Certificates of Insurance
-
ACORDN CERTIFICATE l ~.' LIABILITY INSURANCE OP 10 T~ DATE (MM/DDIYYYY)
ORION-2 04/16/04
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Lutgert Smith Lesher Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1395 Panther Lane HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PO Box 112500 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Naples FL 34108
Phone: 239-262-7171 Fax:239-262-5360 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Zurich US
Orion Bancorp, Inc
First Banco~ Inc INSURER B:
Gulf Coast ational Bank INSURER C
1st Nat'l Bank of FL Keys
3838 Tamiami Trail N. INSURER D:
Naples FL 34103
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 PAID CLAIMS.
LTR NSR[ TYPE OF INSURANCE POLICY NUMBER DATE iMM/DDlYVi I P8klfEYIMM/DDiYYIN LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 500,000
-
A X X COMMERCIAL GENERAL LIABILITY FIAOOOl724 09/18/03 09/18/04 UAMAl.j1:: $100,000
PREMISES (Ea occurence)
I CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 10,000
PERSONAL & ADV INJURY $ 500,000
-
- GENERAL AGGREGATE $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000
I ,nPRO- n EmD Ben. 1,000,000
POLICY JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $1,000,000
A ~ ANY AUTO CAPOO1632700 01/20/04 09/18/04 (Ea accident)
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS ~EME1' I (Per person)
- ~'~'
HIRED AUTOS ~: \iCD;~ " 1 \~ ~
- ~ ---- ~r~ BODILY INJURY $
NON-OWNED AUTOS ~Q -C;;J- (Per accident)
-
- /- , '_{'II PROPERTY DAMAGE $
~ ...,-r:. .._._.......-- -- (Per accident)
GARAGE LIABILITY v "'.._ \' t.' ..."._....~- ""C L/ I
!\ AUTO ONLY - EA ACCIDENT $
=l ANY AUTO WAIVER ~ . ,;-it, 'Q~fj .& OTHER THAN EA ACC $
""'" "- AUTO ONLY: AGG
$
EXCESs/UMBRELLA LIABILITY EACH OCCURRENCE $5,000,000
A tJ OCCUR 0 CLAIMS MADE CCLOOO160810 09/18/03 09/18/04 AGGREGATE $ 5,000,000
$
~ DEDUCTIBLE $
X RETENTION $10,000 $
WORKERS COMPENSATION AND X I TORY L1Mm; I rwr-
ER
A EMPLOYERS' LIABILITY FIAOOO1724 09/18/03 09/18/04 $ 500000
ANY PROPRIETORlPARTNERlEXECUTlVE E.L EACH ACCIDENT
OFFICERlMEMBER EXCLUDED? E.L DISEASE - EA EMPLOYEE $ 500000
If yes, describe under $ 500000
SPECIAL PROVISIONS below E.L DISEASE - POLICY LIMIT
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Ref: Bank ATM Machine, The Key West International Airport, S Roosevelt Blvd,
Key West, FL
Monroe County Board of County Commissioners is additional insured as
respects general liability/auto liab Fax# 305-295-4342 Attn:Bevette Moore;
410-261-7837 attn: Joyce Farrell/Zurich; 262-5390 Attn: Lori Arnold
CERTIFICATE HOLDER
Monroe County Board of
County Commissioners
1100 Simonton Street
Key West FL 33040
CANCELLATION
MONRO- 3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
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
REPRESENTATIVES.
AUTHOR REP ESENTATIVE
@ ACORD CORPORATION 1988
ACORD 25 (2001/08) c..c.:
ACORDN CERTIFICATE OF LIABILITY INSURANCE OP 10 T~ DATE (MM/DDIYYYY)
ORION-2 10/13/04
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Lutgert Smith Lesher Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1395 Panther Lane HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PO Box 112500 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Naples FL 34108
Phone: 239-262-7171 Fax:239-262-5360 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Zurich US
Orion Bancorp, Inc
First Banco~ Inc INSURER B:
Gulf Coast ational Bank INSURER C:
1st Nat'l Bank of FL Keys
3838 Tamiami Trail N. INSURER D:
Naples FL 34103 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 PAID CLAIMS.
NSR[ POLICY NUMBER PD~,;!~Tri~ro"6'r:.tnt: P N LIMITS
LTR TYPE OF INSURANCE DATE MMIDDIYY)
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
~ 09/18/04 09/18/05 ~R~:S~S (Ea occurence)
A X X COMMERCIAL GENERAL LIABILITY FIAOOOl724 $1,000,000
- .-J CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $10,000
PERSONAL & ADV INJURY $1,000,000
GENERAL AGGREGATE $ 2,000,000
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000
"I .nPRO- n Emp Ben. 1,000,000
POLICY JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $ 1,000,000
A X ANY AUTO CAPOO1632700 09/18/04 09/18/05 (Ea accident)
-
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS A~E. (Per person)
- BRISK r1AGEMEN7- '~~
HIRED AUTOS
f--- .. 'j' BODILY INJURY
i:3 y,~ _. "__~ Ijo~1 (Per accident) $
NON-OWNED AUTOS
f-- DAn:: { I-~'--"
~ I((D PROPERTY DAMAGE $
.... /' "-(1 (Per accident)
GARAGE LIABILITY HMI V l:r; ';. A ---.4.- YES_4 ~D ,;-bi Ml AUTO ONLY - EA ACCIDENT $
R ANY AUTO
'-'U(J'~ OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESs/UMBRELLA LIABILITY EACH OCCURRENCE $ 5,000,000
A ~ OCCUR D CLAIMS MADE CCLOOO160810 09/18/04 09/18/05 AGGREGATE $ 5,000,000
$
~ DEDUCTIBLE $
X RETENTION $10,000 $
WORKERS COMPENSATION AND X I TORY L1Mm3 I IUIN-
ER
A EMPLOYERS' LIABILITY FIAOOOl724 09/18/04 09/18/05 $ 500000
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT
OFFICERIMEMBER EXCLUDED? EL. DISEASE - EA EMPLOYEE $ 500000
If yes, describe under $ 500000
SPECIAL PROVISIONS below EL. DISEASE - POLICY LIMIT
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
REVISED - CORRECTION OF LIABILITY LI~ITS
Certificate Holder is included as Additional Insured with respect to the
Named Insured's operations (Bank ATM Machine located at 400 Duval St, Key
West, FL)
Fax to: 305-29~-4564
CERTIFICATE HOLDER
CANCELLATION
MONRO-3
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ 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
REPRESENTATIVES.
AUTHO REP ESENTATIVE
@ ACORD CORPORATION 1988
Monroe County Board of
County Commissioners
Monroe County Risk Mgmt
1100 Simonton Street
Key West FL 33040
ACORD 25 (2001/08)
CC: H...,~"",c.c:...
A CORD_ CERTIFICATE OF LIABILITY INSURANCE OP 10 T~ DATE (MM/DDIYYYY)
ORION 2 01/05/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Lutgert Insurance - Naples ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1395 Panther Lane HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PO Box 112500 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Naples FL 34108
Phone: 239-262-7171 Fax:239-262-5360 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Zurich US
Orion Bancorp, Inc
First Banco~ Inc INSURER B:
Gulf Coast ational Bank INSURER C:
1st Nat'l Bank of FL Keys
3838 Tamiami Trail N. INSURER D:
Naples FL 34103 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 PAID CLAIMS.
LTR NSR TYPE OF INSURANCE POLICY NUMBER PD~,;!~1ri~rJ.f~E P8k~CEY,~~b~J!gN LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
~ DAMAGE:: TO 'c" I CU
A X X COMMERCIAL GENERAL LIABILITY FIAOOOl724 09/18/05 09/18/06 PREMISES (Ea occurence) $1,000,000
I CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $10,000
PERSONAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000
I n PRO- nLOC Emp Ben. 1,000,000
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $ 1,000,000
A X ANY AUTO CAPOO1632700 09/18/05 09/18/06 (Ea accident)
r--
ALL OWNED AUTOS BODILY INJURY
r-- /\p i"j i-;,C'\; t~- :-', $
SCHEDULED AUTOS l (-,,":h\~~ i !i., . (Per person)
f-- '\, f)
HIRED AUTOS BODILY INJURY
c----- ._,~ ~-"- _._."'-~'-- > $
I NON-OWNED AUTOS '. 1-:-: ti':Dj?....... (Per accident)
r-- (.1,/\; .,
....'.4_......_
f-- ,..'1:.', PROPERTY DAMAGE $
i ~Vl\! \1/'": q , i YF,':: (Per accident)
GARAGE LIABILITY ~ ~((J".{) AUTO ONLY - EA ACCIDENT $
R ANY AUTO OTHER THAN EA ACC $
rl' t.l~ AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY II--v. - J. ...4.. IlIllcr"\JP EACH OCCURRENCE $5,000,000
~ OCCUR D CLAIMS MADE 09/18/05 ,",If lUV
A CCLOOO160810 09/18/06 AGGREGATE $5,000,000
$
Gl DEDUCTIBLE $
X RETENTION $0 $
WORKERS COMPENSATION AND X ITORY LIMITS I 10~~-
A EMPLOYERS' LIABILITY FIAOOO1724 09/18/05 09/18/06
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT $ 500000
, OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $ 500000
If yes, describe under $ 500000
SPECIAL PROVISIONS below EL DISEASE - POLICY LIMIT
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Certificate Holder is included as Additional Insured with respect to the
Named Insured's operations (Bank ATM Machine located at 400 Duval St, Key
West, FL and ATM Machine located at Key West Airport)
Fax to: 305-295-4564
CERTIFICATE HOLDER
CANCELLATION
Monroe County Board of
County Commissioners
Monroe County Risk Mgmt
PO Box 1026
Key West FL 33041-1026
MONRO- 3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
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
REPRESENTATIVES.
AUT ZE .?J.RE N :A.TIV
@ ACORD CORPORATION 1988
ACORD 25 (2001!08l..l.#__ ._ _
c.c..~~
PRODUCER
Lutgert Insurance - Naples
1395 Panther Lane
PO Box 1'12500
Naples FL 34108
Phone: 239-262-7171 Fax:239-262-5 60
T;I-!''IL
j"\ ;:\;l
DATE (MM/DDIYYYY)
ORION 2 09 20 06
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY ERS NO RIGHTS UPON THE CERTIFICATE
",'". .-. DER. THIS ERTIFICATE DOES NOT AMEND, EXTEND OR
.; R THE CO ERAGE AFFORDED BY THE POLICIES 8ELOW.
INSURERJFFO~ING COVERAGE NAIC #
2 ~NSURER A: ., Zur ch US
ACORD.
CERTIFICATE OF LIABILITY INSURANCE
INSURED
0-P
\)t
Orion Bancol' Inc
First Banco Inc
Gulf Coast tional Bank
1st Nat'l Bank of FL Keys
3839 Tamiami Trail N.
Naples FL 34103
COVERAGES
INSURER B:
0,
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.
LT. NS. TYPE OF INSUAANCE POLICY NUMBER ~'1!~~ri~Dctf~E 'lI~TEY'~~'l:,w,. LIMITS
~NERAL UABILlTY EACH OCCURRENCE .1,000,000
A X X COMMERCIAL GENE,RAL LIABILITY FIAOOOl724 09/18/06 09/18/07 PREMISES Ea occurence\ .1,000,000
I CLAIMS MAOE ~ OCCUR MED EXP (Anyone pel'$on) .10,000
PERSONAL & ADV INJURY .1,000,000
I-
GENERAL AGGREGATE .2,000 000
I-
GEN'L AGGREGATE LIMlr AP~t PER: PRODUCTS-COM~OPAGG .2 000,000
11, (-n-~.o, Emp Ben. 1,000,000
POLICY JECT LOC
AUTOMOBtLE L1AIILlTY COMBINED SINGLE LIMIT
- .1,000,000
A ~ ANY AUTO CAPOO1632700 09/18/06 09/18/07 (Eaaccidenl)
ALL OWNEO AUTOS SODIL Y INJURY
- .
SCHEDUl1D AUTOS ,..Jl (Per person)
- fll'~C
- HIRED AUTOS , BODILY INJURY
.
NON-O\fNED AUTOS (Peraccidenl)
- . '--C ~d1o:oy,
PROPERTY DAMAGE
- ; (Peraccidenl) .
GARAGE-L1ABIUTY l'- ". l'Jn'O AUTO ONLY. EA ACCIDENT .
~-A"'AUTO ~'.( OTHER THAN EA ACC .
AUTO ONLY: AGG .
EXC&8SfUMBRELLA LIABILITY EACH OCCURRENCE .5,000,000
A x: OCCUR o CLAIMS MADE UMB508618301 09/18/07 09/18/07 AGGREGATE .5,000,000
~' {(C~ JJ;
.
8 ,DEDUCT'SLE M~m&)7e .
X RETENTION .0 '~ .
WORllERS COMPENSATION AND X ITORVU:':f'S I IUE~'
A EMPWYERS" UABIUTY WCPOO03992 09/18/06 09/18/07 .500000
ANyPROPRIETORJPARTNERIEXECUTIVE E.L. EACH ACCIDENT
OFRCERIMEMBER EXCLUDED? t=.L. DISEASE - EA EMPLOYEE .500000
~~I~L~'6v~~~~s below E.L. DISEASE - POLICY UMIT . 500000
C'8HER
DESCRIPTION OF OPERAnoN8 I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Cartificate Holder is included as Additional Insured with respect to the
Named Insured I s operations (Bank ATM Machine located at 400 Duval St, Key
West, FL and ATM Machine located at Key West Airport)
Fax to: 305-295-4564
cc: r:=;';-,a...-,.c ~
CERTIFICATE HOLDER
Monroe Coun.ty Board of
County Commissioners
Monroe Coun'ty Risk Mgmt
PO Box 1026
Key West FL 33041-1026
CANCELLATION
MONRO- 3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 8E CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOncE 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
REPRESENT TrVES,
AUT ~~RE N TrV
@ACORD CORPORATION 1988
ACORD 25 (2001108)
PRODUCER Phone: 239-262-7171 ;
Lutgert Insurance Napl~s
PO Box 112500 '
Naples FL 34108
Fax: ~~?-2~~~5~~P
DATE (MMlDDIYVYY)
5 19 2009
TH CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
o Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HolDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
AL feR THE COVERAGE AFFORDED BY THE POLICIES BELOW.
A CORDTII
CERTIFlCATEuOF LIABILITY ,INSURANCE
JllN
1 2009
INSU~RS AFFORDING COVERAGE
NAlC#
anies
INSURED
Orion Bank
2150 Goodlette Rd N
Naples FL 34102
L
& Liabilit
INSURER E:
COVERAGES
~HE 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.
~ IADD'L POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
...11I1
A ~NERAL LIABILITY FIAOOO1724 9/18/2008 9/18/2009 EACH OCCURRENCE Sl.000.000
I--- COMMERCIAL GENERAL LIABIUTY ~~~SIEa occurencel Sl.000 000
I--- ~. CLAIMS MADE Ii] OCCUR MED EXP (Any one person) $10 000
PERSONAL & ADV INJURY Sl.000 000
-
- GENERAL AGGREGATE S2.000 000
-;l'LAGGnEUMIT APrlPER: PRODUCTS - COMP/OP AGG S2.000 000
X POLICY ~~ LOC
C ~OIIOBILE LIABILITY BAP967435305 9/18/2008 9/18/2009 COMBINED SINGLE UMIT Sl,OOO,OOO
lL ANY AUTO (Ea accident)
- ALL OWNED AUTOS ~~ D BODILY INJURY
S
SCHEDULED AUTOS (Per person)
- ~,
- HIRED AUTOS BODILY INJURY
(Per accident) $
NON-OWNED AUTOS '1
I--- Co ~~\-(
I--- PROPERTY DAMAGE $
(Per accident)
RUAm~ ~ AUTO ONLY - EAACCIDENT $
ANY AUTO OTHER THAN EAACC $
AUTO ONLY: AGG $
B ~ESSJUII8RELLA LIABILITY UMB508618301 9/18/2008 9/18/2009 EACH OCCURRENCE $10.000 000
OCCUR [i] CLAIMS MADE AGGREGATE $10.000 000
$
~ DEDUCTIBLE $
X RETENTION $0 $
B WORKERS COMPENSATION AND WCPOO03992 9/18/2008 9/18/2009 X I ~~LAJ.UrS I laTH-
ER
EMPLOYERS" LIABILITY
ANY PROPRIETORIPARTNERlEXECUTNE D EL EACH ACCIDENT $500.000
OFFICERlMEMBER EXCLUDED? I OA J I EL DISEASE - EA EMPLOYEE $500.000
g~c~~dNSbelow I'(M:; "\ E.L DISEASE - POUCY UMIT $500.000
,
OTHER U / \. 'I'" \.../'-' -- ~
( ) f'( " '
DESCRIPTION OF OPERATIONS' LOCATIONS 'VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT' S~~AL PROVISIONS
~ertificate Holder is included as Additional Insured with respect to the
~amed Insured's operations (Bank ATM Machine located at 400 Duval St, Key
~est, FL and ATM Machine located at Key West Airport) ~ fY)~
I .
c.c,: ~
Monroe County Board of County Commissioners
Monroe County Risk Management
PO Box 1026
Key West FL 33041-1026
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION 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 REPRESENTATIVES.
CERTIFICATE HOLDER
AUTHORIZED REPRESENTAT
ACORD 25 (2001/08)
ACORQM CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDlYYYY)
11/30/2009
PRODUCER Phone: 239-262-7171 Fax: 239-262-5360 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMAnON
Lutgert Insurance - Naples ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PO Box 112500 AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Naples FL 34108
INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A: Amer i can Guarantee & Liabilitv ~6247
Orion Bank INSURER B:
2150 Goodlette Rd N
Naples FL 34102 INSURER C:
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 PAID CLAIMS.
IN:: DO' POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
A
GENERAL LIABILITY
CP005939629
9/18/2009
9/18/2010
EACH OCCURRENCE
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE [i] OCCUR
MED EXP (Anyone person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS-COM~OPAGG
GEN'LAGGREGATE LIMIT APPLIES PER:
PRO-
LOC
A
AUTOMOBILE LIABILITY
X ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
X HIRED AUTOS
X NON-OWNED AUTOS
BAP967435305
9/18/2009 9/18/2010
COMBINED SINGLE LIMIT
(Ea accident)
BODILY INJURY
(Per person)
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
(Per accident)
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
OTHER THAN
AUTO ONLY:
A
EXCESs/UMBRELLA LIABILITY
OCCUR [i] CLAIMS MADE
UMB508618301
9/18/2009
9/18/2010
EACH OCCURRENCE
AGGREGATE
DEDUCTIBLE
X RETENTION $
A WORKERS COMPENSATION AND
EMPLOYERS' L1ABIUTY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
~~~~r:C~~~~;s40NS below
OTHER
WC967435416
9/18/2009 9/18/2010
X
$ 1
$1
$ ,
$ 1
$2
$2
000 000
000 000
000 000
000 000
000 000
$1,000,000
$
$
$
EA ACC
AGG
$
$
$
$5
$5
$
$
$
000 000
000 000
OTH-
ER
$ 500 000
E.L. DISEASE - EA EMPLOYEE $ 5 0 0 000
E.L. DISEASE - POLICY LIMIT $ 500 000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
ertificate Holder is included as Additional Insured with respect to the
amed Insured's operations (Bank ATM Machine located at 400 Duval St, Key
est, FL and ATM Machine located at Key West Airport)
CERTIFICATE HOLDER
SHOULD ANY OF THE ABOVE DESCRIBED OLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER
Monroe County Board of County Commissioners WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE
Monroe County Risk Management CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO
PO Box 1026 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON
Key West FL 33041-1026 THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENT A TlV
ACORD25(~1~8)
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