Certificates of Insurance
ACORDN CERTIFICATE OF LIABILITY INSURANC~I~f~~ n1 DATE (MMlDDIYY)
04/27/04
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Rogers, Gunter, Vaughn ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
POBox 25598 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Tampa FL 33622-5598 INSURERS AFFORDING COVERAGE
Phone: 813-876-5555 Fax: 813-876-5855
INSURED INSURER A: Scottsdale Insurance CO
INSURER B:
Duke Pontin DBA: Spirit Marine INSURER c:
POBox 244 INSURER D:
Big Pine Key FL 33043 INSURER E:
I
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.
I
LTR
TYPE OF INSURANCE
GENERAL LIABILITY
A X COMMERCIAL GENERAL LIABILITY CLS1008541
CLAIMS MADE ~ OCCUR
X BI&PD Ded $500
POLICY NUMBER
04/21/04
LIMITS
EACH OCCURRENCE $ 300 , 000
04/21/05 FIRE DAMAGE (Any one fire) $100,000
MED EXP (Anyone person) $ Excl uded
PERSONAL &ADV INJURY $ 300,000
GENERAL AGGREGATE $ 300,000
PRODUCTS-COMP/OPAGG $ 300,000
LOC
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
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 EMPLOYEE $
E.L DISEASE - POLICY LIMIT $
APP
GARAGE LIABILITY
ANY AUTO
EXCESS LIABILITY
OCCUR D CLAIMS MADE
DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
(!~ .
h"rt CL rt. C e..,
CERTIFICATE HOLDER
Y ADDITIONAL INSURED; INSURER LETTER:
CANCELLATION
Monroe County Board of County
Commissioners
Maria Del Rio
1100 Simonton Street
Key West FL 33040
MONRC-1 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.
AUTHORIZED PRES TATI
CORD CORPORATION 1988
ACORD 25-S (7/97)
ACORO,. CERTIFICATE OF LIABILITY INSURANC~I~r~~ n1 DATE (MM/DDIYYI
07/09/04
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Rogers, Gunter, Vaughn ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
POBox 25598 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Tampa FL 33622-5598 INSURERS AFFORDING COVERAGE
Phone: 813-876-5555 Fax:813-876-5855
INSURED INSURER A: Scottsdale Insurance CO
INSURER B:
Duke Pontin DBA: Spirit Marine INSURER c:
POBox 244 INSURER D:
Big Pine Key FL 33043
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 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.
I~TI~ TYPE OF INSURANCE POLICY NUMBER LIMITS
GENERAL LIABILITY
A X COMMERCIAL GENERAL LIABILITY CLS 1 0 0 8541
CLAIMS MADE [!] OCCUR
X BI&PD Ded $500
04/21/04
EACH OCCURRENCE $ 300,000
04/21/05 FIRE DAMAGE (Any one fire) $100,000
MED EXP (Anyone person) $ Excluded
PERSONAL & ADV INJURY $ 300 , 000
GENERAL AGGREGATE $ 300,000
PRODUCTS - COMP/OP AGG $ 300 , 000
LOC
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
APPR
BY
DATE
GARAGE LIABILITY
ANY AUTO
EXCESS LIABILITY
OCCUR D CLAIMS MADE
DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER
Y ADDITIONAL INSURED; INSURER LETTER:
CANCELLATION
Monroe County Board of County
Commissioners
Maria Del Rio
1100 Simonton Street
Key West FL 33040
MONRC-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ..l...O....... 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 P ES TATI
CORD CORPORATION 1988
t..t .. \
ACORD 25-8 (7/~) .
c..c..: ~
1
FLC 3961183 12
ADDL INSUREDS COPY
VLC 00 F
~.s Insurance
THIS IS A RENEWAL
TERMINATE IF FULL
RECEIVED BY l2:01
BUSINESS AUTO
OFFER ONLY. COVERAGE WILL
RENEWAL PREMIUM IS NOT
A M 02/04/2005.
POLICY
......-.................--.--.-..."........
~[:~[:~[~eQij~Qy[:~[)N~~1:jj.~~:j
FLC 3961183 02/04/2005 08/04/2005 INTEGON
mRt$PQtlpy~~$XQWA$NAM~pli\t$VrM;1?
DUKE PONTIN
SPIRIT MARINE
PO BOX 244
BIG PINE KEY FL
THE JOHNSONS INSURANCE
13361 OVERSEAS HWY
MARATHON SHORES FL
33043
33050
THE INSURANCE AFFORDED IS ONLY WITH RESPECT TO THE FOLLOWING INDICATED COVERAGES
WITH RESPECT TO EACH DECLARED VEHICLE. THE LIMIT OF THE COMPANY'S LIABILITY
AGAINST SUCH COVERAGE SHALL BE STATED HEREIN, SUBJECT TO ALL THE TERMS OF THIS
POLICY HAVING REFERENCE THERETO.
SCHEDULE OF COVERAGES AND LIMITS OF LIABILITY
COVERAGES
BI/PD LIABILITY
BASIC PIP WITHOUT WC
$500,000 COMBINED SINGLE LIMITS
$10,000 LIMIT EACH PERSON
FULL-TERM PREMIUM
$1,090.00
$34.00
FEES $25.00
TOTAL TERM PREMIUM $1,149.00
ATTACHMENT IDENTIFIED BY FORM NUMBER
CV2l-4 0598, CV23 0403, IL0021 0197, 6568
CV24-1 0598.
0103*, CV265
0598 ,
ISSUE DATE 12/17/2004
WAIVER '6,
/
ac.~
CONTINUED ON NEXT PAGE
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FLC 3961183 12
ADDL INSUREDS COpy
VLC 00 F
~s Insurance
BUSINESS AUTO POLICY
THIS IS A RENEWAL OFFER ONLY. COVERAGE WILL
TERMINATE IF FULL RENEWAL PREMIUM IS NOT
RECEIVED BY 12:01 A M 02/04/2005.
DUKE PONTIN
SPIRIT MARINE
PO BOX 244
BIG PINE KEY FL
0025571
.............--..........-.......--...... ..-....-.
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..................................................
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FLC 3961183 02/04/2005 08/04/2005 INTEGON
................'..-..........."........-..--..............'..---..........................,."....--.--......-...........................................
......'.....','.......'.....',.... ...' ,.......,.........,', rit< ...... '...' ....I\:J,6l..iMriS'" '....."'.."..i ,.... ,.,...,..',',........',........'....... ,.......1\16'....... '. ..................,',.......,....'..,.
THISPv4l.cYI,~rn;;XwASNAMEOI,~URED
.................-............,.............................-.....................................................................................
................................................................................................................................................
...........................................................................................................................
.................................................................................................
. ... . ...."............."..............................................
THE JOHNSONS INSURANCE AGENCY 305-289-0213
13361 OVERSEAS HWY
MARATHON SHORES FL
33043
33050
THE INSURANCE AFFORDED IS ONLY WITH RESPECT TO THE FOLLOWING INDICATED COVERAGES
WITH RESPECT TO EACH DECLARED VEHICLE. THE LIMIT OF THE COMPANY'S LIABILITY
AGAINST SUCH COVERAGE SHALL BE STATED HEREIN, SUBJECT TO ALL THE TERMS OF THIS
POLICY HAVING REFERENCE THERETO.
VEH
NO ST TER YR DESCRIPTION
001 FL 050 92 FORD DUMP T
SCHEDULE OF COVERED VEHICLES
STATED AMOUNT
SERIAL NUMBER SYM RAD INC CUSTOM PARTS USE
IFDXK74P2NBA18675 92 100 2000 HVY
VEH
NO
001
BI/PD
$1090
LIABILITY PREMIUM BY VEHICLE
MED PIP
PAY UM/UIM DEDUCT PREM
$34
MED EXP/INC LOSS
PHYSICAL DAMAGE PREMIUM BY VEHICLE
VEH COMP OR SPEC PERILS COLLISION ON-HOOK
NO TYPE DED PREM DED PREM LIMIT DED.
001
PREM
VEH
TOTAL
$1124.00
=
-
-
,
CONTINUED ON NEXT PAGE
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1
FLC 3961183 12
ADDL INSUREDS COPY
VLC 00 F
~ Insurance
BUSINESS AUTO POLICY
THIS IS A RENEWAL OFFER ONLY. COVERAGE WILL
TERMINATE IF FULL RENEWAL PREMIUM IS NOT
RECEIVED BY 12:01 A M 02/04/2005.
0025571
...---.........................."..'.......
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iF.... ... ...YNUlVlBER<
..................-..-.......-.--.........-....
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FLC 3961183 02/04/2005 08/04/2005 INTEGON
.......-_..... ,......-.........-...........................----........----....................................................-........-........-..-_.
",',.",' ......"5 1furi~tf:"fIS' ',",.",",',','",',,',',,"
<. THI..Pv*"I:vYIN~RES......YwASNAMEDIN......uRED:.:...i....<.:..:.
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........--.........,.........--........-.--.......-......,..........................-.........-......................-._........-..........
. .--........-.--.........-......... -........--............-..-...............
...................--........
DUKE PONTIN
SPIRIT MARINE
PO BOX 244
BIG PINE KEY FL
THE JOHN SONS INSURANCE AGENCY 305-289-0213
13361 OVERSEAS HWY
MARATHON SHORES FL
33043
33050
SCHEDULE OF DRIVERS
DVR
NO DRIVER NAME
LICENSE #
DOB
SR22
REQ
02 DALE HANCOCK PONTIN
03 JOHN G COFFIN
P535168532870
C150467533380
08/07/1953
09/18/l953
N
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24 Hour Claims Reporting: 1-800-468-3466 - For Policy Information, Call: 1-877-468-3466 - Internet www.GMACpolicy.com
FLC 3961183 12
ADDL INSUREDS COpy
VLC 00 F
GMAC Insurance
--
BUSINESS AUTO POLICY
THIS IS A RENEWAL OFFER ONLY. COVERAGE WILL
TERMINATE IF FULL RENEWAL PREMIUM IS NOT
RECEIVED BY 12:01 A M 02/04/2005.
..--..,......,---- .........--.......---..--......
n..lllEXNlJI\tl3SRU.
FLC 3961183 02/04/2005 08/04/2005
..........".--......'.......---..,........,...--.....................'....-....,......--..."............."...--......--....-......,...--..............
..-....-...-..---..-....-....- ...........................................,......."......................--.......--....."..,.....--..--..................
,.Pllgelt'8~UI~~~~~.f'.RN~~plpll\t~Q89P:.).
DUKE PONTIN
SPIRIT MARINE
PO BOX 244
BIG PINE KEY FL
0025571
...........--...."'..........
""""""6""'0...".'
Al;/NY
33043
THE JOHNSONS INSURANCE AGENCY 305-289-0213
13361 OVERSEAS HWY
MARATHON SHORES FL
33050
AUTO GARAGING LOCATION
ALL VEHICLES
911 WEST INDIES DR
RAMROD KEY FL
AUTO
GARAGING LOCATION
33042
-
--
-
CONTINUED ON NEXT PAGE
24 HolW Claims Reporting: 1-800-468-3466 - For Policy Information. Call: 1-877-468-3466 _ Internet _.GMACpolicy.com
1
FLC 3961183 12
ADDL INSUREDS COpy
VLC 00 F
GMAC Insurance
--
THIS IS A RENEWAL
TERMINATE IF FULL
RECEIVED BY 12:0l
BUSINESS AUTO
OFFER ONLY. COVERAGE WILL
RENEWAL PREMIUM IS NOT
A M 02/04/2005.
POLICY
0025571
. ........---..............---......---...--....
.::\::].:RQtlGY:::::NQ~~:\\::\::\
FLC 3961183 02/04/2005 08/04/2005 INTEGON
. .............."..............".................--.......--.......-.......-.-........................-.........."..-.....---........--..,"....-....,....-...
tt8l$-RQ4tCYIN$WfU$$XQWA~NAf\IlPgll\,t$WFt!Ep1)
DUKE PONTIN
SPIRIT MARINE
PO BOX 244
BIG PINE KEY FL
THE JOHNSONS INSURANCE AGENCY 305-289-0213
13361 OVERSEAS HWY
MARATHON SHORES FL
33043
33050
AUTO ADDITIONAL INSURED
000 MONROE COUNTY BOCC
llOO SIMONTON ST
KEY WEST FL
AUTO
ADDITIONAL INSURED
33040
y~H_!;J
---------------~--------
12/l7/2004
AUTHORIZED SIGNATURE
DATE
24 Hour Claims Reporting: 1-800-468-3466 - For Policy Information. Call: 1-877-468-3466 - Intenlet _.GMACpolicy.com