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Certificates of Insurance DATE(MM/DD/YYYY) ACORO® CERTIFICATE OF LIABILITY INSURANCE 07/21/2023 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 endorsements. PRODUCER CONTACT HOUSE NAME: Kelly White&Associates Insurance, LLC A/CN 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: Kinsale Insurance Company INSURED INSURER B: Friends of the Pool, Inc INSURER C: 217 Matecumbe Ave INSURER D: INSURER E: Islamorado FL 33036 INSURER F: COVERAGES CERTIFICATE NUMBER: FRIE23072108462274 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) $ 100,000 MED EXP(Any oneperson) $ Excluded A X KW20230720 07/20/2023 07/20/2024 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ❑PRO ❑ Excluded JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED APPROVED BY RISK MANAGEMENT BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED „,, PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY DATE �]�2,L��2,n2,, Per accident) ccident $ 4 $ UMBRELLA LIAB OCCUR WAIVER N/A YES EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Monroe County BOCC and Monroe County Tourist Development Council are additional insureds for General Liability as required by contract. 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. Monroe County Tourist Development Council AUTHORIZED REPRESENTATIVE P.O. Box 1026 Key West FL 33041 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 26(2016/03) The ACORD name and logo are registered marks of ACORD 1996 Edition MONROE COUNTY, FLORIDA Request For Waiver of Insurance Requirements It is requested that the insurance requirements, as specified in the County's Schedule of Insurance Requirements, be waived or modified on the following contract. Contractor: Friends of the Pool, Inc. Contract for: Alligator Light House Repairs Address of Contractor: 217 Matecumbe Ave Islamorada, FI 33036 APPROVED BY RISK MANAGEMENT By Phone: 305-664-7149 DATE 7/24/2023 WAIVER NIA- YES-Scope of Work: Repair/Restore Alligator Reef Light House Reason for Waiver: Organization has no employees or automobiles Policies Waiver will apply to: Worker Co p and Auto 4 Signature of Contract Approved of Approved Risk Management: Date: County Administrator Appeal: Approved Not Approved Date: Board of County Commissioners Appeal: Approved Not Approved Meeting Date: Administration Instruction#4709.2