIMITS OF COVERAGE $ M and $ M (Each Person) (Each Occurrence) $ (Each Occurrence) $ M and $ M (Each Person) (Each Occurrence) We agree to provide you with written notice of termination in the event this policy becomes cancelled. Notice provided may be more than ten (10) days, but not less than ten (10) days. U99 (9-07) . l..� R CERTIFICATE OF LIABILITY INSURANCE D /DD/YYYY) 9/2/22/2011 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 ADDITIONAL INSURED, the policy(ies) 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 Keys Insurance Services, Inc. 5800 Overseas Hwy #43 P.O. Box 500280 Marathon FL 33050-0280 CONTACT Lourdes Montagne PHONE (305) 743-0494 A/C No: (305)743-0582 AIL ADDRESS:lmontagne@keysinsurance.com PRODUCER 00005060 INSURERS AFFORDING COVERAGE NAIC # INSURED Anthony Culver, DBA: Culverrs Cleaning Company PO Box 500333 Marathon FL 33050-0761 INSURERA:Bankers Insurance Cc 33162 INSURER B :Western Surety INSURERC: INSURER D INSURER E INSURERF: COVERAGES CERTIFICATE NUMBERMaster RFVISION N1IMRFR- 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 LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DDlYYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR X 090004892905308 8/30/2011 8/30/2012 DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PRI - LOC $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS 1 AP V" BY D CyiS(i EW �� COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ NON -OWNED AUTOS ��C G ) t �/ $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEDUCTIBLE $ $ RETENTION $ WORKERS COMPENSATION WC STATU- OTH- TR AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N / A FIR E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ B Fidelity Bond 68634853 7/30/2012 7/30/2013 $10,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Monroe County Risk Management Board of County Commissioners 1100 Simonton Street Key West, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Montagne/XM ACUKU zo (LUUa/ua) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200909) % The ACORD name and logo are registered marks of ACORD C_G; , -.� O CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 9/6/2012 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 ADDITIONAL INSURED, the policy(ies) 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 Keys Insurance Services 5800 Overseas Hwy #43 P.O. BOX 500280 Marathon FL 33050-0280 CONTACT g NAME: Lourdes Monta ne FAX PHONE0. Extj(305) 7 4 3 - 0 4 9 4 A/C No: (305)743-0582 ADMDRESS:lmontagne@keys insurance. com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Granada Insurance Company 16870 INSURED Anthony Culver, DBA: Culver's Cleaning Company PO BOX 500333 Marathon FL 33050-0761 INSURER B INSURERC: INSURERD: INSURER E INSURERF: COVERAGES CERTIFICATE NUMBERktaster REVISION NUMBER: 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. I NSRPOLICY LTR TYPE OF INSURANCE ADDL UBR POLICY NUMBER EFF MM DD/YYYY POLICY EXP MM DD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY :2 CLAIMS -MADE I —XI OCCUR X 0185FL00038609 8/30/2012 8/30/2013 EACH OCCURRENCE $ 1,000,000 DAMAGE ( RENTED PREMISES Ea occurrence $ 100 000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC PRODUCTS -COMP/OP AGG $ include $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS AP 0 E BY R GM ENT COM (Ea accidentSINGLE LIMIT BODILY INJURY (Per person) $ DA WAI 0� �,�(.�/1 �• t/i l BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB EXCESS LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE S AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A WC STATU- OTH- R ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County Risk Management Board of County Commissioners AUTHORIZED REPRESENTATIVE 1100 Simonton Street Key West, FL 33040 Lourdes Montagne ACORD 25 (2010/05) INS015 rmnnFi m ©1988-2010 ACORD CORPORATION. All rights reserved. The ACr1Rrl name and Innn arc rcnictcrnrl mnrlrc of Arr1Rr1 GEICO GENERAL INSURANCE COMPANY zo One GEICO Center Macon, GA 31295-0001 Named Insured and Address: ANTHONY D AND ANGELA D CUL PO BOX 500333 MARATHON FL 33050-0333 Name and Address: MONROE COUNTY RISK MANAGEMENT BOARD OF COUNTY COMMISSIONERS 1100 SIMONTON ST KEY WEST FL 33040 RECEIVED NOV - MONRTY :ISK MANANAGENIGEA9ENpate Of ertificate: 10-21-12 y mber:0403-89-08-09 Policy Period: 12-04-12 to 06-04-13 (12:01 A.M. Local Time) (12:01 A M. Local Time) vE _R4NT pA WAN (This Certificate of Insurance does not amend, extend, or alter the coverage afforded by this policy.) During the term of coverages provided, the Company and the insured shall be bound by the provisions of the policy (or policies) of insurance in current use by the Company in the state. This is to certify that the captioned policy includes the limits specified herein for each person and for each occurrence under the Bodily Injury Liability Coverage; the limits specified herein for each occurrence under the Property Damage Liability Coverage; and limits specified herein for each person and for each occurrence for Bodily Injury under the Uninsured Motorists Coverage. Description of Vehicle: 06 FORD 1 FTRW1 2W36KB23026 Description of Vehicle: COVERAGE LIMITS OF COVERAGE Bodily Injury Liability $ 100 M and $ 300 M (Each Person) (Each Occurrence) Property Damage Liability $ 50M (Each Occurrence) Uninsured Motorists $ M and $ M (Bodily Injury) (Each Person) (Each Occurrence) INTERESTED PARTY LIMITS OF COVERAGE $ M and $ M (Each Person) (Each Occurrence) (Each Occurrence) $ M and $ M (Each Person) (Each Occurrence) We agree to provide you with written notice of termination in the event this policy becomes cancelled. Notice provided may be more than ten (10) days, but not less than ten (10) days. GG � u cfZ U99 (9-07) �yl GEICO GENERAL INSURANCE COMPANY Certificate of Insurance One GEICO Center Macon, GA 31295-0001 Named Insured and Address: ANTHONY D AND ANGELA D CULVER PO BOX 500333 MARATHON FL 33050-0333 Name and Address: MONROE COUNTY RISK MANAGEMENT BOARD OF COUNTY COMMISSIONERS 1100 SIMONTON ST KEY WEST FL 33040 Date of Certificate: 04-21-13 Policy Number: 0403-89-08-09 Policy Period: 06-04-13 to 12-04-13 (12:01 A.M. Local Time) (12:01 A.M. Local Time) LIA BY GEMEDI bfj, yJ (This Certificate of Insurance does not amend, extend, or alter the coverage afforded by this policy.) During the term of coverages provided, the Company and the insured shall be bound by the provisions of the policy (or policies) of insurance in current use by the Company in the state. This is to certify that the captioned policy includes the limits specified herein for each person and for each occurrence under the Bodily Injury Liability Coverage; the limits specified herein for each occurrence under the Property Damage Liability Coverage; and limits specified herein for each person and for each occurrence for Bodily Injury under the Uninsured Motorists Coverage. Description of Vehicle: 06 FORD 1 FTRW12W36KB23026 Description of Vehicle: COVERAGE LIMITS OF COVERAGE Bodily Injury Liability $100 M and $300 M (Each Person) (Each Occurrence) Property Damage Liability $ 50M (Each Occurrence) Uninsured Motorists $ M and $ M (Bodily Injury) (Each Person) (Each Occurrence) INTERESTED PARTY LIMITS OF COVERAGE $ M and $ M (Each Person) (Each Occurrence) $ (Each Occurrence) $ M and $ M (Each Person) (Each Occurrence) We agree to provide you with written notice of termination in the event this policy becomes cancelled. Notice provided may be more than ten (10) days, but not less than ten (10) days. U99 (9-07) A� a CERTIFICATE OF LIABILITY INSURANCE 100�8/2 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 ADDITIONAL INSURED, the policy(ies) 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 Keys Insurance Services 5800 Overseas Hwy #43 P.O. BOX 500280 Marathon FL 33050-0280 NAME:C Lourdes zzMontagne PHONE (305)743-0494 FAX (305)743-0582 EMLE :lmontagneokeysinsurance.com INSURERS AFFORDING COVERAGE NAIC0 1 INSURERA:Granada Insurance Company6870 INSURED Anthony Culver, DBA: Culver's Cleaning Company PO Box 500333 Marathon FL 33050-0761 INSURER B:Wes tern Buret INSURERC: INSURERD: INSURER E : INSURERF: CAVFRArFS: CFRTIFICATF NIIMRFR-2013-2014 REVISION NUMBER: 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 TR TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP LIMITS GENERALUABILITY EACH OCCURRENCE $ 11000,000 DAMAGE TO RENTE15- PREMISES E $ 100,000 X COMMERCIAL GENERAL LIABILITY A CLAIMS -MADE OCCUR X OIBSPL00038609 /23/2013 /23/2014 MEDEXP(Anyone person) $ 51000 PERSONAL dADVINJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEWL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ included $ X POLICY PRO- LOC AUTOMOBILE LIABILITY COMBINEDNLIMIT E 1 BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) S ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PR PERTY DAMAGE Mar 1 S S UMBRELLA UAB EACH OCCURRENCE S HOCCUR AGGREGATE S EXCESS UAB CLAIMS -MADE DED RETENTION S 5 WORKERS COMPENSATION WC STATU- OTH. AND EMPLOYERS' UABIUI Y Y I N ANY PROPRIETORVARTNERIEXECUTIVE E.L.EACH ACCIDENT $ OFFICERWEMBER EXCLUDE DT r7 N / A (Mandatory in NH) E.L DISEASE - EA EMPLOYEE S M yes describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMB S B Fidelity Bond 8634853 /30/2013 /30/2014 SI0,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, N mom space is required) APP I K Mtivl DA CERTIFICATE HOLDER CANCELLATION -_4 =- I SHOULD ANY OF THE ABOVE DESCRIBED POLICIE>i aE CANCEL14D BE14RE THE EXPIRATION DATE THEREOF, NO L BE DELIVERED IN ACCORDANCE WITH THE POLICY PRO NS. Monroe County Risk Management Me M Board of County Commissioners AUTHORIZED REPRESENTA E CS 1100 Simonton Street Key West, FL 33040 v ACORD 25 (2010105) INS025 (2otomyot ©1988-2010 ACORD CORPORATION. All rights reserved.' The ACORD name and logo are registered marks of ACORD 9 GEICO GENERAL INSURANCE COMPANY Certificate of Insurance One GEICO Center Macon, GA 31295-0001 Named Insured and Address: ANTHONY D AND ANGELA D CULVER PO BOX 500333 MARATHON FL 33050-0333 Name and Address: MONROE COUNTY RISK MANAGEMENT BOARD OF COUNTY COMMISSIONERS 1100 SIMONTON ST KEY WEST FL 33040 Date of Certificate:10-21-13 Policy Number: 0403-89-08-09 Policy Period: 12-04-13 to 06-04-14 (12:01 A.M. Local Time) (12:01 A.M. Local Time) to I Ew *VEM Ord: CIL Cc.�tl-e (This Certificate of Insurance does not amend, extend, or alter the coverage afforded by this policy.) During the term of coverages provided, the Company and the insured shall be bound by the provisions of the policy (or policies) of insurance in current use by the Company in the state - This is to certify that the captioned policy includes the limits specified herein for each person and for each occurrence under the Bodily Injury Liability Coverage; the limits specified herein for each occurrence under the Property Damage Liability Coverage; and limits specified herein for each person and for each occurrence for Bodily Injury under the Uninsured Motorists Coverage. Description of Vehicle: 06 FORD 1 FTRW12W36KB23026 Description of Vehicle: COVERAGE LIMITS OF COVERAGE Bodily Injury Liability Property Damage Liability Uninsured Motorists (Bodily Injury) $100 M and $ 300 M (Each Person) (Each Occurrence) LIMITS OF COVERAGE $ M and $ M (Each Person) (Each Occurrence) $ - o ; (Each Occurrence) $ M and $ =' M (Each Person) (Each Ooe�rrence) 1 .r� - -_ a z INTERESTED PARTY We agree to provide you with written notice of termination in the event this policy becomes cancelled. Notice *vided may be more than ten (10) days, but not less than ten (10) days. $ 50M (Each Occurrence) $ M and $ M (Each Person) (Each Occurrence) 0 0 0 0 0 0 0 U99 (9-07) GEICO GENERAL INSURANCE COMPANY Certificate of Insurance One GEICO Center Macon, GA 31295-0001 Named Insured and Address: ANTHONY D AND ANGELA D CULVER PO BOX 500333 MARATHON FL 33050-0333 Name and Address: MONROE COUNTY RISK MANAGEMENT BOARD OF COUNTY COMMISSIONERS 1100 SIMONTON ST KEY WEST FL 33040 Date of Certificate: 04-21-14 Policy Number: 0403-89-08-09 Policy Period: 06-04-14 to 12-04-14 (12:01 A.M. Local Time) (12:01 A.M. Local Time) ,• 6M 40IP NT / (This'Gerfificate ofinsurance does not amend, extend, or alter the coverage afforded by this Policy:) During the. term Qfcoverages.Qrovided, the Company and the insured shall be bound by the provisions of the policy (or policies) of insurance in current use -by the Companlrin the state. This is to cefAfy that tha'captioned policy includes the limits specified herein for each person and for each occurrence under tht; Boy Injury Liability Coverage; the limits specified herein for each occurrence under the Property Damage Liability Cove ge; and limits specified herein for each person and for each occurrence for Bodily Injury under the Uninsured Motorists Coverage. I. Description of Vehicle: 06 FORD 1 FTRW12W36KB23026 Description of Vehicle: COVERAGE LIMITS OF COVERAGE Bodily Injury Liability $100 M and $ 300 M (Each Person) (Each Occurrence) Property Damage Liability $ 50M (Each Occurrence) Uninsured Motorists $ M and $ M (Bodily Injury) (Each Person) (Each Occurrence) INTERESTED PARTY LIMITS OF COVERAGE $ M and $ M (Each Person) (Each Occurrence) (Each Occurrence) $ M and $ M (Each Person) (Each Occurrence) We agree to provide you with written notice of termination in the event this policy becomes cancelled. Notice provided may be more than ten (10) days, but not less than ten (10) days. U99 (9-07) AC CERTIFICATE OF LIABILITY INSURANCE DATE {ii c10YYYV) 7/30/2014 CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS THIS DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES CERTIFICATE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED BELOW. THIS CERTIFICATE OF INSURANCE REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT, if the certificate holder Is an ADDITIONAL INSURED, the policy(iea) must be endorsed. If SUBROGATION IS WAIVED, subject to A on this certificate does not confer rights to the the terms and conditions of the policy, certain Policies may require an endorsement. statement certificate holder in lieu of such endorsements . NANTA T I.aurdes zzMoat agree PRODUCER Keys Insurance Services PRO181cNE , (305)743-0494 FAx (305)743-05e2 5800 Overseas' Hwy #43 Apngl .imontagae keysinaurance.com p,0. Box 5002$0 INSURERS) AFFORDING COVERAGE NAIC11. Marathon FL 33050-0280 INSURER A.,Granada Insurance 0 16870 INSURED INSURERS.: western Surety INSURER C t Anthony Culver, DBA: Culver' s Cleaning Company p0 BOX 50033.3 INSURERD: INSURER. E.:. 1 INSURER F: NfiFIIMRr Marathon FL 33050-0761 _. __.__ COVERAGES CERTIFICATE NUMBER'4— -�,-- " BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED OF ANY CONTRACT OR OTHERDOCUMENT WTH RESPECT TO WHICH THIS INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL. THE TERMS. CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, EXCLUSIONS AND CONDITIONS L POU Y EFF PLTUCY EXP LIMITS N8RLTR TYPE OFiNSURANCE POLI Y NUMBER M r N M! rY 5 1,000,000 GENERAL LIABILITY r--l00 000 X COMMERCIAL GENERAL LIABILITY�r �1�3jZD13 /2�ixoza S S 5a000 A CLASS -MADE OCCUR X Ie5PLQ8i?3$609 WOrCURRENCE oneRe�semt ,. DVINJURY S 1,000,000 REGATE S 2,000,000 OMPtAPAGG S include dl GEN1 AGGREGATE LIMIT APPLIES PER S X POLICYJ71 PRO- LOC COMBINE SINOL LIMIT AUTOMOBILE LIAMLITY — BODILY INJURY (Per Person) S ANY AUTO. ALL O+i.NEA SCHEDULED HOAILY INJURY (Forax4e4st) AUTOS 4V PROPERTY DAMAGE S NO NNEA P HIRED AUTOS AUTOS S UMBRELLA U0.a OCCUR EACH OCCURRENCE S S ' EXCESS LIAS CLAiMtS4AADE AGGREGATE S $ DED:. RETENTIONS WORKERS COMPENSATION I § STATU- OTH- , T AND EMPLOYERV LIYIN £.L. EACH ACC➢GENT S ANY PROPRIETORiPARTNEWtEXECUTIVE OFF?C£RIMEMBER EXCLUDED? ^j NIA £.L DISEASE - EA EMPLOYE S — --- E L DISEASE - POLICY LIMIT S StA, (Mandatory In NH) I(yyes daw-e radar DESCRIPTION OF OPERATIONS Cek;w I 8634053 /301�024 l30l2415 B 81d t and O �y LA- DESCRIPTI F DP: nON3 f LO NS I VEHICLES (Attach ACORD I01, Additional Remarks Schedule, if morn space Is required) V NAGEMENT O '� V $Y 1 pl,D�'� W Q W — L- '► =r C race r ..� !: L SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRA N DATE THERE NOTICE WILL BE DELIVERED IN ACCORDAN WITH THE P ROVISi S. Monroe County Risk Management Board. of County Commissioners AUTHORIZEDR R NTAnvE 1100 Simonton Street Key West, FL 33040 1% e022-'JA A AnnAn CORPORATION. All riahts reserved. ACORD 25 (2010105) INS025 po'=5) 01 The ACORD name and logo are registered marks of ACORD ACC)R f® CERTIFICATE OF LIABILITY INSURANCE ATE 4 D/26/IDD/Y2014 926/ 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 ADDITIONAL INSURED, the policy(ies) 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 Keys Insurance Services 5800 Overseas Hwy P.O. BOX 500280 Marathon FL 33050 CONTACT Lisa Rider NAME: PHONE . (305)743-0494 FAXAIC No): EMAILADDRESS,lrider@keys insurance. com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Granada Insurance Company 16870 INSURED Anthony Culver, DBA: Culver's Cleaning Company PO BOX 500333 Marathon FL 33050-0761 INSURER B:Wes tern Surety INSURE RC: INSURERD: INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:2014-15 Master GL REVISION NUMBER: 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 LTR OF INSURANCE ADDLSTYPE U R POLICY NUMBER POLICYIYYYYI EFF MM/ ICY YXY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence) $ 100,000 A CLAIMS -MADE 7OCCUR X 0185FL00038609 8/2 3/20 14 8/23/2015 MED EXP (Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ include $ T POLICY PRO LOC AUTOMOBILE LIABILITY CEa aOMBINEDccident SINGLE LIMIT BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PPROPEcRT (DAMAGE $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION WC STATU- O R LIMIT AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE r—I OFFICER/MEMBER EXCLUDED? u N i A E.L. EACH ACCIDENT $ (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ I E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below B Bond 68634853 /30/2014 /30/2015 Employee Dishonesty 10,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) A MEW APA. WAIVE /Ace l.tK I IFIt+A I t MULUtK %,AIYVCLLA I IVry Monroe County Risk Management Board of County Commissioners 1100 Simonton Street Key West, FL 33040 ACORD 25 (2010/05) INS025 (201005).01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Grimi Betancourt/LISA 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD GEICO GENERAL INSURANCE COMPANY Certificate of Insurance One GEICO Center Macon, GA 31295-0001 Named Insured and Address: ANTHONY D AND ANGELA D CULVER PO BOX 500333 MARATHON FL 33050-0333 Name and Address: MONROE COUNTY RISK MANAGEMENT BOARD OF COUNTY COMMISSIONERS 1100 SIMONTON ST KEY WEST FL 33040 Date of Certificate:10-21-14 Policy Number: 0403-89-08-09 Policy Period: 12-04-14 to 06-04-15 (12:01 A.M. Local Time) (12:01 A.M. Local Time) SEWNT 4WAJNJ;*1�.zV—M � ec. _ (This Certificate of Insurance does not amend, extend, or alter the coverage afforded by this policy.) During the term of coverages provided, the Company and the insured shall be bound by the provisions of the policy (or policies) of insurance in current use by the Company in the state. This is to certify that the captioned policy includes the limits specified herein for each person and for each occurrence under the Bodily Injury Liability Coverage; the limits specified herein for each occurrence under the Property Damage Liability Coverage; and limits specified herein for each person and for each occurrence for Bodily Injury under the Uninsured Motorists Coverage. Description of Vehicle: 06 FORD 1 FTRW12W36KB23026 Description of Vehicle: COVERAGE LIMITS OF COVERAGE Bodily Injury Liability $100 M and $ 300 M (Each Person) (Each Occurrence) Property Damage Liability $ 50M (Each Occurrence) Uninsured Motorists $ M and $ M (Bodily Injury) (Each Person) (Each Occurrence) INTERESTED PARTY LIMITS OF COVERAGE $ M and $ M (Each Person) (Each Occurrence) s (Each Occurrence) $ M and $ M (Each Person) (Each Occurrence) d 1� A1N►103 308NOW 3 `813 'N11 We agree to provide you with written notice of termination in the event this policy becomes cancelled. Notice provided may be more than ten (10) days, but not less than ten (10) days. Ch :6 WV E— 330 biol 08003� 80.4 0311J U99 (9-07) ACC>RV CERTIFICATE OF LIABILITY INSURANCE IdMlDDrrYYY) 71U1,2118/2016_ 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 ADDITIONAL INSURED, the policy(los) 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 endorsements . PRODUCER ^ Angel Yarbrough Keys Insurance Services PHONE (305) 743-0494 FAIC . (305)743-0582 'MOIL DOREft 5800 Overseas Hwy INSURER B AFFORDING COVERAGE NAIC a P.O. Box 500280 INSURERA:Granada Insurance Company 16870 Marathon FL 33050 INSURED INSURERB:Woutern Surety INSURERC: Anthony Culver, DBA: Culver's Cleaning Company INSURERD: PO Box 500333 INSURER E - INSURER F: Marathon FL 33050-0761 rn�rcowncc CFDTIFICATF NI IMRFR•2015-16 tdauter GL REVISION NUMBER: 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. INSRLTR TYPE OF INSURANCE SUBRI POLICY NUMBER POLICY EPF POLICY WhDrfyrn UMIT8 X I COMMERCIAL GENERAL LJABILITY EACH OCCURRENCE 3 1,000,000 A CLAIMS -MADE I —XI OCCUR PREMISES (Ea $ 100,000 µED EXP (Any ana 3 5,000 X 0185FL00038609 8/23/2015 8/23/2016 PERSONAL SADVINJURY S 1,000,000 GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 1 3 2,000,000 PRODUCTS - COMP/OP AGG 3 included X POLICY ❑ PRO ❑ LOC 3 JECT OTHER: COMBINED SINGLE LIMB 3 AUTOMOBILE LIABILITY BODILY INJURY (Per Person) 3 ANY ALTO BODILY INJURY (Per accWam) 3 ALL OHNED SCHEDULED AUTOS AUTOS OOWNED PROPERTY DAMAGENON- Per $ HIRED AUTOS AUTOS 3 I 1 UMBRELLA LIAR OCCUR EACH OCCURRENCE 3 HCLALMS-MADE AGGREGATE 3 EXCESS L1AB DED I I RETENTIONS PER OTH- $ WORKERS COMPENSATION TATUTE E.L.__1 EACH ACCIDENT 3 AND EMPLOYERS' LLABILJTY Y I N J ANY PROPRIETORIPARTNER/EXECUTIVE E.L DISEASE - EA EMPLOYE $ OFFICER/MEMBER EXCLUDED? N I A (Mandatory In NH) E.L DISEASE -POLICY LIMIT 3 yya8s, ooscnoeHH) DESCRIPTION OF OPERATIONS below I B Bond i I 68634853 1/30/2015 7/30/2016 Employee Dishonesty 10,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, AddlUona{ Remarks Schedolo, may boa hed H more space Is mgLdmd) PPRO ' NA(`EMENT B WAIVER �� ' "v YESJ(Jj N7A _ �(►" .�( NOW Monroe County Ri k •ManageM29Vr P10 Board of County C9, is8ioners 1100 Simonton St3cee -3a GUJ Key West, FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 26 (2014101) iNS025 (201401) imi Betancourt/LZSA w to The ACORD name and logo are registered marks of ACORD GEICO GENERAL INSURANCE COMPANY Certificate of Insurance One GEICO Center Macon, GA 31295-0001 Named Insured and Address: ANTHONY D AND ANGELA D CULVER PO BOX 500333 MARATHON FL 33050-0333 Name and Address: MONROE COUNTY BOCC 1100 SIMINTON ST KEY WEST FL 33040 Date of Certificate:04-21-16 Policy Number: 0403-89-08-09 Policy Period: 06-04-16 to 12-04-16 (12:01 A.M. Local Time) (12:01 A.M. Local Time) APPR BY _ME Y NT WAIVER (This Certificate of Insurance does not amend, extend, or alter the coverage afforded by this policy.) During the term of coverages provided, the Company and the insured shall be bound by the provisions of the policy (or policies) of insurance in current use by the Company in the state. This is to certify that the captioned policy includes the limits specified herein for each person and for each occurrence under the Bodily Injury Liability Coverage; the limits specified herein for each occurrence under the Property Damage Liability Coverage; and limits specified herein for each person and for each occurrence for Bodily Injury under the Uninsured Motorists Coverage. Description of Vehicle: 13 FORD 1FTFWlCFXDFD93779 Description of Vehicle: COVERAGE LIMITS OF COVERAGE Bodily Injury Liability Property Damage Liability $100 M and $ 300 M (Each Person) (Each Occurrence) $ 50M (Each Occurrence) LIMITS OF COVERAGE $ M and $ M (Each Person) (Each Occurrence) (Each Occurrence) Uninsured Motorists $ M and $ M $ M Person) (Each Occurrence) (Each Person) and $ M (Each currence)� '_' r (Bodily Injury) (Each z -o m INTERESTED PARTY M� We agree to provide you with written notice of termination in the event this policy becomes card. N No�ice pfbvided may be more than ten (10) days, but not less than ten (10) days. U99 (9-07)