Certificates of Insurance
A CORD_ CERTIFICA TE OF LIABILITY INSURANC~~p~~l I DATE (MMIDDIYY)
07/28/00
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Hugh Cotton Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 1701 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Orlando FL 32802
Phone: 407-898-1776 Fax: 407-894-5278 INSURERS AFFORDING COVERAGE
INSURED INSURER A: Commercial Union Insurance CO.
INSURER B:
A.S.A.P., Inc. INSURER c:
P.O. Box 804 INSURER D:
Tavernier FL 33070
I INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOlWlTHSTANDING
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 OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I~f: TYPE OF INSURANCE POLICY NUMBER b2~bl;l~it~BmYE P6'AL{~~~r6~~N LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
f--
A X COMMERCIAL GENERAL LIABILITY CZJH20236 06/09/00 06/09/01 FIRE DAMAGE (Anyone fire) $ 50,000
i CLAIMS MADE ~ OCCUR .--
MED EXP (Anyone person) $ 5,000
~ Protection & PERSONAL & ADV INJURY $1,000,000
_ Indemni ty Incl. GENERAL AGGREGATE $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS. COMP/OP AGG $1,000,000
n n PRO. nLOC
POLICY JECT
AUTOMOBILE LIABILITY '''~ 'M COMBINED SINGLE LIMIT
f-- b $
ANY AUTO (Ea accident)
C-
ALL OWNED AUTOS -- '/ o.,cu, BODILY INJURY
- $
SCHEDULED AUTOS "'Tf:_ .&J- bV- 6l< (Per person)
-
HIRED AUTOS --- -(
- ......._-" BODILY INJURY $
NON.OWNED AUTOS "#'!';-r;:. "~'t~ 'J~ (Per accident)
f-- ~, ..,
-'- ) Cc PROPERTY DAMAGE
c- '.-'- $
A'. (Per accident)
GARAGE LIABILITY e vt;Vn if Ill~ AUTO ONLY. EA ACCIDENT $
q ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY - . "", 0\,-~ ,D EACH OCCURRENCE $
OCCUR o CLAIMS MADE ~- AGGREGATE $
IJI).JJ.~-"" ._~ $
R DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND I TORYLIMrrS I IVER'
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT $
E.L. DISEASE. EA EMPLOYEI $
E.L. DISEASE. POLICY LIMIT $
OTHER
DESCRIPTION OF OPERA TIONSlLOCA TIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
POLLTION COVERAGE INCLUDED. Certificate holder named as addtional insured.
CERTIFICA TE HOLDER I Y I ADDITIONAL INSURED; INSURER LETTER: A CANCELLATION
MONRCOU SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
Monroe County Board DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
of Commissioners -
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Attn: Risk Management IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
5100 College Rd. R~ATIVES.
Key West, FL 33040 .I
(.L.P~~ '~" ~- 0'. ,
I I ~- Co1:Em ~u"}ance Inc.
ACORD 25-8 (7/97) ~ @ACORDCORPORATION 1988
ACORD.. CERTIFICATE OF LIABILITY INSURANCF:Jfp~~1 I DATE (MMlDDNY)
07/12/00
PRODUCER ~ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Hugh Cotton Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 1701 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Orlando FL 32802 INSURERS AFFORDING COVERAGE
Phone: 407-898-1776 Fax:407-894-5278
INSURED INSURER A: Commercial Union Insurance CO.
INSURER B:
A.S.A.P., Inc. INSURER c:
P.O. Box 804 INSURER D,
Tavernier FL 33070
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 MAYBE 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 ~2~IfTM~~7-l.}YE ~kf~1~6~?N LIMITS
~NERAL LIABILITY EACH OCCURRENCE $1,000,000
A X COMMERCIAL GENERAL LIABILITY CZJH20236 06/09/00 06/09/01 FIRE DAMAGE (Anyone fire) $ 50,000
I CLAIMS MADE [!J OCCUR MED EXP (Anyone person) $5,000
X Protection & PERSONAL & ADV INJURY $1,000,000
Indemnity Incl. GENERAL AGGREGATE $2,000,000
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $1,000,000
I n PRO- nLOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
I-- $
ANY AUTO (Ea accident)
I--
ALL OWNED AUTOS l'y '~-'ffrt ~j)( [?b~" BODILY INJURY
- " .~' ~,:. ~ $
SCHEDULED AUTOS (Per person)
-
HIRED AUTOS
c-- I 11 flY') -- BODILY INJURY $
NON-OWNED AUTOS D!jTE ~ (Per accident)
-
---
- .........v PROPERTY DAMAGE $
W:'''.TO, . .. (Per accident)
GARAGE LIABILITY ..r_ , ..) AUTO ONLY - EA ACCIDENT $
R ANY AUTO ~ " CJPiP OTHER THAN EA ACC $
AUTO ONLY, AGG $
EXCESS LIABILITY ~ lj;Qo EACH OCCURRENCE $
:J OCCUR o CLAIMS MADE CC .t\~~rn( I AGGREGATE $
b.ee $
R DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND I TORY L1MrrS I IOJ~-
EMPLOYERS' LIABILITY
EL. EACH ACCIDENT $
----....-..----- . --.-
EL. DISEASE - EA EMPLOYEE $
EL. DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS/LOCATlONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Monroe County, Board of County Commisioners named as Additional Insured
regarding General Liability. Fax #305-295-4317 (Attn: Kim McGee)
CERTIFICATE HOLDER I y I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
MONROE 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
Monroe County, Board of County DATE THEREOF, THE ISSUING ~ ~L ENDEAVOR TO MAlL 30 DAYS WRITTEN
Commissioners. ~"' e..n"",,, "'". A "ro "m~. '" ,";;;;;- ro 00 "'......,
5100 College Road - ~j
Public Svc Bldg-Wing IV-Rm 410 IMP 0 PBLlG.ynoN OR \ lABILITY NY KIND UPON THE INSURER, ITS AGENTS OR
Key West FL 33040 REP NT"T1VES'
I HUqh\~ ~I I\!~~ vii XW!JAJ\
v
ACORD 25-5 (7/97)
@ACORDCORPORATION 1988
ACORDN CERTIFICA TE OF LIABILITY INSURANC~~l}~l r DATE (MM/DDNY)
07/05/00
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMA nON
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Hugh Cotton Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 1701 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Orlando FL 32802 INSURERS AFFORDING COVERAGE
Phone: 407-898-1776 Fax: 407-894-5278
INSURED INSURER A: Commercial Union Insurance CO.
INSURER B:
A.S.A.P., Inc. INSURER C:
P.O. Box 804 INSURER D:
Tavernier FL 33070
I INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOlWlTHSTANDING
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.
'~T: TYPE OF INSURANCE POLICY NUMBER LIMITS
GENERAL LIABILITY EACH OCCURRENCE
A X COMMERCIALGENERALLIABILITY CZJH20236
CLAIMS MADE ~ OCCUR
06/09/00
06/09/01 FIRE DAMAGE (Anyone fire)
MED EXP (Anyone person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS. COMP/OP AGG
$1,000,000
$50,000
$ 5,000
$1,000,000
$ 2,000,000
$ 1,000,000
LOC
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-DWNED AUTOS
GARAGE LIABILITY
ANY AUTO
\I
u:
D.~iE
EXCESS LIABILITY
OCCUR D CLAIMS MADE
DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
OTHER
DESCRIPTION OF OPERATIONSlLOCATIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER
Y ADDITIONAL INSURED; INSURER LETTER: A
CANCELLA TION
Monroe County Board
of Commissioners
Attn: Risk Management
5100 College Rd.
Key West, FL 33040
MONRCOU
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 $
$
$
$
$
E.L. DISEASE. EA EMPLOYE $
E.L. DISEASE. POLICY LIMIT $
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRA TIO
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
ACORD 25-S (7/97)
Inc.
@ACORDCORPORATION 1988
ACORQ CERTIFICATE OF LIABILITY INSURANCE I CERTIFICATE NO./ DATE
VC2 -4064 7 -48666
5/17/00 10:10:15 AM
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Hanafin Bates & Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
8144 Walnut Hill Lane #1081 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Dallas, TX 75231 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
214-346-1510 fax: 214-346-1531
INSURERS AFFORDING COVERAGE
INSURED INSURER A: Reliance National Indemnitv Comoanv
ASAP, Inc.
P. O. Box 804 INSURER B:
Tavernier, FL 33070 INSURER C:
305-852-4554 fax: 305-852-4554
INSURER D:
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 flC\ID CLAIMS.
I,~R TYPE OF INSURANCE POLICY NUMBER P~A~~~::'68'w~ Pg~'fJI~:h~N LIMITS
~NERAL LIABILITY EACH OCCURRENCE $
COMMERCIAL GENERo,L LIABILITY FIRE DAMAGE (Anyone fire) $
I-- h CLAIMS MADE 0 OCCUR
MED EXP (Anyone person) $
PERSONAL & ADV INJURY $
-
GENERAL AGGREGATE $
-
GEN'L AGGREGATE LIMIT APPLIES PER: ;~-..'Mr r1'0l r 7f)''-'f PRODUCTS - COMP/OP AGG $
I POLICY Ii jffi n LOC ' ':":'" ': ~
~OMOBILE UABILITY V , ~ \ . Ul J JJJ COMBINED SINGLE LIMIT $
ANY AUTO LI I \ " ,~ (Ea accident)
I-- n~TE __ Ole: 7P
ALL OWNED AUTOS BODILY INJURY
- .- $
SCHEDULED AUTOS [,. (Per person)
-
HIRED AUTOS \~/! ~\TR: i"'~1 " '" f- vFS BODILY INJURY
- " - (Per accident) $
NON-OWNED AUTOS J (aA [Y
- Q)ll
PROPERTY DAMAGE $
(Per accident)
RGE UABILITY II 00 AUTO ONLY - EA ACCIDENT $
ANY AUTO CL"'l OTHER THAN EA ACC $
AUTO ONLY:
." '-' -" AGG $
~ESS LIABILITY ~ mq EACH OCCURRENCE $
_ OCCUR 0 CLAIMS MADE ll/V'() )(JL AGGREGATE $
$
DEDUCTIBLE $
I--
RETENTION $ $
---_._--_.._,~._._.~.- --~--- 11WCSfA1U- I PJh'
WORKERS COMPENSATION AND NWAOll7768-06 5/17/00 12/31/00 X TORY LIMITS ER
EMPLOYERS' LIABILITY
A E.L. EACH ACCIDENT $ 1,000,000
E.L. DISEASE - EA EMPLOYEE $ 1,000,000
E.L. DISEASE - POLICY LIMIT $ 1,000,000
OTHER
I LIMIT $
LIMIT $
DESCRIPTION OF OPERATlONSlLOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
1. Certificate holder is provided with a Waiver of Subrogation for Workers Compensation 2. The Workers
Compensation policy certified, includes $1,000,000 limit for Maritime Employers Liability {Jones Act}, USL & H,
Outer Continental Shelf Lands Act, Blanket Waiver of Subrogation, In Rem, Transportation Wages Maintenance and
Cure, Alternate Employer Endorsement, and Voluntary Compensation Maritime Endorsement. 3. Insured is afforded
Workers Compensation & Employers Liability as a co-employer under the policy for employees leased from AMS Staff
Leasing, Inc.
CERTIFICATE HOLDER I I ADDmONAL INSURED; INSURER LETTER: CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
Monroe County Board of Commissioners DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ..1.L DAYS WRITTEN
Attn; Risk Management NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
5100 College Rd.
Key West, FL 33040 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
fax: REPRESENTATIVES.
'-~) d- 'J-/ DZ) AUTHORIZED REPRESENTATIVE ~~C?~
L~ --n:x-
ACORD 25-S (7/97) I""", ....-~"~---- I @ACOND CCR?ORATlON 1!)83
INITIAL ___~..+.___._
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