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Certificate of Insurance DATE(MM/DD/YYYY) ACCOR" CERTIFICATE OF LIABILITY INSURANCE 3/11/2024 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 have ADDITIONAL INSURED provisions or 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 CONTACT NAME: Sarah Trltz Holmes Murphy&Associates PHONE FAX 2727 Grand Prairie Parkway A/C No Ext: 515-223-6813 A/C,No): E-MWaukee IA 50263 ADDRESS: stritz@holmesmurphy.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Travelers Indemnity Company 25658 INSURED GENASPPC INSURER B:Travelers Property Casualty Co.America 25674 General Asphalt Co, LLC INSURERC: Charter Oak Fire Insurance Company 25615 4850 NW 72nd Avenue Miami , FL 33166 INSURERD: Great American Insurance Company 16691 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1223703729 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD MM/DD A X COMMERCIAL GENERAL LIABILITY VTC2KC07W3485391ND24 2/1/2024 2/1/2025 EACH OCCURRENCE $2,000,000 CLAIMS-MADE � OCCUR DAMAGE TO RENTED PREMISES Ea occurrence) $300,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY� PE� LOC PRODUCTS-COMP/OP AGG $4,000,000 OTHER: $ B AUTOMOBILE LIABILITY VTC2JCAP7W348527TIL24 2/1/2024 2/1/2025 COMBINED SINGLE LIMIT $2,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident B UMBRELLALIAB X OCCUR CUP7W3485402525 2/1/2024 2/1/2025 EACH OCCURRENCE $2,000,000 X EXCESS LAB CLAIMS-MADE AGGREGATE $2,000,000 DED X RETENTION$1 n nnn $ C WORKERS COMPENSATION UB4X542098 11/1/2023 2/1/2025 X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTEI ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICE R/M EMBER EXCLUDED? FN] N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 D Excess Liability TUE025052412 2/1/2024 2/1/2025 Occur/Aggregate 10,000,000 B Leased/Rented Equipment QT6600VV264833TIL24 2/1/2024 2/1/2025 Limit 500,000 Contractors Equipment Limit Per Schedule DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: Card Sound Road Asphalt Milling& Resurfacing FIN Project No.449693-1-54-01 Monroe County BOCC, !ts employees and officials,and Florida Department of Transportation are included as Additional Insured on the General Liability and Auto Liability,on a Primary and Non-Contributory basis,when required by written contract with the insured,per policy terms and conditions. Waiver of Subrogation applies in favor of Additional Insureds on the General Liability,when required by written contract with the insured, per policy terms and conditions. By CERTIFICATE HOLDER CANCELLATION �311 244 ® SHOULD ANY OF TF WAN" E THE EXPIRATION _._._ _..__ __.__ __ ___.__.___ .N Monroe County BOCC ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonson St Key West FL 33040 AUTHORIZED REPRESENTATIVE USA @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD AC � CERTIFICATE OF LIABILITY INSURANCE 10/27/20 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 have ADDITIONAL INSURED provisions or 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 1-800-247-7756 CONTACT NAME: Holmes Murphy & Associates - WDM PHONE FAX A/C No Ext: A/C,No): E-MAIL PO Box 9207 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Des Moines, IA 50306-9207 INSURERA: ZURICH AMER INS CO 16535 INSURED INSURER B: General Asphalt Co, LLC INSURER C 4850 NW 72nd Avenue INSURERD: INSURER E Miami, FL 33166 INSURERF: COVERAGES CERTIFICATE NUMBER: 66996227 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD MM/DD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ OCCUR DAMAGE S( RENTED CLAIMS-MADE PREMISES Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: 'Ira, y �� GENERALAGGREGATE $ POLICY D jE� LOC PRODUCTS-COMP/OP AGG $ W ""•.�."'"OTHER: $ ANY AUTO l COMBINED SINGLE LIMIT $Ea accident AUTOMOBILE LIABILITY 2 23 BODILY INJURY(Per person) $ OWNED SCHEDULED N ' BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ PER A WORKERS COMPENSATION WC3757135 11/01/22 11/01/23 % STATUTE OE TRH- AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? IN I (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Project: Card Sound Road Asphalt Milling & Resurfacing FIN Project No. 449693-1-54-01 Monroe County BOCC, its employees and officials, and Florida Department of Transportation are included as additional insured with respect to general liability and auto liablity on a primary and non-contributory basis when required by written contract. Waiver of subrogation applies in favor of the additional insured with respect to general liability when required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County BOCC 1100 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Simonton Street ACCORDANCE WITH THE POLICY PROVISIONS. Key West, F1 33040 AUTHORIZED REPRESENTATIVE USA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD stritzwdsm 66996227 GENEASP-01 SSIMEON ACORO"° CERTIFICATE OF LIABILITY INSURANCE DATE(M/202YYY) 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 have ADDITIONAL INSURED provisions or 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 CONTACT Sandy Simeon NAME: Collinsworth,Alter,Fowler&French,LLC PHONE FAX 16060 NW 79th Court (A/C,No,Ext): (A/C,No): Suite 200 E-MAIL ssimeon@caffllc.com Miami Lakes,FL 33016 INSURER S AFFORDING COVERAGE NAIC# INSURER A:Travelers Indemnity Company 25658 INSURED INSURER B:Great American Insurance 16691 General Asphalt Company Inc. INSURER C:Travelers Property Casualty Co.of America 25674 P O Box 622306 INSURER D Miami,FL 33166 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD MMIDDIYYYY MMIDDIYYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE �X OCCUR X X VTC2KCO2N2542311ND23 2/1/2023 2/1/2024 DAMAGE PREMISES(Ea RENTED ence $ 300,000 MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: - GENERAL AGGREGATE $ 4,000,000 POLICY F JECT LOC I.ww. • 2 2 3 4,000,000 DA PRODUCTS-COMP/OP AGG $ OTHER A t $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 2,000,000 Ea accident $ X ANY AUTO X VTC2KCAP2N2541511ND23 2/1/2023 2/1/2024 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X HIRED IX NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident) ccident $ B X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 EXCESS LIAB CLAIMS-MADE T00026062411 2/1/2023 2/1/2024 AGGREGATE $ 10,000,000 DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Leased Rented QT6607S952638TIL23 2/1/2023 2/1/2024 w/$5000. Ded 500,000 C Scheduled Equip QT6607S952638TIL23 2/1/2023 2/1/2024 w/$5000. Ded 11,718,656 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Project:Card Sound Road Asphalt Milling&Resurfacing FIN Project No.449693-1-54-01 Monroe County BOCC,!ts employees and officials,and Florida Department of Transportation are included as additional insured with respect to general liability and auto liablity on a primary and non-contributory basis when required by written contract. Waiver of subrogation applies in favor of the additional insured with respect to general liability when required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe Count BOCC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street Key West,FI 33040 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD