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HomeMy WebLinkAboutCertificates of Insurance AMERCOM-02IBRIDGES DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 1/8/2026 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). CONTACT Heather Leivas PRODUCER NAME: PHONEFAX Florida Insurance Center, Inc. (813)946-8060(813)754-3450 (A/C, No, Ext):(A/C, No): 414 N Alexander St E-MAIL hleivas@floridainsurancecenter.com Plant City, FL 33563 ADDRESS: INSURER(S) AFFORDING COVERAGENAIC # Palomar Excess and Surplus Insurance Co16754 INSURER A : INSURED Clear Blue Specialty Insurance Co28860 INSURER B : American Compliance Technologies Inc Dba A-C-T American Interstate Ins Co31895 INSURER C : Environmental & Infrastructure Inc, A-C-T Environmental Solutions Inc Southern-Owners Insurance Co10190 INSURER D : 1875 W Main St Travelers Casualty & Surety Co19038 INSURER E : Bartow, FL 33830-7718 INSURER F : COVERAGESCERTIFICATE 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. INSRADDLSUBRPOLICY EFFPOLICY EXP TYPE OF INSURANCEPOLICY NUMBERLIMITS LTRINSDWVD(MM/DD/YYYY)(MM/DD/YYYY) 1,000,000 A COMMERCIAL GENERAL LIABILITY X EACH OCCURRENCE$ DAMAGE TO RENTED 300,000 CLAIMS-MADEOCCUR X ENC0313787017/8/20257/8/2026 $ PREMISES (Ea occurrence) X Prof & Poll Liabilit25,000 X MED EXP (Any one person)$ 1,000,000 PERSONAL & ADV INJURY$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- 2,000,000 XX POLICYLOC PRODUCTS - COMP/OP AGG$ JECT CONTRACTUAL LIA1,000,000 OTHER:$ COMBINED SINGLE LIMIT 1,000,000 B AUTOMOBILE LIABILITY $ (Ea accident) ANY AUTO AQ1YFL004515-0112/11/202512/11/2026 BODILY INJURY (Per person)$ X OWNEDSCHEDULED X AUTOS ONLYAUTOSBODILY INJURY (Per accident)$ PROPERTY DAMAGE HIREDNON-OWNED XX (Per accident)$ AUTOS ONLYAUTOS ONLY PIP10,000 $ 4,000,000 A XX UMBRELLA LIABOCCUR EACH OCCURRENCE$ ENX0005257057/8/20257/8/2026 4,000,000 EXCESS LIABCLAIMS-MADE AGGREGATE$ 0 X DEDRETENTION$ $ PEROTH- WORKERS COMPENSATION C X STATUTEER AND EMPLOYERS' LIABILITY Y / N AVWCFL343626202512/25/202512/25/2026 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A N OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS belowE.L. DISEASE - POLICY LIMIT$ Leased/Rented2089278412/11/202512/11/2026 Limit500,000 D Cyber Liability10684870812/10/202512/10/2026 1,000,000 E DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) General Liability policy also includes coverage for Contractors Pollultion Liability and Professional Liability. Professional Liability is claims made and includes a Retro Date of 5/29/92 with a per Occurrence and Per Claim limit. These policies includes their own separate limits of $1,000,000 per Occurrence/ $2,000,000 Aggregate. The Umbrella policies also provides additional coverage limits for the Contractors Pollution Liability, Professional Liability, Automobile Liability and Workers Compensation as well as it follows forms on underlying polices listed. Blanket additional insured applies to the general liability and professional and contractors pollution liability and auto liability with a waiver of subrogation on all policies listed above including the work comp. Coverage is primary and non-contributory as per written contract. 30 day cancellation applies except 10 day SEE ATTACHED ACORD 101 CERTIFICATE HOLDERCANCELLATION 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. 1100 Simonton Street Key West, FL 33040 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03)© 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AMERCOM-02IBRIDGES AGENCY CUSTOMER ID: 1 LOC #: Page of 11 ADDITIONAL REMARKS SCHEDULE AGENCYNAMED INSURED American Compliance Technologies Inc Dba A-C-T Environmental Florida Insurance Center, Inc. & Infrastructure Inc, A-C-T Environmental Solutions Inc 1875 W Main St POLICY NUMBER Bartow, FL 33830-7718 SEE PAGE 1 CARRIERNAIC CODE SEE PAGE 1SEE P 1 EFFECTIVE DATE: SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, ACORD 25Certificate of Liability Insurance FORM NUMBER:FORM TITLE: Description of Operations/Locations/Vehicles: for non-payment The Monroe County Board of County Commissioners is included as additional insured with respect to general liability and auto liability when required by written contract. Jones Act Coverage Recognizing that the work governed by this contract involves Maritime Operations, the Contractor's Workers' Compensation Insurance Policy shall include the coverage for claims subject to the Federal Jones Act (46 U.S.C.A. subsection 688) with limits not less than $1 Million. The Contractor shall be permitted to provide Jones Act Coverage through a separate Protection and Indemnity Policy, in so far as the coverage provided is no less restrictive than would have been provided by a Workers' Compensation Policy. ACORD 101 (2008/01)© 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AMERCOM-02 (BRIDGES ACORO"° CERTIFICATE OF LIABILITY INSURANCE D TE 12/11/2024Y) 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 Heather Leivas NAME: Florida Insurance Center,Inc. PHONE FAX 414 N Alexander St (A/C,No,Ext): (813)754-3561 (A/C,No):(813)754-3450 Plant City,FL 33563 E-MAIL hleivas@floridainsurancecenter.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Nautilus Insurance Co 17370 INSURED American Compliance Technologies Inc Dba A-C-T INSURERB:Clear Blue Specialty Insurance Co 28860 Environmental INSURERC:Brid efield Employers Ins Co 10701 &Infrastructure Inc,A-C-T Environmental Solutions Inc INSURERD:Westfield Insurance Company 24112 1875 W Main St INSURERE:Travelers Casualty &Surety Co 19038 Bartow,FL 33830-7718 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 MMIDD/YYYY MMIDD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR ECP2045500-10 12/10/2024 12/10/2025 DAMAGE TO RENTED 300��� X PREMISES Ea occurrence $ X Prof&Poll Liabilit 6 25,000 A�, '(' MED EXP An one person) $ I J 7 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: Y_.-...m 2.11.24� GENERAL AGGREGATE $ 2,000,000 POLICY� PRO- F LOC DAiR ...�-- .... JECT — PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: CONTRACTUAL LIA $ 1,000,000 B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ X ANY AUTO X AQlYFL004515-00 12/11/2024 12/11/2025 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ PIP $ 10,000 A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 EXCESS LIAB CLAIMS-MADE FFX2045501-10 12/10/2024 12/10/2025 AGGREGATE $ 4,000,000 DED X RETENTION$ 0 $ C WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N 0830-46953 12/25/2024 12/25/2025 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (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 $ D Leased/Rented CMM4993818 12/11/2024 12/11/2025 Limit 500,000 E Cyber Liability 0106848708LB 11/8/2024 12/10/2025 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) General Liability policy also includes coverage for Contractors Pollultion Liability and Professional Liability. Professional Liability is claims made and includes a Retro Date of 5/29/92 with a per Occurrence and Per Claim limit. These policies includes their own separate limits of$1,000,000 per Occurrence/ $2,000,000 Aggregate. The Umbrella policies also provides additional coverage limits for the Contractors Pollution Liability,Professional Liability,Automobile Liability and Workers Compensation as well as it follows forms on underlying polices listed. Blanket additional insured applies to the general liability and professional and contractors pollution liability and auto liability with a waiver of subrogation on all policies listed above including the work comp.Coverage is primary and non-contributory as per written contract.30 day cancellation applies except 10 day SEE ATTACHED ACORD 101 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of County Commissioners THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty ty ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street Key West,FL 33040 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID:AMERCOM-02 IBRIDGES LOC#: 1 A�©� ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Florida Insurance Center, Inc. American Compliance Technologies Inc Dba A-C-T Environmental &Infrastructure Inc,A-C-T Environmental Solutions Inc POLICY NUMBER 1875 W Main St SEE PAGE 1 Bartow,FL 33830-7718 CARRIER NAIC CODE SEE PAGE 1 SEE P 1 EFFECTIVE DATE:SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations/Locations/Vehicles: for non-payment. The Monroe County Board of County Commissioners is included as additional insured with respect to general liability and auto liability when required by written contract. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AMERCOM-02 (BRIDGES ACORO"° CERTIFICATE OF LIABILITY INSURANCE DAT 1/5/2D/YYYY) 024 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 Heather Leivas NAME: Florida Insurance Center,Inc. PHONE FAX 414 N Alexander St (A/C,No,Ext): (813)754-3561 (A/C,No):(813)754-3450 Plant City,FL 33563 E-MAIL hleivas@floridainsurancecenter.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Underwriters at Lloyds INSURED INSURERB:Westfield Insurance Company 24112 American Compliance Technologies Inc Dba A-C-T Environmental INSURER C:Certain Underwriters at Lloyds AA-112 &Infrastructure Inc,A-C-T Environmental Solutions Inc INSURERD:Brid efield Employers Ins Co 10701 1875 W Main St INSURERE:Travelers Casualty &Surety Co 19038 Bartow,FL 33830-7718 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 MMIDD/YYYY MMIDD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR ENC000525604 11/8/2023 12/10/2024 DAMAGE TO RENTED 300 000 X PREMISES Ea occurrence $ X Prof Liab&Pollutio MED EXP(Any oneperson) $ 25,000 AP X T PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: bY,..... -� ""'�""""" GENERAL AGGREGATE $ 2,000,000 POLICY�X JECT LOC DA. 1..8.24� PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: 'WA -' �-- CONTRACTUAL LIA $ 1,000,000 B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ X ANY AUTO X CMM4993818 11/8/2023 12/10/2024 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ PIP $ 10,000 C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 EXCESS LIAB CLAIMS-MADE ENX000525704 11/8/2023 12/10/2024 AGGREGATE $ 4,000,000 DED X RETENTION$ 0 $ D WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N 0830-46953 12/25/2023 12/25/2024 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,UUU If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B Equipment Floater CMM4993818 11/8/2023 12/10/2024 Limit 500,000 E Cyber Liability 0106848708LB 11/8/2024 11/8/2025 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) General Liability policy also includes coverage for Contractors Pollultion Liability and Professional Liability. Professional Liability is claims made and includes a Retro Date of 5/29/92 with a per Occurrence and Per Claim limit. These policies includes their own separate limits of$1,000,000 per Occurrence/ $2,000,000 Aggregate. The Umbrella policies also provides additional coverage limits for the Contractors Pollution Liability,Professional Liability,Automobile Liability and Workers Compensation as well as it follows forms on underlying polices listed. Blanket additional insured applies to the general liability and professional and contractors pollution liability and auto liability with a waiver of subrogation on all policies listed above including the work comp.Coverage is primary and non-contributory as per written contract.30 day cancellation applies except 10 day SEE ATTACHED ACORD 101 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of County Commissioners THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty ty ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street Key West,FL 33040 AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. AGENCY CUSTOMER ID:AMERCOM-02 (BRIDGES yam" LOC#: 1 A` ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Florida Insurance Center, Inc. American Compliance Technologies Inc Dba A-C-T Environmental &Infrastructure Inc,A-C-T Environmental Solutions Inc POLICY NUMBER 1875 W Main St EE PAGE 1 Bartow,FL 33830-7718 CARRIER NAIC CODE ,SEE PAGE 1 SEE P 1 EFFECTIVE DATE:SEE PAGE 1 The ACORD name and logo are registered marks of ACORD ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations/Locations/Vehicles: for non-payment. The Monroe County Board of County Commissioners is included as additional insured with respect to general liability and auto liability when required by written contract. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AMERCOM-02 (BRIDGES �►co�ro,,, CERTIFICATE OF LIABILITY INSURANCE D TE 11/10/2023Y) 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 Heather Leivas NAME: Florida Insurance Center,Inc. PHONE FAX 414 N Alexander St (A/C,No,Ext): (813)754-3561 (A/C,No):(813)754-3450 Plant City,FL 33563 E-MAIL hleivas@floridainsurancecenter.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Certain Underwriters at Lloyds AA-112 INSURED American Compliance Technologies Inc.&A-C-T INSURER B:Westfield Insurance Company 24112 Environmental Solutions Inc.& INSURERC:Brid efield Employers Ins Co 10701 A-C-T Environmental&Infrastructure Inc. INSURERD:Travelers Casualty &Surety Co 19038 1875 W Main Street Bartow,FL 33830-7718 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 MMIDD/YYYY MMIDD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR ENC0005256-03 11/8/2023 11/8/2024 DAMAGE TO RENTED 300,000 X PREMISES Ea occurrence $ X Prof Liab&Pollutio MED EXP(Any oneperson) $ 25,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JECT1:1 LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: CONTRACTUAL LIA $ 1,000,000 B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ X ANY AUTO X CMM4993818 11/8/2023 11/8/2024 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS APP 16 BODILY INJURY Per accident $ X HIRED X NON-OWNED ®�"'""'� PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY °"Tk-- a'�-�� — Per accident) ccident $ PIP $ 10,000 A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 EXCESS LIAB CLAIMS-MADE ENX0005257-03-FUTURE 11/8/2023 11/8/2024 AGGREGATE $ 4,000,000 DED X RETENTION$ 0 $ C WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N 0830-46953 12/25/2023 12/25/2024 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000'OOO If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B Equipment Floater CMM4993818 11/8/2023 11/8/2024 Limit 500,000 D Cyber Liability 0106848708LB 11/8/2023 11/8/2024 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) General Liability policy also includes coverage for Contractors Pollultion Liability and Professional Liability. Professional Liability is claims made and includes a Retro Date of 5/29/92 with a per Occurrence and Per Claim limit. These policies includes their own separate limits of$1,000,000 per Occurrence/ $2,000,000 Aggregate. The Umbrella policies also provides additional coverage limits for the Contractors Pollution Liability,Professional Liability,Automobile Liability and Workers Compensation as well as it follows forms on underlying polices listed. Blanket additional insured applies to the general liability and professional and contractors pollution liability and auto liability with a waiver of subrogation on all policies listed above including the work comp.Coverage is primary and non-contributory as per written contract.30 day cancellation applies except 10 day SEE ATTACHED ACORD 101 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of County Commissioners THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty ty ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street Key West,FL 33040 AUTHORIZED REPRESENTATIVE v&"'°" U ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID:AMERCOM-02 IBRIDGES LOC#: 1 A�©� ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Florida Insurance Center, Inc. American Compliance Technologies Inc.&A-C-T Environmental Solutions Inc.& POLICY NUMBER A-C-T Environmental&Infrastructure Inc. 1875 W Main Street SEE PAGE 1 Bartow,FL 33830-7718 CARRIER NAIC CODE SEE PAGE 1 SEE P 1 EFFECTIVE DATE:SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations/Locations/Vehicles: for non-payment. The Monroe County Board of County Commissioners is included as additional insured with respect to general liability and auto liability when required by written contract. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AMERCOM-02 (BRIDGES �►co�ro,,, CERTIFICATE OF LIABILITY INSURANCE DAT4/5/2 D/YYYY) 023 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 Heather Leivas NAME: Florida Insurance Center,Inc. PHONE FAX 414 N Alexander St (A/C,No,Ext): (813)754-3561 (A/C,No):(813)754-3450 Plant City,FL 33563 E-MAIL hleivas@floridainsurancecenter.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Certain Underwriters at Lloyds AA-112 INSURED American Compliance Technologies Inc.&A-C-T INSURER B:Westfield Insurance Company 24112 Environmental Solutions Inc.& INSURERC:Brid efield Employers Ins Co 10701 A-C-T Environmental&Infrastructure Inc. INSURERD:Travelers Casualty &Surety Co 19038 1875 W Main Street Bartow,FL 33830-7718 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 MMIDD/YYYY MMIDD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR ENC0005256-03 11/8/2022 11/8/2023 DAMAGE TO RENTED 300,000 X PREMISES Ea occurrence $ X Prof Liabo u Io (� '� „ MED EXP An one person) $ 25,000 P PERSONAL&ADV INJURY $ 1'000'000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ ,000,000 POLICY�X JECT1:1 LOC !�rA 4 ' 10 . 23— _.:-, -tea, PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: CONTRACTUAL LIA $ 1,000,000 B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ X ANY AUTO CMM4993818 11/8/2022 11/8/2023 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ PIP $ 10,000 A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 EXCESS LIAB CLAIMS-MADE ENX0005257-03 11/8/2022 11/8/2023 AGGREGATE $ 4,000,000 DED X RETENTION$ 0 $ C WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N 0830-46953 12/25/2022 12/25/2023 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,UUU If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B Equipment Floater CMM4993818 11/8/2022 11/8/2023 Limit 500,000 D General Liability 0106848708LB 11/8/2022 11/8/2023 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) General Liability policy also includes coverage for Contractors Pollultion Liability and Professional Liability. Professional Liability is claims made and includes a Retro Date of 5/29/92 with a per Occurrence and Per Claim limit. These policies includes their own separate limits of$1,000,000 per Occurrence/ $2,000,000 Aggregate. The Umbrella policies also provides additional coverage limits for the Contractors Pollution Liability,Professional Liability,Automobile Liability and Workers Compensation as well as it follows forms on underlying polices listed. Blanket additional insured applies to the general liability and professional and contractors pollution liability and auto liability with a waiver of subrogation on all policies listed above including the work comp.Coverage is primary and non-contributory as per written contract.30 day cancellation applies except 10 day SEE ATTACHED ACORD 101 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County Board of County Commissioners THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty ty ACCORDANCE WITH THE POLICY PROVISIONS. 1100 Simonton Street Key West,FL 33040 AUTHORIZED REPRESENTATIVE v&* ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID:AMERCOM-02 IBRIDGES LOC#: 1 A�©� ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Florida Insurance Center, Inc. American Compliance Technologies Inc.&A-C-T Environmental Solutions Inc.& POLICY NUMBER A-C-T Environmental&Infrastructure Inc. 1875 W Main Street SEE PAGE 1 Bartow,FL 33830-7718 CARRIER NAIC CODE SEE PAGE 1 SEE P 1 EFFECTIVE DATE:SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations/Locations/Vehicles: for non-payment. The Monroe County Board of County Commissioners is included as additional insured with respect to general liability when required by written contract. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD