Certificates of Insurance
THE FLORIDA KEYS
&KEYWE5I~
Key Largo, Islamorada, Marathon, Lower Keys, Key West
May 5, 1994
Mr. Danny Kolhage
Clerk of the Circuit Court
500 Whitehead Street
Key West, Florida 33040
Dear Mr. Kolhage:
The Board of County Commissioners approved a funding agreement with the Greater
Marathon Chamber of Commerce covering Pirates in Paradise '94, on May 21-22,
1994.
Enclosed please find the original insurance certificates approved by Risk
Management.
Also enclosed is a Declarations Update Endorsement for Diversified Services
Company. Per Ms. Kay Bahleda of Risk Management, please attach to the original
insurance certificate provided to you with the contract.
If you should have any questions regarding the above, please do not hesitate to call.
Sincerely
~d
Carol A. Fish r
Administrative Assistant
:caf
Enclosures
Acknowledge Receipt: --.f2. ~/
Date: i 5/1 r
3406 N. Roosevelt Blvd. Suite #201 P.O. Box 866 Key West, FL 33041 U.S.A. (305)296-1552 . Fax: (305)296-0788
~= === ====== = = == "==== = == = === ===== == ==:::: == =::= ::== =:::: =::c =::::::=:::: = ==~CE1VED =:: =" ::::::::::" ,,:::::::::::::: =:::::: =,;.;=':: ~ ISSUE DA TE: (11M/DCi y~,):',
: CERTIFICATE OF INS U R A :-1: - E AP R 2 5 19,oJr : ~;, ~ r . :
I tI"I I I I u4/ J,v. " i
1 ====== ========= =:::: ::=::::: == =:: == ==:: =:: = = = = ::== == c" =:::: =:: =::= =:::::::: ,::: c:.. _: ..:::::: =:: = :::= === ==:: == =:: =::=:: == =~....= =:: ==: =::::=== ==== ===== =::::=:::: ::==:: = .: \'
I PRODUCER 'THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
( (NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,:
,1 Washington In3Ui ance 501 vices /EXTENC OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW I
l~i~n~~~~~ ~~(t2~~~~ ~~~~e : -- ,------- - COM~ANi~~ ~FFO~DI~~-~OVE~AG~-------------.--. --. :
(703) 351-7400 ICOM~ANY Pacific Employers Insuranc.c Company I
-i~;~~~~---- ---------------..---------------------- f~~~~~~Y A i
LETTER B
, r '~"~At'" I
I cVI'W , J I
,LETTER C I
I, ~~T~~ n I
,L~ I, LJI ~ I
. COVERAGES = :.- .: -:::::, - :: co =: = :.:= ===== = ============== = === == i~~~~~~=== =~==== =======WMVEI;== =~,lA:=k=~=== =::= ==.. _..::. __ _ :
/ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD I
~ INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTACT OR OTHER DOCU~lENT WITH RESPECT TO W::IC:: THIS I
: CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AfFORDED BY THE POLICIE~ DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, :
I EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I
!CO : --..- .. -- ____mm......,___.... - .. ! POLICY 1 POLICY I \
iLiR: TYPE OF INSURANCE POLICY NUMBER iEm:CTIVE (eXPIRATION: :_;~ms (
I ' I I DA TE I DA TE I I
/1--"/1' GENERAL LIABILITY -"-1/,-- ----- --- .- ----. ---r- /: GENERAL AG~~EG~i~'--- --------..is--. ~~~~;~;;o-:
A D2362'1136 10/0U< 10/05/94 I PRODUCTS-COMP/OPS AGGREGATt 1$ 2,000,000 I
: : [xl COMMERCIAL GENERAL LIABILITY: I I PERSONAL & ADVERTISING INJURY ,$ 1 000,000 I
I I (l CLAIMS MADE (xl OCCUR. I "I EACH OCCURRENCE : $ 1 000 ;000 I
I f J OWN[:~ 's & CONTRACTOR'S PROT. UB~ QBNB!j~ LBn e' e J $ TQQQ
I ! x Addl Insured IF shown below! I!! MEDICAL EXPENSdA~~ o~~rperson),$ \000 :
;---r ~~i~~~~i~~-~iA~i~ITy.----------}---' .--------- -..-;----------I----------~-CGM8INED SINGLE : :
LIMIT $ 1 000,000
\ 1 r 1 ANY AUTO I I I \ ~ I
I A It 1 ALL OWNED AUTOS : 23629136 : 10/05/93 : 10/05/94 : -3CDILY INJU:~,( ... 1 :
: :~ SCHEDULED AUTOS I ,PCI f'CI~Ur'l $ I
: : ~;~ ~!;E~w~~!OlUTO\ I : i i ;OOllY ;:o,;,;----mm--j :
1/ II t j GARAGE LIABILITY I I I (Per accident) I $ II
\ 1 : : : PROPERTYDAMAGE-'- .... -- i,l - I
/ I I I 1 I I
: 'J rElxuCmEbssi.w.~lilQA-~FiOL-)i..,T:~-------------..-t------------------- ----------t ---. I EACH OCCURENCE . .-------- .t$ :
o. '" I I AGGREGATE 1$
: ! t JOther Than Umbrella Form II! 1 ~:
I r -...---..--. .., '- 1 I _,
1 WORKER'S COMPENSATION 1 "; .l S T:, TUT ORY LHII is 1 /
I AND I EAi;H ACCIDENT I $ I
I Et1PLGI~,~S' LIABILITY I I DISEASE - POLlCY Wi,l Is I
: 1 ! I DISEASE - EACH EMPLOYEE ; $ :
:: OTHER ----.----.-.... --- - r'-" -- i-n--------- :
I I I ! I I
I 1 I I I Received I
,I I I I I I
: D[~CRIPTION -~F-oPERATioNs/~oCATIONS/VEHICLES/SPECIAL ITEt1S . -. _H. - --. --RiS!d.4~~.- Lu"'s-eontrut --..--- I
I . P t P j M ~1 &;~ 199; D_ "',",.,' ___.,_~. _._IS 7. V' I
\ re- ira es in al"auise i5Y ~ LL, L q , '" A; _. ________~ !
: Certificate.holder is included a3 an Additional Insured, ATIMA, as D'fll[f\:" __ Pi<. u.)/~~ :
/ rc~fiects thLJ ~vellt , I
1- CERTIFICATE flOLDER -----------------------------....---.--- "ANCELLATION _._______________________________________.._______________I
/- \ I 1 -------------------______________u___ \, --------------____________u___________________________--I
I .. . 11 SHOULD ANY OF THE ABO~E DESCRIBED POLICIES BE CANCELLED BEFORE THE I
I Monroe Lounty Tourist Development Coun~ll I EXPIRATION DATE THER~Or, THE I~~UING COMPANY ~ILL ENDEAVOR TO I
I 3406 North Roosevelt Blvd. I MAIL 30 DAYS WRITTEN NOTICE TO THE CERTI~ICATE HOLDER NAMED TO THE \
I Key West FL 33040 I LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR I
I I LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OF REPRESENTATIVES. I
; !'Auifl;RliE~~)i;-j '..H_ -.. --.. !
~~~~~~~~~=~========~===~============~=~==~~~=~~~============~=~==~=~~~=~========-====================~========~:~===~=====
Florida Keys Land SOd Trust
POBox 536
Marathon, FL 33050
---- ---- ---~~=~=====;=~~~===~~~~~-----~~~=~==~~~~------~-- !. -~~~~----~~~~==~~~~~~~~===---=---~-------========~=------~~==--- ---~-
~ IB'~ ; ~SJ.'.UE DATE (MM/DD/YY) \
C E R T I F I CAT [ 0 FIN SUR A N C ~ ~CE!\/', 1 ~ n
~ = = === == = = = =:'" = ':=:0 = = == =; ,,: -: ===,,: =: :::. ==== == == = =: =; ===: :::;;:==:,,::== = = ======= = =:'=o~'!=~ ,:1_!~ = =="= ==L L l. ====~:~~ ~~~:; ==.:" : (
: PRODUCER ;THIS CERTIFICATE IS ISSUED AS A MATTtR~F INFORMATION ONLY AND CONFERS I
,NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,;
\EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW \
: . COMPANIES AFFORDING COVERAGE .----....... (
I~O~~A~~--------~:~iii~-~;;i~;;;;-i~~:;~~~~'~~;;~~;--------------------. /
\~ETTER A I
I COMPANY APPROVED BY RISK MANAGEM~N' I
ILETTER, B :
I'JI'r'HI I BY I
,LETTER C I
I L"~T"" 0 OATC I
I , (,1 (,1\ V ", ~ I
: = COVERAGES == == =========== ===== === =::=== ========== == === =lt~!l~~~ == =~ = = = = = ==== =~:f~= =:~; ~ ~= = ='~-;:=\;=~;~: == ===:: = == ==== === == )
I THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TIlE INSURED NAMED AGOVE FOR THE POLICY PERIOD \
I INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TH:~ I
) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, J
\ EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. \
;CO : ------- -.------ - . n _.._h____.____.... , POLICY , POLICY , I
ILTRI TYPE OF INSURANCE POLICY NUMBER :EFFE~J1VE :EXP1R0IION) LIMITS )
! " 1 DH I t 1 uA I ~ \
r ;' GENERAL LIABILITY I { -,' GENERAL AGGREGATE ........~$- ~ ,GOO ,ee: I
, A I i D23629136 10/05/93 10/05/94: PRODUCTS-COMP/OPS AGGREGATE : $ 2,000,000:
[X] COMMERCIAL GENERAL LIABILITY I PERSONAL & ADVERTISING INJURY ,$ 1 000,000 1
I I [] CLAIMS ~lADE [X] OCCUR. I I lACH OCCURRENCE : $ 1 000 :000 I
i ! fxi ~~~iRi~s~r~~NI~A~~~:~Sb~~~~'! ! ~~~~c~tM~~~E~~~(A~~eO~~r~~rson),; 5~,~~~ :
) .-...} ~~TOM~BI~~ Li~~i~ii~---"-----"'j ,-- -..------. -----f--- ; I COM~i~~~ 5IN~~E -----.. -------t --- I
I I \ I LIMIT :$ 1 VVV,VVJ \1
r 1 ANY AUTO I t
I A U 1 ALL OWNED AUTOS 23629136 10/05/93 I 10/05/94 'BODIL Y INJUR~"------ ,.'. I
: : ~xli ~f~~~U~~~o~UTOS : : (r'e; per 3011) ! $ :
\ I ~X NON-OWNED AUTOS I '-BODILY-INJURY ---U--_hhh---t-h---m--_.__,
: it GARAGE LIA8ILITY : : (Per_acddent) :~ :
I II J I I 1 I
I I I I PROPERTY DM-IACE I I
I 1 1 1 1 1 $ I
-I -------- .---------------------t----------------------I.- -- --. '1- '- '---"--1, -- -- ----'------------------t---------------
: ; EXCESS L:ABI~ITY 1 1 1 EACH OCCURENCE '$ ,
r 'jUmbrella Form I I', AGGREGATE ,1$,'
: ! [ Other Than Umbrella Form ! ! 1 I
1---;- ---WORKER:;'COMPENSATION-- : -. : --"--T-- I ~ STATUTORY-LIMITS- i ,
I I AND I I I ~~rH ~CClOtN,1 U"T 1$ :
I I EMPLOYERS' LIABILITY , I u..jEA.jE - POu,Y LIMil$
\ '__~h-- __..__h_____._____..._______.~--.. . -,----m-:-1 __ 1 D~SEAS~___~~~~_.~M~~~!~~____ !$ :
I 10TH"" , 'I, ,
\ I ~I\ I I I
I I I I I
: ~ l ~ . Received \
I Risk:- M~;l'n, .,;,-- .. -'-:-:Cantrot ~
C[:CRIPTION OF OPERtiTIONS/LOC,iTIONS/'JEHICLES/SPECIAL ITEMS .....h./. ;
; Ie: Pirates in Paradise May 21 & 22, 1994 DATE ----~'-f;.:~_. \
( Certificate holder is included 0:;1 an Additional Insured, ATIMA, as INI'l1AL ~ --:;;---= I
I respects this event I
\- rERTIFICATE HOLD~R' ---...-----.--...-------------.,-...----- rONC"" ATION -- .---- -'-.., ... -_._., ________________________._><___.., I
,- ~ L -------------------------------------- ~M ~LL ---------________________________________________________
I \ SHOULD ANY OF THE A80VE DESCRIBED POLICIES BE CANCELLED BEFORE TllE II
MUili OB Cvuiity aUalJ of CVLiiitl Commissioners EXPIRATION DATE THEREOF, ~d[ ISSUING COMPANY WILL ENDEAVOR TO
( 500 Whitehead Street : MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE :
I KeY West FL 33040 I LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR I
I I LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OF REPRESENTATIVES. I
!~~~~~~,~~"'~"'~~~"~~~"~"'~"'~"'~~"""'~"'""',!_~~:~~~~~E~~~~~~,~""_~~~~~,~,,:_,_j
Washington Insurance Services
1655 North Fort Myer Drive
Arlington, VA 22209.3108
(703) 351-7400
INSURED
Florida Keys Land Sea Trust
P 0 Bo x 536
Marathon, rL 33050
~ '-0-' -, ,- "0.. - ',- 0.,' -.... - ---~-_.... _ _..- ._~ '_~,~. ___~r_ n,. .~_ _ _ ___, _~_W'" ~ ~",._,~, .. __." ',,' '. ',," _.0" ,.__.______ ,...."', V" " .'_, _ >0 '''_',.. .. 0
---..------------------------------------------------------.-. -----------------..---------..
,---,-. -.~.,-._"._--------------------------
.-------------------------------------
I ISSUE DATE (MM/DD/YY) ,
C [ t\ T I F I CAT E 0 FIN SUR A N C E , J/E.l?:'- '- . 1""'. : ;, ^' " C I' , :
: PRODUCER . -:. =~====~==o = = === === == ===== = = =====:=~~HI~=~ERTlrI~~~=I~~IssuED?A~~A~~~TfE*otn~~~T~o~ =ONL~:~~~~~~NFERS== :
I NO RIGHTS UPON THE CERTIFICATE HOLDER, TH~;.j[RiIFICATE DOES NOT AME:;D,:
: ~ashington Insurance ~e~vices (EXTEND OR ALTER THE COVERAGE AFFORDED BY THE'~LICIES BELOW \
I 165? North tort Mi~1 01 "'J~ /-- ---h.___________nu_n.... m._____.____________._ I
I Arlington, VA 22209-3108 I COMPANIES AFFORDING COVERAGE I
: (703) 351-7400 ,. _.._ _. ..__. ,..... .___ :t~~~~~y A Pacific Employ~;.~-II;~~;.~~~~-c~I~~~~~ _h_ H
~ INSURED !COMPANY
I LETTER B
I r10rida Keys La~d Sea rru~t 'COMPANY
\ P 0 Sox 53G I LETTER C
I Marathon, Fl 33050 'COMPANY
I I, r"TT"'R Ol)
I IL~I ~
I ,COMPANY \
, ILETTEK E I
'e COVERAGES "=========cc=="====c="c==c=~"=oo:=:==========="c=~="c===========""c======="==~========~===:=~=c:====="":ccc:c=:c=:==c=
: 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 CONTACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
: CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS 5USJECT TO ALL THE TERMS. :
I EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. \
"'0 I "m.___,__________..._.. -- ,"-POLICY--;-POLICY I n. _n_m.__ -.. ------.----,--. I
:LTR:, TYPE OF INSURriNCE POLICY tiUMOER IEFFECTIVE 'EXPIRATION I L:MITS :
: DATE ~ DATE :
i , i GENERAL LIABILITY ,-' "'--TGENERAL-AGGREGATE ;$ '-2,000,000" i
I ,; I 023629136 10/05/93 10/05/94 PRODUCTS-COMP/OPS AGGREGATE ,$ 2,000,000 I
I [X] COMMERCIAL GENERAL LIABILITY : PERSONAL & ADVERTISING INJURY 1$ 1 000,000
: : [] CLAIMS MADE [X] OCCUR, : I lACH OCCURRtNCE : $ 1 000 000 i
I 1[,,1 ~~NER'S_&.cqNrBA~TOR'S PRaLl I E1B~ QeMe~~ L8n~ Oile 11..) $ 50:000 I
, iLIJ AlJdl III~UlelJ H ~huwn below, I MEDICAL EXPENSE(Any'o~e';erson),$ 5,000 I
i - .---.. _..n________.., .....-- --- hl__ '._ ----t-
) ; AUTOM08ILE LIABILITY; ;; COMBINED SINGLE ; :
: A ) t ~ ~~~ ~~~~D AUTOS 123629136 10/05/93 i 10/05/94 : ~~:;~Y INJURY ". h.t~m'~~~O~~OO )
: I.. i SCHEDULE~ iiUTes II (Per person) ! $ II
I rX~ HIRED AUTOS / I t
'II l rXi NON.OWNED AUTOS I I I-BODILY-iNJURy------'----..n, :
: t t GARAGE LIABILITY ( :: ~Per _~::~dent) ~$ \
: l J : (: PRDPERTY DAMAGE ;.. :
i , 'I I ,$ I
i .......---..-------------..-..---- t- ------------------t..-~, -.- -1--- ..-. --..t--------------------------------t------..--------
I EXCESS LIABILITY I ;: E~CH OC~URENCE ; $ :
I r jUmbrella Form I I I AbGREGA,E 1$ 1
.__It__~~~~~_!~~n Umbrella Form ____~__ 1----- --.------------------------t-.-------------I
I WORKER'S COMPENSATION ' " STATUTORY LIMITS I I
I AND I I' tACH ALClDtNI '$ I
: EMPLOYERS' LIABILITY I 'I DISlASE - POLlCY LIMIl 1$ :
I : !! DISEASE - EACH l~lPLOYEE : $ \
rOTHER -- h mnh-,-t.---- ,n.__. -+ I - ---.-- ....___._n. i
I I I
I I I
\ I Received I
DEscrmTION"OF'OPERATIONS/LOCATIONSIVEHICLES/SPECIAL ITEMS - INO" -~I'-"~IRisI._,r A: L_,_k.~~~~)C~.'" ~ L.;=;:ontrOI=----- III:
re: Pirates in Paradise May 21 & 22, 1994 ~________ _ _~~ __
Certificate holder is included as an Additional Insured, AlIMA, as
respects this event
I
CERTIFICATE HOLDER =====o=~======================~:====== CANCELLATION ==============================c==========================1
; SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE :
Greater Mdrathu~ C~amber of Comffier~e I EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO '
12222 Overseas Highway I MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE (
Marathon FL 33050 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
I I, TABTLnv OF ^'f' 1'1"0 ''PON ~HE c~W'''v -T"'~"H OF ~EP~EScNTATTw" i
I 1_ L.I. ,.L..l.1 I v hi I . \ f~U I I lV /"'rI111, 11...) ~1ULi'; i,J' f\.i'I l _.. I J. ~IL"). i
I""""""""""",",","""~,"",""""~"","""",",""",,",",""",""",!"~~::::~~~~~~":::_:::::,_:,_,_:,!
CIGNA FIRE UNDERWRITERS INSURANCE COMPANY:
-'DECLARATI_ "'ATE EIIDORS~
IIAIIED INSURED
DIVERSIFIED SERVIeESC~ANY
1505 FLAGLER AVE~UE
KEY WEST .Fl' 33040
STIt
ISVpl
POLICY ID
I D1 77 15 68 91
DIRECT BILLED
ENDORSEMENT EFFECTIVE DATE 01/02/94 POLICYPERIOD 01/02/94 TO 01/02/95
ELDtEIITS OF YOUR ....ICT DECLARATIONS ARE CHANCED AS SHOWII BELOW. ALL OTHER
ELDtEIITS :OF Y.... ....ICTDECLMATlO_ ARE HOT AFFECTED .Y THIS ENDORSEIIEIIT.
THESE CHAlICES APPLY TO LOSS.IIUURY. OR DAllACE WHICH OCCURCS> ON OR AFTER
THE EFFECTIVE DAtE ..... ABOVE. . ~
PRE:" 'I U" C H A . C E S
YOUR PREMIUM IS lOT CHANGED.
- O' THE R C H A . C E'S
ADDED AS ADDITIONAL INSURED
MONROE COUNTY AID "ONROE COUNTY TOURIST DEVELOPMENT COUNCIL
WING II. PUBLIC S~RVICE BUILDING
5100'JUNIOR COLLEGE ROAD
srOCK ISLA1tD.-
KEY WEST.FL 33140
DAVID W. FREEMAN- CPCU
aP~~
AUTHORIZED AGENT
ENDORSEMENT I 001
ClAST PAGE)
PAGE
1
THIS COPY TO:
I INSURED I
CC-9P99
PROCESSED: PRODUCER: DESTINATION
04/06/94 I I P00l94 1.1 P00194 I
9ft096.
ICPK-9ft16
.rtKT= me
APR 12 \994