6th Amendment 04/19/2023 lll
ra/ Ir02
THIS CERTIFICATE IS ISSUED AS A MATm.0 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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
The terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
PRODUCER IE M. DIAZ
DIAZ INSURANCE AGENCY �
100 Island Cottage Way Ste 20OF 23� 765®6571 (239�7Fa�m5214
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St Augustine, rL 32080
GREAT
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NNSN0*0 CLIFFHANGER C, PROGRESSIVE INSURANCE 10193
7283 1W 77th St GREAT AMERICAN INSKJRANCE C0I4PANY 35378
Medley, 33166 „. BURLINGTON INS CO
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DES CANCELLATION
Monroe
County Board of County
SHOU.UIL,D ANY OF:"rlHIE rr,VK)VE.DESCRIBED POLICIES BE(Al CIPLAIIEID IC%ff,G-LURE.
Commissioners TIRE IEXF"uWIGH DWAFIE rKEI EO , I4OPCr WWGG.N IRr IDELU II-IRED GIIW
1100 Simonton St ACCL,hIRDAN OE IWWrTrU TII-nlw°.Ir�kLua.
Key West, FL 33040
�kJ"U'N IEUWCIE'1CU IFrlk,r'RESE„NrVTdW'G'GV�IE
01088-2013 AaCORD CORFIORATION All rights reserved.
ACORD:Y 25(2013104) The ACIORD name and logo are registered marks of ACORD
Date
CERTIFICATE OF LIABILITY INSURANCE 1/12/2023
Producer: Plymouth Insurance Agency This Certificate is issued as a matter of information only and confers no
2739 U.S. Highway 19 N. rights upon the Certificate Holder. This Certificate does not amend,extend
Holiday, FL 34691 or alter the coverage afforded by the policies below.
(727)938-5562 1 Insurers Affording Coverage NAIC#
Insured: South East Personnel Leasing, Inc. &Subsidiaries Insurer A: Lion Insurance Company 11075
2739 U.S. Highway 19 N. Insurer B:
Holiday, FL 34691 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 ADDL Policy Effective Policy Expiration Limits
LTR INSRD Type of Insurance Policy Number Date(MM/DD/YY) Date(MM/DD/YY)
GENERAL LIABILITY Each Occurrence
Commercial General Liability Damage to rented premises(EA
Claims Made ❑ Occur occurrence)
Med Exp
Personal Adv Injury
General aggregate limit applies per:
General Aggregate
Policy ❑Project ❑ LOC
Products-Comp/Op Agg
AUTOMOBILE LIABILITY Combined Single Limit
(EA Accident)
Any Auto
Bodily Injury
All Owned Autos
(Per Person)
Scheduled Autos
Hired Autos "R�w Bodily Injury
AP ,
Non-Owned Autos 7. 12723
f "N'„ (Per Accident)
" ' 1'�w�f """"W�"°'."'""m`"' Property Damage
WC oI"11TT (Per Accident)
EXCESS/UMBRELLA LIABILITY WAS - Each occurrence
Occur ❑Claims Made Aggregate
Deductible
A Workers Compensation and x I WC Statu- OTH-
Employers'Liability WC 71949 01/01/2023 01/01/2024 tory Limits ER
Any proprietor/partner/executive officer/member E.L.Each Accident $1,000,000
excluded? NO
E.L.Disease-Ea Employee $1,000,000
If Yes,describe under special provisions below.
E.L.Disease-Policy Limits $1,000,000
Other Lion Insurance Company is A.M. Best Company rated A(Excellent). AMB# 12616
Descriptions of Operations/Locations/Vehicles/Exclusions added by Endorsement/Special Provisions: Client ID: 24-66-296
Coverage only applies to active employee(s)of South East Personnel Leasing,Inc.&Subsidiaries that are leased to the following"Client Company":
Cliffhanger Janitorial,Inc.
Coverage only applies to injuries incurred by South East Personnel Leasing,Inc.&Subsidiaries active employee(s) ,while working in: FL.
Coverage does not apply to statutory employee(s)or independent contractor(s)of the Client Company or any other entity.
A list of the active employee(s)leased to the Client Company can be obtained by emailing a request to certificates@lioninsurancecompany.com
Project Name: KEY WEST INTERNATIONAL AIRPORT 3491 S.ROOSEVELT BLVD.KEY WEST,FL.33040
ISSUE 01-12-23(KLT)
Be in Date:4 S 2015
CERTIFICATE HOLDER CANCELLATION
MONROE COUNTY BOARD OF 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
COUNTY COMMISSIONERS do so shall impose no obligation or liability of any kind upon the insurer,its agents or representatives.
1100 SIMONTON STREET ��
KEY WEST, FL 33040 �� _t_ .