Certificates of Insurance
"^,, "'M State Farm Mutual Automobile InsurancQ Company
$'l 7401 Cypress Gardens Boulevard .
~ Winter Haven FL 33888
50557.4.A MATCH 01095 MUTL VOL
"COpy" DECLARATIONS PAGE "COpy"'
PAGE 1 OF 2
IN~URAN(E
@
POLICY NUMBER
_ 8855229-D21-591
Policy Period from JAN 02 2002 to APR 21 2002
01095 59-2741-442A
COUNTY OF MONROE
5100 COLLEGE RD
KEY WEST FL 33040-4319
DO NOT PAY PREMIUMS SHOWN ON THIS PAGE.
SEPARATE STATEMENT ENCLOSED IF AMOUNT DUE.
AGENT
BILL BOWMAN INSURANCE AGCY INC
720 W INDIANTOWN ROAD
JUPITER, FL 33458-750'1
NAMED INSURED: FOSTER, DAVID DBA AMERICAN
PHONE: (561)746-5050 or (561)746-7202
2002
4DR
1030401
P10
No
'.7'.}1'.....''''.
I 'Total premium for thl. policy period. '.'" , "
'" $3Z6.15 this is not a bill.
IMeOR1'ANr'NlESSAG,~
Your policy consists of this declarations page, the policy booklet - form 9810.7, and any endorsements that apply, including
those issued to you with any subsequent renewal notice.
Replaced policy number 8855229-59H.
New Policy Form
Your total current 6 month premium for OCT 21 2001 to APR 21 2002 is $538.20.
For questions, problems or to obtain information about coverage call: (561 )746-5050.
APP~Y~ ~
BY_ .,,~. 'Mwl~
DATE -L'^3i>J- ~
WAIVER N/A~S /lfl n)
Dl~ ~ U!oLW
Olj-()-
LL, ~
~ L'll) m(~
CONTINUED
155-3866 12-1999 (01a025ha)
(01 a02520)
"'",, 'm State Farm Mutual Automobile Insurance Company
1$ 7401 Cypress Gardens Boulevard ,
~ 1 Winter Haven FL 33888 ' ,
IN\UIUl,loj(~j
50557-4-A MATCH 01095 MUTL VOL
"COpy" OECLARA liONS PAGE "COpy" I
PAGE20F2
POLICY NUMBER
885 5229-D21-591
Policy Period from JAN 02 2002 to APR 21 2002
,jli, '
01095 59-2741-442A
COUNTY OF MONROE
5100 COLLEGE RD
KEY WEST FL 33040-4319
, , ..-..".-".....-.-...----,.-..,',.,....
.-'" ',-', ...-.... ", ... ... ..", --.-.',-----.,,--..----- .... " . ...
.." EXCEe,..IONS~NDENOORSEM~N.iSe.h,dIV ", '",.
FINANCED- GMAC INSURANCE SERVICE CENTER, PO BOX 2525, HUDSON OH 44236-0025.
01 6028E.5 ADDITIONAL INSURED-COUNTY OF MONROE,5100 COLLEGE RD, KEY WEST
FL 33040-4319.
02 6028E.5 ADDITIONAL INSURED-CITY OF VERO BEACH, PO BOX 1389, VERO BEACH
FL 32961-1389.
01 6037F.11 CERTIFICATE OF INSURANCE-SOUTH FLORIDA WATER MANAGEMENT, PO BOX
24680 WEST PALM BCH FL 33416-4680.
02 60~7F.11 CERTIFICATE OF INSURANCE-CITY OF FT LAUDERDALE PUBLIC SVCS
DEPT/ENGINEERING, CITY HALL 100 N ANDREWS 4TH FLR, FORT LAUDERDALE FL
33301-1016.
03 6037F.11 CERTIFICATE OF INSURANCE-CITY OF VERO BEACH, PO BOX 1389, VERO
BEACH FL 32961-1389.
04 6037F.11 CERTIFICATE OF INSURANCE-BOARD OF COUNTY COMMISSIONER ATTN: KIM
MCGEE~ C/O RISK MANAGEMENT 5100 COLLEGE RD RM 207~ KEY WEST FL 33040-4319.
05 60~7F.11 CERTIFICATE OF INSURANCE-MONROE COUNTT BOARD OF COUNTY
COMMISSIONER, C/O RISK MANAGEMENT 5100 COLLEGE RD RM 410, KEY WEST FL
33040-4319.
6126EZ.1 AMENDMENT OF DEFINED WORDS - NO FAULT AND MEDICAL PAYMENT
COVERAGES.
Named Insured- FOSTER, DAVID DBA AMERICAN UNDERWATER CONTRACTORS 4196 RUSSELL ST TEQUESTA FL
33469-2632
155-3866 12-1999 (o1a025ha) (o1a0254b)
(o1a0257b)
"
,-
,
Agent: BILL BOWMAN INSURANCE AGCY INC
Telephone: (561}746-5050
Prepared JAN 07 2002 2741-594
"^H "'M State Farm Mutual Automobile Insurance Company
I t8 7401 Cypress Gardens Boulevard
I ~ . Winter Haven FL 33888
~ INSURAN(E
@
91688-4-A MATCH 00709 MUTL VOL
'COPY' DECLARATIONS PAGE 'COPy'l
POLICY NUMBER
__ 890 5775-C03-59E
Policy Period from FEB 01 2002 to SEP 03 2002
00709 59-2741-442A
COUNTY OF MONROE
5100 COLLEGE RD
KEY WEST FL 33040-4319
DO NOT PAY PREMIUMS SHOWN ON THIS PAGE.
SEPARATE STATEMENT ENCLOSED IF AMOUNT DUE.
AGENT
BILL BOWMAN INSURANCE AGCY INC
720 W INDIANTOWN ROAD
JUPITER, FL 33458-7507
NAMED INSURED: AMERICAN UNDERWATER
PHONE: (561 )746-5050 or (561 )746-7202
YEAR
2002
MAKE
DODGE
MODEL
DURANGO
BODY STYLE
SPORT WG
VEHICLE ID. NUMBER
1B4HR58Z62F109228
CLASS
1 L3H901
SYMBOLS
COVERAGES..,,"",""
;':.'. .
:... .~
, PREMIUMS
2002
DODGE
$254.53
, A.'
See polley for coverage details.
" '.'.,'..'... Bodily lojury/Propedy Damage Llabllity
Limits of
;;,-:;<:,,:;>:--:,-.,,("
,......,.,.$1.09..9.09...",. .".,"",..,.~~'O'O.,.'O'O9........,...,.,.",...\....,.,.'."."'."...""..'.'..,.".....,.',...'....'.
, .,.,Limitsof, L.iability~CoverageIN:)ropertYDamage
Each
f;::""..
Fault
Limit of
C
$94.99
""$$9.91
$20,000
:D500' '''$500Deductible'Comprehensive:.:""""
G500 "'" , m .$500Decjuctible Collision """""".,,"""m' ,..,...
~3 ......... · ~~ne~~a~~l:g R~~~~~~c~Olor. ~.hicl. ... ... .... r5~,fili.a:;. . . .... ~ 112. S 7
. LimitsofL.iability:O~f.""" ", Y~.2r
ifb~:bb~on!..:;g~:~gid.nl 'L i", K~ff~
I Total premium for this policy period. $777.44 This is not a bill. '
IIMPOROTANTMESSAGES',<<" .,.... .,.". .,
Your policy consists of this declarations page, the pOlicy booklet - form 9810.7, and any endorsements that apply, including
those issued to you with any subsequent renewal notice.
Replaced policy number 8905775-59D.
Your total current 6 month premium for MAR 03 2002 to SEP 03 2002 is $664.33.
For questions, problems or to obtain information about coverage call: (561 )746-5050.
EXCEPJ;lONSANDENDORSEMENTS.(See'lndlvlduillendorsement fol' details.)
FINANCED- CHRYSLER FINANCIAL COMPANY LLC, POBOX 958412, LAKE MARY FL
32795-8412.
6028E.5 ADDITIONAL INSURED-COUNTY OF MONROE, 5100 COLLEGE RD, KEY WEST FL
33040-4319.
6126EZ.1 AMENDMENT OF DEFINED WORDS - NO FAULT AND MEDICAL PAYMENT
COVERAGES.
Named Insured- AMERICAN UNDERWATER CONTRACTORS DBA SCUBA SCRUBBERS 4196 RUSSELL ST TEQUESTA
FL 33469-2632
155.3866 12-1999 (01a025ha) (01a0254b)
(01 A0252c)
Agent: BILL BOWMAN INSURANCE AGCY INC
Telephone: (561)746-5050
Prepared FEB 05 2002 2741-594
['&MJ
"'''....H.
00803 59-2741-442C
23385-4-C MATCH 00803 MUTL VOL
.COPY. DECLARATIONS PAGE .COPY.
PAGE 1 OF2
POLICY NUMBER 8855229-D21-59J
u~_un _un _.. "" ~... ~_ ,_ . .. ....~....__ . .._ ~__.
POLICY PERIOD JUL 29 2002 to OCT 21 2002
State Farm Mutual Automobile Insurance Company
7401 Cypress Gardens Boulevard
Winter Haven FL 33888
COUNTY OF MONROE
5100 COLLEGE RD
KEY WEST FL 33040-4319
NAMED INSURED: FOSTER, DAVID DBA AMERICAN
AGENT
BILL BOWMAN INSURANCE AGCY INC
720 W INDIANTOWN ROAD
JUPITER, FL 33458-7507
DO NOT PAY PREMIUMS SHOWN ON THIS PAGE.
SEPARATE STATEMENT ENCLOSED IF AMOUNT DUE.
PHONE: (561 )746-5050 or (561 )746-7202
YEAR
2002
MAKE
GMC
MODEL
YUKON XL
BODY STYLE
SPORT WG
VEHICLE ID. NUMBER
1 GKFK66U82J190357
CLASS
1 D3H401
SYMBOLS
COVERAGES
P10
See olic for covera e details.
Bodily Injury/Property Damage Liability
Limits of Liability-Coverage A-Bodily Injury
Each. Person I EachAccident
$100,000 ",,$300,000 """"'" """"'"
Limits of Liability-Coverage A-Property Oamage
Each Accident
$50,000
No Fault
Medical Payments
Limit of Liability-Coverage C
Each Person
$20,000
$500 Deductible Comprehensive
$500 Deductible Collision
Nonstacking Uninsured Motor Vehicle
Limits of Liability-U3, ""~""" , '"
Each Person, Each Accident
$100.000 $300.000
A
$23.89
$17 .74
0500
G500
U3
$21.34
$66.12
$44.87
Total premium for this policy period JUL 29 2002 to OCT 21 2002.
$256.13
This is 1101 a bill.
I · IMPORTANT MESSAGES
Your policy consists of this declarations page, the policy booklet - form 9810.7, and any endorsements that apply, including
those issued to you with any subsequent renewal notice.
Replaced policy number 8855229-591.
Your total current 6 month premium for APR 21 2002 to OCT 21 2002 Is $561.70.
For questions, problems or to obtain information about coverage call: (561 )746-5050.
~ SKM_A~~(~ji~
DATE
[I . :1";7.
C(.~
}~rmmC~
CONTINUED
155-3866,1 03.2002 (010025hb)
(010025Ic)
I~
00803 59-2741-442C
23385-4.C MATCH 00803 MUTL VOL
.COPV. DECLARATIONS PAGE .COPV.
PAGE 2 OF 2
POLlCV NUMBER 885 5229-D21-59J
POLICY PERIOD JUL 29 2002 to OCT 21 2002
State Farm Mutual Automobile Insurance Company
7401 Cypress Gardens Boulevard
Winter Haven FL 33888
COUNTY OF MONROE
5100 COLLEGE RD
KEY WEST FL 33040-4319
I . EXCEPTIONS AND ENDORSEMENTS (See Individual endorsement for details.)
FINANCED- GMAC INSURANCE SERVICE CENTER, PO BOX 2525, HUDSON OH 44236-0025.
01 6028E.5 ADDITIONAL INSURED-COUNTY OF MONROE, 5100 COLLEGE RD, KEY WEST
FL 33040-4319.
02 6028E.5 ADDITIONAL INSURED-CITY OF VERO BEACH, PO BOX 1389, VERO BEACH
FL 32961-1389.
OJ 6028E.5 ADDITIONAL INSURED-CITY OF FT LAUDERDALE, 100 N ANDREWS AVE, FT
LAUDERDALE FL 33301-1016.
01 6037F.11 CERTIFICATE OF INSURANCE-SOUTH FLORIDA WATER MANAGEMENT, PO BOX
24680 WEST PALM BCH FL 33416-4680.
02 60~7F.11 CERTIFICATE OF INSURANCE-CITY OF FT LAUDERDALE PUBLIC SVCS
DEPT/ENGINEERING, CITY HALL 100 N ANDREWS 4TH FLR, FORT LAUDERDALE FL
33301-1016.
03 6037F.11 CERTIFICATE OF INSURANCE-CITY OF VERO BEACH, PO BOX 1389, VERO
BEACH FL 32961-1389.
04 6037F.11 CERTIFICATE OF INSURANCE-BOARD OF COUNTY COMMISSIONER ATTN: KIM
MCGEE~ C/O RISK MANAGEMENT 5100 COLLEGE RD RM 207a KEY WEST FL 33040-4319.
05 60~7F.11 CERTIFICATE OF INSURANCE-MONROE COUNTT BOARD OF COUNTY
COMMISSIONER, C/O RISK MANAGEMENT 5100 COLLEGE RD RM 410, KEY WEST FL
33040-4319.
6126~Z.1 AMENDMENT OF DEFINED WORDS - NO FAULT AND MEDICAL PAYMENT
COVERAGES.
6910 AMENDMENT OF DEFINED WORDS' INSURED'S DUTIES' LIABILITY
NO-FAULTA MEDICAL PAYMENTSt' UNINSURED MOTOR VEHICLE & PHYSICAL
DAMAGE CuVERAGES; & CONDIT ONS.
Named Insured- FOSTER, DAVID DBA AMERICAN UNDERWATER CONTRACTORS 603 COMMERCE WAY STE 15
JUPITER FL 33458-8843
~ .
ec:~
Agent: BILL BOWMAN INSURANCE AGCY INC
Telephone: (561 )746-5050
Prepared JUL 31 2002 2741-594
155-3866,1 03-2002 (ola025hbXo1a0254b)
(o1a025vc)
ACORDN CERTIFICATE OF LIABILITY INSURANC~~~ ~ DATE (MM/DDIYY)
08/27/02
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Plastridge Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
811 s. E. Ocean Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
stuart FL 34994-2427 INSURERS AFFORDING COVERAGE
Phone: 561-287-5532 Fax: 561-287-5572
INSURED INSURER A: American National Fire Ins.
INSURER B:
American Underwater Contractor INSURER C:
& Scuba Scrubbers, Inc.
102 Sunfish Lane INSURER D:
Jupiter FL 33477-7212 INSURER E:
I
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,
'~f.f TYPE OF INSURANCE POLICY NUMBER 6Xfe"tMM/DDlYvi' DATEIMM,oBN..;-?N LIMITS
GENERAL liABiliTY
-
A X COMMERCIAL GENERAL LIABilITY OMH2 50095903
I CLAIMS MADE D OCCUR
~ Shiprepairers Lia
-
GEN'l AGGREGATE LIMIT APPLIES PER:
I POLICY n j~8i n lOC
AUTOMOBilE liABiliTY
-
08/30/02
EACH OCCURRENCE $ 1000000
08/30/03 FIRE DAMAGE (Any one fire) $ 50000
MED EXP (Anyone person) $ 2500
PERSONAL & ADV INJURY $ 1000000
GENERAL AGGREGATE $ 2000000
PRODUCTS - COMPlOP AGG $ 1000000
OTHER
APPR6Vf'D FW'\~K MAtflGEMENT
BY \' \ :\.\1. 'Y /i , 11 Y
DATE ' ~'14ltli1 .-
WAIVER N/A ....c::::::YES
RtJ\/ ' )"A (~
..... ~ '-7 i ~ <->r-'"
U ,~UO-
Cc J " -
,j {iwl(l~C6fO
V \.
COMBINED SINGLE LIMIT $
(Ea accident)
BODilY INJURY $
(per person)
BODilY INJURY $
(Per accident)
PROPERTY DAMAGE $
(Per accident)
AUTO ONLY. EA ACCIDENT $
OTHER THAN EA ACC $
AUTO ONLY: AGG $
EACH OCCURRENCE $
AGGREGATE $
$
$
f----
f----
ANY AUTO
All OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON.OWNED AUTOS
~
-
-
-
GARAGE liABILITY
~ ANY AUTO
EXCESS liABiliTY
tJ OCCUR D CLAIMS MADE
R DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' liABiliTY
I TORY LIMITS IFJ/:'
EL EACH ACCIDENT $
E.l. DISEASE - EA EMPLOYEE $
E.l. DISEASE. POLICY LIMIT $
DESCRIPTION OF OPERATlONSlLOCATlONSlVEHIClESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Certificate holder is listed as additional insured with regards to the
General Liability
c:.c.
/.
~~~
CERTIFICATE HOLDER
[y I ADDITIONAL INSURED; INSURER lETTER:
CANCELLATION
Monroe County Board of County
Commissioners
ATTN: Kim McGee-305-295-4317
5100 College Road RM 410
Key West FL 33040
I
ACORD 25-5 (7/97)
MONRO-5 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEllED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER Will ENDEAVOR TO MAil ~ 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
Jean Reed Parks
@ACORD CORPORATION 1988
ACORDN CERTIFICATE OF LIABILITY INSURANC~~r1~ ~ DATE (MM/DDIYY)
08/27/02
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Plastridge Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
811 S. E. Ocean Bl.vd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Stuart FL 34994-2427
Phone: 561-287-5532 Fax: 561-287-5572 INSURERS AFFORDING COVERAGE
INSURED INSURER A: American National. Fire Ins.
INSURER B:
American Underwater Contractor INSURER C:
& Scuba Scrubbers, Inc.
102 Sunfish Lane INSURER D:
Jupiter FL 33477-7212
I INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
I~f~ TYPE OF INSURANCE POLICY NUMBER b~f~Ci'MM/DDIYYi ' DATE (MM/DDIYY liMITS
GENERAL liABiliTY EACH OCCURRENCE $ 1000000
r-- 08/30/02 08/30/03
A X COMMERCIAL GENERAL LIABilITY OMH250095903 FIRE DAMAGE (Anyone fire) $ 50000
J CLAIMS MADE 0 OCCUR MED EXP (Anyone person) $ 2500
X Shiprepairers Lia PERSONAL & ADV INJURY $ 1000000
i GENERAL AGGREGATE $ 2000000
-
GEN'l AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1000000
I POLICY n ~~8r n lOC
AUTOMOBilE liABiliTY COMBINED SINGLE liMIT
- $
ANY AUTO (Ea accident)
r--
All OWNED AUTOS BODilY INJURY
r-- $
SCHEDULED AUTOS (Per person)
r---
HIRED AUTOS BODilY INJURY
r-- $
NON-OWNED AUTOS (Per accident)
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE liABiliTY APPRft\ ~ '.K M~~ AUTO ONLY. EA ACCIDENT $
R ANY AUTO tJEMENT OTHER THAN EA ACC $
BY '\. 'V' /i , 111) Y AUTO ONLY: AGG $
EXCESS liABiliTY , --I1<-i\M- EACH OCCURRENCE $
D OCCUR D CLAIMS MADE DATE
N/A ...LYES AGGREGATE $
WAIVER $
R DEDUCTIBLE F~d\v ; '/llA(L $
RETENTION $ ~r ,,' ~ ..-.. $
WORKERS COMPENSATION AND U , ":L Uo I TORY llMrTS I IUE~-
EMPLOYERS' liABiliTY C(
j ,,- EL EACH ACCIDENT $
-,) tivv1 (l Cbf1/ EL DISEASE. EA EMPLOYEE $
E L DISEASE - POLICY LIMIT $
OTHER V \.
DESCRIPTION OF OPERATIONSllOCATIONSNEHICLESlEXClUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Certificate hol.der is l.isted as additional. insured with regards to the
General. Liability
/
t.c. ~
x,~_~
CERTIFICATE HOLDER I y I ADDITIONAL INSURED; INSURER lETTER: CANCELLATION
MONRO-5 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEllED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WIll ENDEAVOR TO MAil ~ DAYS WRITTEN
Monroe County Board of County NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE lEFT, BUT FAilURE TO DO SO SHAll
Commissioners
ATTN: ~ McGee-305-295-4317 IMPOSE NO OBLIGATION OR liABiliTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
5100 Col.l.ege Road RM 410 REPRESENTATIVES.
Key West FL 33040 AUTHORIZED REPRESENTATIVE
I Jean Reed Parks
ACORD 25-5 (7/97)
@ACORD CORPORATION 1988