Certificates of Insurance
ACORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDlYYYY)
4/15/2004
PRODUCER 305 852 8022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Insurance Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
91880 Overseas Highway HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Tavernier FL 33070
License #A073977/ A315441 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Colonv Insurance Co
Barley's Bay Festival, Inc. INSURER B:
P.O. Box 2694 INSURER C:
Key Largo FL 33037 INSURER D:
INSURER E:
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 PAID CLAIMS.
II~SR ,~~~ POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
TR
A GENERAL LIABILITY Binder 5/08/2004 5/08/2004 EACH OCCURRENCE $ 1,000,000
t!3MERCIAL GENERAL LIABILITY ~~~~~J9E~~~J~~nce $ 50,000
f--- CLAIMS MADE [1<J OCCUR MED EXP (Anyone person) $ 1,000
PERSONAL & ADV INJURY $ 1,000,000
- Z,UUU,OOU
- GENERAL AGGREGATE $
~'L AGGREFl LIMIT APn PER: PRODUCTS. COMPIOP AGG $
POLICY P'f?r LOC
~OMOBILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)
~
c-- ALL OWNED AUTOS BODILY INJURY
$
SCHEDULED AUTOS (Per person)
I---
f--- HiRED AUTOS BODILY INJURY
$
NON-OWNED AUTOS (Per accident)
-
- PROPERTY DAMAGE $
(Per accident)
~GE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO AP~" f" ~ () IiI OTHER THAN EA ACC $
~l AUTO ONLY: AGG $
OESS/UMBRELLA LIABILITY 'ff r u, '\']; ~;~NAG'etN ,. EACH OCCURRENCE $
OCCUR 0 CLAIMS MADE BY..1.u\..' '/ III 61 V AGGREGATE $
DArt --.-!:f { ~ Vi-I $
R DEDUCTIBLE WAIVER N/A~ 'x $
,
RETENTION $ ,,_. $
. , ~( 1 T"/,f STATU- I 10TH,
WORKERS COMPENSATION AND - T RY IMITS ER
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE I E.L EACH ACCIDENT $
OFFiCER/MEMBER EXCLUDED? E,L, DISEASE - EA EMPLOYEE $
If yes, describe under
SPECIAL PROVISIONS below E,L DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Fund raiser-Music Festival
CERTIFICATE HOLDER
CANCELLATION
COVERAGES
Monroe County BOCC & Monroe County TOC
1100 Simonton Street, Room 2-277
Key West, FL 33040
Additional Insureds
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUtNG INSURER WILL ENDEAVOR TO MAIL ..3kl- DAYS WRtTTEN
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
REPRE
AUT R
ACORD 25 (2001/08y' .
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