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HomeMy WebLinkAboutCertificates of Insurance DATE(MM/DD/YYYY) ACORO® CERTIFICATE OF LIABILITY INSURANCE 08/19/2025 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 endorsements. PRODUCER CONTACT HOUSE NAME: Kelly White&Associates Insurance, LLC AICN No, Ext: FAX A/c No): 1622 Hickman Road E-MAIL ADDRESS: kelly@kwhiteinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# Jacksonville FL 32216 INSURER A: RLI Insurance Co AM Best A+XI 13056 INSURED INSURER B: Travelers Property&Casualty Company 36161 Coffin Marine Services, Inc INSURERC: P O Box 430538 INSURER D: Everest National Insurance Company 10120 INSURER E: Water Quality Insurance Syndicate Big Pine Key FL 33043 INSURER F: COVERAGES CERTIFICATE NUMBER: COFF25081908420107 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 ADDL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE F_X1 OCCUR PREMISES(Ea occurrence) $ 50,000 X P&I including Jones Act MED EXP(Any oneperson) $ 5,000 A X Salvors Liability X X MRP0200000 09/23/2024 09/23/2025 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ❑PRO ❑ 1,000,000 JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: Protection&Indemnity $ $1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED BA4902R108 08/17/2025 08/17/2026 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED IX NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Personal Injury $ 10,000 UIAB �v._._.' --� OCCUR EACH OCCURRENCE $ EXCESS LIAB .19. 9�25 CLAIMS-MADE WAr. NJ. r.,F. AGGREGATE $ MBRELLA L DED RETENTION$ $ WORKERS COMPENSATION X STATUTE X EORH Includes USL&H AND EMPLOYERS'LIABILITY Y/N D ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑N NIA 9700000381-231 12/21/2024 12/21/2025 (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 $ Per co Schedule $1,000,000 E Vessel Pollution 57-83732 09/23/2024 09/23/2025 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Certificate Holder is an Additional Insured with respects General Liability as per form (Blanket Additional InsuredAA/aiver of Subrogation)OMGL 624(11/07) and Auto Liability,with respects to insureds operations as required by written contract. Protection& Indemnity is proof of Jones Act coverage required by law. USL& H coverage is provided under Workers Compensation policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Monroe County Board of County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. Marine Resources Office AUTHORIZED REPRESENTATIVE 2798 Overseas Highway Ste.420 Marathon FL 33050 - ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 26(2016/03) The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 12/18/2024 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 endorsements. PRODUCER CONTACT HOUSE NAME: Kelly White&Associates Insurance, LLC AICN No, Ext: FAX A/c No): 1622 Hickman Road E-MAIL ADDRESS: kelly@kwhiteinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# Jacksonville FL 32216 INSURER A: RLI Insurance Co AM Best A+XI 13056 INSURED INSURER B: Travelers Property&Casualty Company 36161 Coffin Marine Services, Inc INSURERC: P O Box 430538 INSURER D: Everest National Insurance Company 10120 INSURER E: Water Quality Insurance Syndicate Big Pine Key FL 33043 INSURER F: COVERAGES CERTIFICATE NUMBER: COFF241 21 81 051 1 590 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 ADDL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE F_X1 OCCUR PREMISES(Ea occurrence) $ 50,000 X P&I including Jones Act MED EXP(Any oneperson) $ 5,000 A X Salvors Liability X X MRP0200000 09/23/2024 09/23/2025 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ❑PRO ❑ 1,000,000 JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: Protection&Indemnity $ $1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED BA4902R108 08/17/2024 08/17/2025 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED IX NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY A '. 1tsX ,T Per accident Personal Injury $ 10,000 UMBRELLA LIAB OCCUR Y_'"'^"""-"'"gym; EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ WAN" " $ WORKERS COMPENSATION X STATUTE X �R" Includes USL&H AND EMPLOYERS'LIABILITY Y/N D ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑N NIA 9700000381-231 12/21/2024 12/21/2025 (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 $ Per co Schedule $1,000,000 E Vessel Pollution 57-83732 09/23/2024 09/23/2025 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Certificate Holder is an Additional Insured with respects General Liability as per form (Blanket Additional InsuredAA/aiver of Subrogation)OMGL 624(11/07) and Auto Liability,with respects to insureds operations as required by written contract. Protection& Indemnity is proof of Jones Act coverage required by law. USL& H coverage is provided under Workers Compensation policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Monroe County Board of County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. Marine Resources Office AUTHORIZED REPRESENTATIVE 2798 Overseas Highway Ste.420 Marathon FL 33050 - ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 26(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC#: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Kelly White&Associates Insurance, LLC Coffin Marine Services, Inc POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: 12/18/2024 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Marine Work Only ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 12/12/2023 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 HOUSE NAME: Kelly White&Associates Insurance, LLC AICN No, Ext: FAX A/c No): 1622 Hickman Road E-MAIL ADDRESS: kelly@kwhiteinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# Jacksonville FL 32216 INSURER A: RLI Insurance Co AM Best A+XI 13056 INSURED INSURER B: Travelers Property&Casualty Company 36161 Coffin Marine Services, Inc INSURERC: P O Box 430538 INSURER D: Everest National Insurance Company 10120 INSURER E: Water Quality Insurance Syndicate Big Pine Key FL 33043 INSURER F: COVERAGES CERTIFICATE NUMBER: COFF23121209594483 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 ADDL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE F_X1 OCCUR PREMISES(Ea occurrence) $ 50,000 X P&I including Jones Act MED EXP(Any oneperson) $ 5,000 A X Salvors Liability X X MRP0200000 09/23/2023 09/23/2024 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ❑PRO ❑ 1,000,000 JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: Protection&Indemnity $ $1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED BA4902R108 08/17/2023 08/17/2024 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED IX NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident as s�7 m -T Personal Injury $ 10,000 UMBRELLA LIAB OCCUR ®y ��__. �. � r-�-"-��- EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ WAN DED RETENTION$ $ WORKERS COMPENSATION X STATUTE X EORH Includes USL&H AND EMPLOYERS'LIABILITY Y/N ANY D OFFICER/MEMBERPROPRIETOR/PARTNER/EXECUTIVEEXCLUDED? NIA 9700000381-221 12/21/2023 12/21/2024 E.L.EACH ACCIDENT $ 1,000,000 (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 $ Per co Schedule $1,000,000 E Vessel Pollution 57-83732 09/23/2023 09/23/2024 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Certificate Holder is an Additional Insured with respects General Liability as per form (Blanket Additional InsuredAA/aiver of Subrogation)OMGL 624(11/07) and Auto Liability,with respects to insureds operations as required by written contract. Protection& Indemnity is proof of Jones Act coverage required by law. USL& H coverage is provided under Workers Compensation policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Monroe County Board of County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. Marine Resources Office AUTHORIZED REPRESENTATIVE 2798 Overseas Highway Ste.420 Marathon FL 33050 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 26(2016/03) The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 09/08/2023 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 HOUSE NAME: Kelly White&Associates Insurance, LLC AICN No, Ext: 904-880-8881 A/c NO): 1622 Hickman Road E-MAIL ADDRESS: kelly@kwhiteinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# Jacksonville FL 32216 INSURER A: RLI Insurance Co AM Best A+XI 13056 INSURED INSURER B: Travelers Property&Casualty Company 36161 Coffin Marine Services, Inc INSURERC: P O Box 430538 INSURER D: Everest National Insurance Company 10120 INSURER E: Water Quality Insurance Syndicate Big Pine Key FL 33043 INSURER F: COVERAGES CERTIFICATE NUMBER: COFF23090812361459 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 ADDL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE F_X1 OCCUR PREMISES(Ea occurrence) $ 50,000 X P&I including Jones Act MED EXP(Any oneperson) $ 5,000 A X Salvors Liability X X MRP0200000 09/23/2023 09/23/2024 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ❑PRO ❑ 1,000,000 JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: Protection&Indemnity $ $1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED X BA4902R108 08/17/2023 08/17/2024 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED IX NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Personal Injury $ 10,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ r $ WORKERS COMPENSATION XJPER STATUTE X EORH Includes USL&H AND EMPLOYERS'LIABILITY Y/N ANY D OFFICER/MEMBERPROPRIETOR/PARTNER/EXECUTIVEEXCLUDED? NIA 9700000381-221 12/21/2022 12/21/2023 E.L.EACH ACCIDENT $ 1,000,000 (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 $ Per co Schedule $1,000,000 E Vessel Pollution 55-83732 09/23/2023 09/23/2024 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) P Z1167 „, T _ , 9.8. 3 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Monroe County BOCC ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West FL 33040 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 26(2016/03) The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 09/08/2023 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 HOUSE NAME: Kelly White&Associates Insurance, LLC AICN No, Ext: 904-880-8881 A/c NO): 1622 Hickman Road E-MAIL ADDRESS: kelly@kwhiteinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# Jacksonville FL 32216 INSURER A: RLI Insurance Co AM Best A+XI 13056 INSURED INSURER B: Travelers Property&Casualty Company 36161 Coffin Marine Services, Inc INSURERC: P O Box 430538 INSURER D: Everest National Insurance Company 10120 INSURER E: Water Quality Insurance Syndicate Big Pine Key FL 33043 INSURER F: COVERAGES CERTIFICATE NUMBER: COFF23090812361459 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 ADDL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE F_X1 OCCUR PREMISES(Ea occurrence) $ 50,000 X P&I including Jones Act MED EXP(Any oneperson) $ 5,000 A X Salvors Liability X X MRP0200000 09/23/2023 09/23/2024 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ❑PRO ❑ 1,000,000 JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: Protection&Indemnity $ $1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED X BA4902R108 08/17/2023 08/17/2024 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED IX NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Personal Injury $ 10,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ r $ WORKERS COMPENSATION XJPER STATUTE X EORH Includes USL&H AND EMPLOYERS'LIABILITY Y/N ANY D OFFICER/MEMBERPROPRIETOR/PARTNER/EXECUTIVEEXCLUDED? NIA 9700000381-221 12/21/2022 12/21/2023 E.L.EACH ACCIDENT $ 1,000,000 (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 $ Per co Schedule $1,000,000 E Vessel Pollution 55-83732 09/23/2023 09/23/2024 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) P Z1167 „, T _ , 9.8. 3 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Monroe County BOCC ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street AUTHORIZED REPRESENTATIVE Key West FL 33040 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 26(2016/03) The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) ACORO® CERTIFICATE OF LIABILITY INSURANCE 06/26/2023 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 HOUSE NAME: Kelly White&Associates Insurance, LLC AICN No, Ext: 904-880-8881 A/c NO): 1622 Hickman Road E-MAIL ADDRESS: kelly@kwhiteinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# Jacksonville FL 32216 INSURER A: RLI Insurance Co AM Best A+XI 13056 INSURED INSURER B: Travelers Property&Casualty Company 36161 Coffin Marine Services, Inc INSURERC: P O Box 430538 INSURER D: Everest National Insurance Company 10120 INSURER E: Water Quality Insurance Syndicate Big Pine Key FL 33043 INSURER F: COVERAGES CERTIFICATE NUMBER: COFF23062608201202 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 ADDL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE F_X1 OCCUR PREMISES(Ea occurrence) $ 50,000 X P&I including Jones Act MED EXP(Any oneperson) $ 5,000 A X Salvors Liability X X MRP0200000 09/23/2022 09/23/2023 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ❑PRO ❑ 1,000,000 JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: Protection&Indemnity $ $1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED BA4902R108 08/17/2022 08/17/2023 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED IX NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY APPROVED BY RISK MANAGEMENT Per accident `/ Personal Injury $ 10,000 UMBRELLA LIAB OCCUR DATE 6/27/k2`3 � EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE WAIVER N/A YES AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION XJPER STATUTE X EORH Includes USL&H ND EMPLOYERS'LIABILITY Y/N ANY D OFFICER/MEMBERPROPRIETOR/PARTNER/EXECUTIVEEXCLUDED? NIA 9700000381-221 12/21/2022 12/21/2023 E.L.EACH ACCIDENT $ 1,000,000 (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 $ Per co Schedule $1,000,000 E Vessel Pollution 55-83732 09/23/2022 09/23/2023 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Certificate Holder is an Additional Insured with respects General Liability as per form (Blanket Additional InsuredAA/aiver of Subrogation)OMGL 624(11/07) and Auto Liability,with respects to insureds operations as required by written contract. Protection& Indemnity is proof of Jones Act coverage required by law. USL& H coverage is provided under Workers Compensation policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Monroe County Board of County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. Marine Resources Office AUTHORIZED REPRESENTATIVE 2798 Overseas Highway Ste.420 Marathon FL 33050 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 26(2016/03) The ACORD name and logo are registered marks of ACORD