Certificates of InsuranceACORD CERTIFICATE OF LIABILITY INSURANCF.,oPID
DATE (MM/DDlYY)
PRODUCER RI32 03/24/03
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
The Plastridge Agency -SO ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
911 S . E . Ocean Blvd. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Stuart FL 34994-2427 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Phone:772-287-5532 Fax:772-287-5572 INSURERS AFFORDING COVERAGE
INSURED
American Underwater Contractor
& Scuba Scrubbers, Inc.
JupiterfFLh33477-7212
INSURER A: Great American Insurance
INSURER B:
INSURER C.-
INSURER D:
COVERAGES 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 MAYBE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS D SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR
LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIV O I EXPIR TIO
GENERAL LIABILITY DATE MMlDD/YY DATE MM/DD/YY LIMITS
A X COMMERCIAL GENERAL LIABILITY OMH250095903 EACH OCCURRENCE $ 1000000
08/30/02 08/30/03 FlREDAMAGE(Anyonefire) $ 50000
CLAIMS MADE ❑OCCUR
X Ship -repairers Lia MEDEXP(Any one person) $ 2500
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY n JE
-ECTCT
n LOC
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
GARAGE LIABILITY
-1 ANY AUTO
EXCESS LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
A (Boat Liability I OMH250095903
��a�rclr I ION OF OPERATIONS/LO CATIONS/VEHICLES/EXCLUSIONSADDED
Diving/ 1989 24' Privateer Watercraft
CERTIFICATE HOLDER Y ADDITIONAL INSURED; INSURER LETTER:
MONRO-5
Monroe County Board of County
Commissioners
ATTN: Kim McGee-305-295-4317
5100 College Road RM 410
Key West FL 33040
ACORD 25-S (7/97)
08/30/02
PERSONAL & ADV INJURY $ 10 0 0 0 0 0
GENERAL AGGREGATE $ 2000000
PRODUCTS - COMP/OPAGG $ 1000000
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
$
$
(
$
TORY LIMITS ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
$
E.L. DISEASE -POLICY LIMIT
$
08/30/03 Liability
500000
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATH
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.
OACORD CORPORATION 1988
ID Jl DATE(MM/DD/YY
ACORD CERTIFICATE OF LIABILITY INSURANCE
E
AMERI32 12 11 03
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
The Plastridge Agency -SO
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
710 S . E. Ocean Blvd.
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Stuart FL 34994-2427
Phone: 772-287-5532 Fax:772-287-5572
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURER A: Great American Insurance Co.
INSURER B:
American Underwater Contractor
& Scubba Scrubbers, Inc.
17536 SE Conch Bar Ave.
Tequesta FL 33469
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. 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.
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM/DD/YY
POLICY EXPIRATION
DATE MM/DD/YY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1000000
A
X COMMERCIAL GENERAL LIABILITY
OMH2500959-05
08/30/03
08/30/04
PREMISEESE occurence)
$ 50000
CLAIMS MADE OCCUR
MED EXP (Any one person)
$ 2500
SHIP REPAIRERS
OMH2500959-05
08/30/03
08/30/04
PERSONAL &ACV INJURY
$ 1000000
GENERAL AGGREGATE
$ 2000000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OPAGG
$ 1000000
PROJECT LOC
POLICY F7
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
ryeyl�
APPR
�M A
IHI�'AIV E EN
BY
DATE
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
WAIVER N//%
--
. ...
YES
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
$
..,
AUTO ONLY: AGG
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
$
DEDUCTIBLE
CG .
$
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS'LIABILlTY
ANY PROPRIETOR/PARTNER/EXECUTIVE
i
lj
/ �'
jo
TORYLIMITS ER
E.L. EACH ACCIDENT
_______
$
E.L. DISEASE - EA EMPLOYE
$
OFFICER/MEMBER EXCLUDED?
If yes, describe under
E.L. DISEASE - POLICY LIMIT
$
SPECIAL PROVISIONS below
OTHER
A
P&I
OMH2500959-05
08/30/03
08/30/04
Liability 500000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Monroe County Board of County Commissioners is an additional insured.
CERTIFICATE HOLDER CANCELLATION
Monroe County Board of
County Commissioners
Maria Slavik/Risk Mgmt
1100 Simonton St., Rm 268
Key West FL 33040
0 000000 ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRA
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
ACORD 25 (2001/08)
cc'. - 41-
TION 1