Certificates of Insurance
A CORD_ CERTIFICATE OF LIABILITY INSURANCE OP 10 2~ DATE (MM/DDIYYYY)
AMERI32 04/30/04
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATlOl\
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
The Plastridge Agency-SO HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
710 s. E. Ocean Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Stuart FL 34994-2427
Phone: 772-287-5532 Fax: 772-287-5572 INSURERS AFFORDING COVERAGE NAIC#
~-_... ---_..~.
INSURED INSURER A: Great American Insurance CO.
INSURER B:
American Underwater Contractor INSURER C:
& Scubba Scrubbers, Inc.
17536 SE Conch Bar Ave. INSURER D:
Tequesta FL 33469
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 ! ,:qIJ1Ir~~!:Ec.r)Yt: POLIC;vc~~r.ll-!~!~~N LIMITS
LTR TYPE OF INSURANCE DATE MMIDDIYV!' DATE MM/DD/YY
GENERAL LIABILITY EACH OCCURRENCE $ 1000000
- 08/30/03 08/30/04 PREMISES (Ea occurence)
A X X COMMERCIAL GENERAL LIABILITY OMH2500959-05 $ 50000
I CLAIMS MADE D OCCUR MED EXP (Anyone person) $ 2500
SHIP REPAIRERS OMH2500959-05 08/30/03 08/30/04 PERSONAL & ADV INJURY $ 1000000
-
GENERAL AGGREGATE $ 2000000
-
GEN'L AGGREGATE LIMiT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1000000
n POLICY n ~~8i ,-l LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $
ANY AUTO (Ea accident)
-
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS (Per person)
-
HIRED AUTOS BODILY INJURY
- NOON-OWNED AUTOS (Per accident) $
r----
r---- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
=1 ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: --~
AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
o OCCUR D CLAIMS MADE AGGREGATE $
, '---
$
-- -'-'---'-'-
C1 DEDUCTIBLE $
--.--
RETENTION $ $
WORKERS COMPENSATION AND I ITORY LIMITS I IU~~'
EMPLOYERS' LIABILITY '-'--
ANY PROPRIETOR/PARTNER/EXECUTIVE EL. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? I ---- -- --'--
If yes, describe under E.L. DISEASE - EA EMPLOYEE $ . ---- ---'~
SPECIAL PROVISIONS below EL. DISEASE. POLICY LIMIT $
OTHER
A P&I OMH2500959-05 08/30/03 08/30/04 Liability 500000
""'''''''''''' ~ ""'''''''''' '~no", "'"'"'' , 8<CW,"" ~"'""' "OO",EO.." '"'''' "o;;;~vf 8 ~ MA~~ENT
BY' .. 'llf .1
D~E_~~~__
N/A L YES
CERTIFICATE HOLDER CANCELLATION
Monroe County Board of County
Commissioners, Monroe Cnty
Marine Resc., Attn: Mayla
2798 Overseas Highway Ste 400
Marathon FL 33050
MONRO- 5 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.
AUTHORIZED REPRESENTATIVE
RATION 1
ACORD 25 (2001108)