Certificate of Insurance CERTIFICATE OF COVERAGE
Certificate Holder Administrator Issue Date 1/24/23
UH US BIG PINE 2019 LLC Florida League of Cities,Inc.
C/O DOCUTRAX Department of Insurance Services
P.O.Box 538135
8 WOOD HOLLOW ROAD,SUITE 201 Orlando,Florida 32853-8135
PARSIPPANY,NJ 07054
COVERAGES
THIS IS TO CERTIFY THAT THE AGREEMENT BELOW HAS BEEN ISSUED TO THE DESIGNATED MEMBER FOR THE COVERAGE 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 COVERAGE AFFORDED BY THE AGREEMENT DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH AGREEMENT
COVERAGE PROVIDED BY: FLORIDA MUNICIPAL INSURANCE TRUST
AGREEMENT NUMBER: FMIT 0386 COVERAGE PERIOD: FROM 10/1/22 COVERAGE PERIOD: TO 10/1/23 12:01 AM STANDARD TIME
TYPE OF COVERAGE-LIABILITY TYPE OF COVERAGE-PROPERTY
General Liability ❑ Buildings ❑ Miscellaneous
❑X Comprehensive General Liability,Bodily Injury,Property Damage, ❑ Basic Form ❑ Inland Marine
Personal Injury and Advertising Injury ❑ Special Form ❑
Electronic Data Processing
❑X Errors and Omissions Liability ❑ Personal Property ❑ Bond
❑X Employment Practices Liability ❑ Basic Form
❑X Employee Benefits Program Administration Liability ❑ Special Form APPROVED BY RISK MANAGEMENT
❑X Medical Attendants'/Medical Directors'Malpractice Liability ❑ Agreed Amount
0 Broad Form Property Damage ❑ Deductible N/A DATE 1/712023
❑ Law Enforcement Liability ❑ Coinsurance N/A WAIVER N/A YES_
❑X Underground,Explosion&Collapse Hazard ❑ Blanket
Limits of Liability ❑ Specific
*Combined Single Limit ❑ Replacement Cost
Deductible N/A ❑ Actual Cash Value
Automobile Liability Limits of Liability on File with Administrator
❑X All owned Autos(Private Passenger) TYPE OF COVERAGE-WORKERS'COMPENSATION
❑X All owned Autos(Other than Private Passenger)
❑ Statutory Workers Compensation
❑X Hired Autos
❑ Employers Liability $1,000,000 Each Accident
❑X Non-Owned Autos $1,000,000 By Disease
$1,000,000 Aggregate By Disease
Limits of Liability ❑
Deductible N/A
*Combined Single Limit
❑X $500,000 Self Insured Retention
Deductible N/A
Automobile/Equipment-Deductible
❑X Physical Damage Per Schedule-Comprehensive-Auto Per Schedule-Collision-Auto NA-Miscellaneous Equipment
Other
The limit of liability is$5,000,000(combined single limit)bodily injury and/or property damage each occurrence in excess of a self-insured retention of$200,000.
This limit is solely for any liability resulting from entry of a claims bill pursuant to Section 768.28(5)Florida Statutes or liability/settlement for which no claims bill has
been filed or liability imposed pursuant to Federal Law or actions outside the State of Florida.
Description of Operations/Locations/Vehicles/Special Items
RE:Evidence of Insurance—201 Key Deer Blvd,Unit#82,Big Pine Key
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 AGREEMENT ABOVE.
Designated Member Cancellations
Monroe County Board of County Commissioners SHOULD ANY PART OF THE ABOVE DESCRIBED AGREEMENT BE CANCELED BEFORE THE EXPIRATION
DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 45 DAYS WRITTEN NOTICE TO THE
1111 12th Street Suite 408 CERTIFICATE HOLDER NAMED ABOVE,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO
OBLIGATION OR LIABILITY OF ANY KIND UPON THE PROGRAM,ITS AGENTS OR REPRESENTATIVES.
Key West FL 33040
AUTHORIZED REPRESENTATIVE
FMIT-CERT(10/2011)