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Certificates of Insurance ACORDN CERTIFICATE OF LIABILITY INSURANCE OP 10 2~ DATE (MMIDDIYYYY) AMERI32 10/28/04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIOII 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# , -- I INSURED I INSURER A Great American Insurance Co. I i INSURER B Colony National Insurance Co. American Underwater Contractor ---~--- & Scubba Scrubbers, Inc. H~SURER C - -------- 175i6 SE Conch Bar Ave. Tequesta FL 33469 INSURER D , ~~~RER 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. POLICY EFFECTIVE DATE MM/DD/YY COVERAGES L TR NSR POLICY NUMBER TYPE OF INSURANCE GENERAL LIABiliTY A x X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 0 OCCUR OMH250095906 08/30/04 08/30/05 GEN'L AGGREGATE LIMIT APPLIES PER: ~~8i LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS W SCHEDULED AUTOS U HIRED AUTOS ~ NON-OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESS/UMBRELLA LIABILITY OCCUR 0 CLAIMS MADE WI\! DEDUCTIBLE RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below OTHER A Equipment Floater 08/30/04 OMH2500959-05 08/30/05 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Certificate holder is listed as additional insured. CERTIFICATE HOLDER CANCELLATION LIMITS EACH OCCURRENCE $ 1000000 $ 50000 $ 2500 $ 1000000 $ 2000000 $ 1000000 PREMISES (Ea occurence) r...1ED EXP (Anyone person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG COMBINED SINGLE LIMIT (Ea accident) $ BODilY INJURY (Per person) ~ I BODILY INJURY (Per accident) r;~OPERTY DAMAGE , (Per accident) $ $ I AUTO ONLY - EA ACCIDENT $ EA ACC $ OTHER THAN AUTO ONLY: AGG $ EACH OCCURRENCE AGGREGATE L $ $ E L. DISEASE - POLICY LIMIT Monroe County Marine Resources Dept. of Juvenille Justice Bld Attn: Kim McGee 5503 College Rd. ,Rm 2024 Key West FL 33040 0000000 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 ACORD 25 (2901/08) ee:~ RATION 1 ,1.11.1""'. A STATE FARM INSURANCE COMPANIES@ 1"'~""IR"~ 7401 Cypress Gardens Boulevard Winter Haven FL 33888 DATE OF NOTICE: FEB 17 2005 CODE: 48A A COUNTY OF MONROE 5100 COLLEGE RD KEY WEST FL 33040-4319 NOTE: PLEASE NOTIFY STATE FARM AT THE ADDRESS LISTED AT THE TOP, LEFT CORNER OF THIS PAGE REGARDING ANY CHANGE OF ADDRESS INFORMATION. 5 1..11...11.11..111..111....1..1..11....111.1..11...11.....11.1 :!l o o o (/) ~ ADDITIONAL INSURED'S NOTICE.OF COVERAGE State Farm Mutual Automobile Insurance Company NAMED INSURED: POLICY NO: 890 5775-C03-59F ! AMERICAN UNDERWATER YR/MAKElMODEL: 2004 FORD PICKUP ~ CONTRACTORS VIN/CAMPER: 1FTNX21P84EA11796 ;: DBA SCUBA SCRUBBERS AGENT NAME: BILL BOWMAN INSURANCE AGCY INC a:~ 603 COMMERCE WAY STE 15 AGENT PHONE: (561}746-5050 JUPITER FL 33458-8843 ENDORSEMENT NO: 6028E.5 2741-F607-L COVERAGE: BI AND PO LIABILITY $100,0001$300,0001$50,000 $500 OED. COMPo $500 DED COLL. II 'i" ~ POLICY MESSAGES: l!l The policy includes a loss payable clause protecting the additional insured's interest in the described car to the extent of the insurance ..!!. .... provided and subject to all policy provisions. The additional insured will be given 10 days notice if the policy is terminated. Until such notice !Q is provided, it shall be presumed that the required renewal premiums have been paid. The additional insured must notify us within 10 days of ~ any change of interest or ownership coming to their attention. Failure to do so will render this policy null and void. co ~ ... POLICY EFFECTIVE FEB 14 2005 UNTIL TERMINATED :~P~'~~~J~WGEMENT DATE~K -C!) WAIVER N/A _~YES 0lt,<<1LL ~~J~ / ic....~ FRT ACORDN CERTIFICATE OF LIABILITY INSURANCE OP 10 2~ DATE (MM/DD/YYYY) AMERI32 10/13/04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATlm 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: Colony National Insurance Co. 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. IN"" ~~d POLICY NUMBER ~~~~YM~rDEEfr:-!XE POLICY,~~P!~A. TIRN LIMITS LTR TYPE OF INSURANCE DATE MMIDO/YY GENERAL LIABILITY EACH OCCURRENCE 1$ 1000000 - UAMAGt: 1$ 50000 A ~ COMMERCIAL GENERAL LIABILITY OMH250095906 08/30/04 08/30/05 PREMISES (Ea occurence) ~ CLAIMS MADE D OCCUR MED EXP (Anyone person) $ 2500 f---- PERSONAL & ADV INJURY $ 1000000 f---- GENERAL AGGREGATE $ 2000000 e-- GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1000000 II n PRO- nLOC POLICY JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT e-- $ ANY AUTO (Ea accident) f---- ALL OWNED AUTOS BODilY INJURY e-- (Per person) $ SCHEDULED AUTOS I--- --t -- HIRED AUTOS BODILY INJURY 1$ ~- b NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE 1-------~ : i -^ ", (Per accident) i $ ".--...". I : GARAGE LIABILITY APP -;;:: - Er~ ,~~: i'lli' ~'~ AUTO ONLY - EA ACCIDENT $ R ANY AUTO 11.\("~'__"- -..j. -- BY OTHER THAN EA ACC $ V" ""'i\T ,\\li--l' _ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY DATE __.._.k_:=:: 1_,_, ,...- .- EACH OCCURRENCE $ =:J OCCUR D CLAIMS MADE '{Ire - ' ':"".,.) ....,>",..~-_...'._,. AGGREGATE $ WAIVER :'1 A ----. '.- I $ ~ DEDUCTIBLE $ RETENTION $ I $ WORKERS COMPENSATION AND I I TORY LIMITS T IOJ~- EMPLOYERS' LIABILITY I , ANY PROPRIETORi?ARTNER/EXECUTIVE I EL EACH ACCIDENT $ --~._---_....- --~_._,'- l----- _. _.~------_..- . - OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $ If yes, describe under ..- SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER A Equipment Floater OMH2500959-05 i 08/30/04 08/30/05 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Monroe County Board of County Commissioners is an additional insured. Fax 305-295-4364 CERTIFICATE HOLDER CANCELLATION Monroe County Board of County Commissioners Maria Slavik/Risk Mgmt 1100 Simonton st., Rm 268 Key West FL 33040 0000000 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 (2001/0J} . C .', ,~ ~La/z,' -",C L. ~c.- "-"- ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDIYY) TM 05/31/2005 PRODUCER Serial # 1 00383 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION SOUTHEAST INS. BROKERAGE CORP. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR TWO ALHAMBRA PLAZA - #1200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. CORAL GABLES, FL 33134 INSURERS AFFORDING COVERAGE NAlC# INSURED INSURER A: AMERICAN HOME ASSURANCE CO. AMERICAN INSHORE DIVERS CORP. INSURER B: COMMERCE & INDUSTRY INS. CO. 2098 NE 4TH COURT INSURER C: UNDERWRITERS AT LLOYD'S BOCA RATON, FL 33431 INSURER D: 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 POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ~'idl TYPE OF INSURANCE POLICY NUMBER "g~fl,U~B~~ "g~fl,~:'bRif'~N LIMITS LTR GENERAL UABlUTY EACH OCCURRENCE $ 1,000,000 - A X X COMMERCIAL GENERAL LIABILITY B2784 11-6-2004 11-6-2005 ~~~~~HqfaE~~~nce) $ 50,000 \ CLAIMS MADE 00 OCCUR MED EXP (Anyone person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000 'Xl POLICY n jf8;: n LOC ~TOMOBILE UABlUTY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) r-- ALL OWNED AUTOS BODILY INJURY r-- $ SCHEDULED AUTOS ,{ '. "". , <,.. . ;',A t= fl (Per person) r-- /,PP~D rrO.' HIRED AUTOS J1~ BODILY INJURY r- 8'{ ''i 'A $ NON-OWNED AUTOS (Per accident) r-- V r I J).-Q DATE -..-.UL -_._.~--_.. PROPERTY DAMAGE $ (Per accident) GARAGE UABlUTY WAIVER NiA :J r-'''' ES - . ...-- AUTO ONLY - EA ACCIDENT $ R- ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA UABlUTY EACH OCCURRENCE $ o OCCUR 0 CLAIMS MADE AGGREGATE $ $ ~ ~EDUCTlBLE $ RETENTION $ $ WORKER'S COMPENSAOON AND WC 584 24 84 11-1-2004 11-1-2005 X I.WCSTATU-\ FJH- TORY LIMITS ER B EMPLOYERS' UABIL1TY 1,000,000 ANY PROPRIETORlPARTNERlEXECUTIVE EL EACH ACCIDENT $ OFFICERlMEMBER EXCLUDED? INCLUDES USL&H EL DISEASE - EA EMPLOYEE $ 1,000,000 ~ yes, descrllle under 1,000,000 SPECIAL PROVISIONS below EL DISEASE - POLICY LIMIT $ C OTHER PG 000100T 11-1-2004 11-1-2005 ANY ONE PERSON $ 1,000,000 MARITIME / MEL ANY ONE ACCIDENT $ 1,000,000 INCL WAIVER OF SUBROGATIO l. DEDUCTIBLE $ 5,000 DESCRIPTION OF OPERAOONSlLOCATlONSlVEHICLEl3IEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER IS INCLUDED AS AN ADDITIONAL INSURED AS RESPECTS GENERAL LIABILITY. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL.J.Q..... DAYS WRITTEN Ie SOU'THEAST 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 INSURANCE RE l~SENTATIVES(\ /'1 G R 0 U P AU E~ ~~ ~S~~~ KATHI PENNEY-GOEBEL t ~J(bj v Senior Vice President J ~ @ACORD CORPORATION 1988 Tw o Alhambra Plaza Phone: 954-915-0273 Suite 1200 Fax: 954-915-0158 Coral Gables, FL 33134 Cell: 954-646-2229 E-Mail: kathi-semna@comcast.net Main: 800-780-8990 www.southeastinsurancegroup.com STATE FARM INSURANCE COMPANIESQ!) 7401 CypreBB GardenB Boulevard Winter Haven FL 33888 DATE OF NOTICE: OCT 262005 CODE: 49A A COUNTY OF MONROE 5100 COLLEGE RD KEY WEST FL 33040-4319 NOTE: PLEASE NOTIFY STATE FARM AT THE ADDRESS LISTED AT THE TOP, LEFT CORNER OF THIS PAGE REGARDING ANY CHANGE OF ADDRESS INFORMATION. 1..11...11.11....1..111....1..1..11....111.1..11...11.....11.1 ADDITIONAL INSURED'S NOTICE OF COVERAGE State Farm Mutual Automobile Insurance Company NAMED INSURED: POLICY NO: 890 5775-C03-59G AMERICAN UNDERWATER YR/MAKElMODEL: 2004 FORD PICKUP CONTRACTORS INC VIN/CAMPER: 1FTNX21P84EAl1796 DBA SCUBA SCRUBBERS AGENT NAME: BILL BOWMAN INSURANCE AGCY INC 603 COMMERCE WAY STE 15 AGENT PHONE: (561)746-5050 JUPITER FL 33458-8843 ENDORSEMENT NO: 6028E.5 2741-F607-L COVERAGE: BI AND PD LIABILITY $100,0001$300,0001$50,000 $500 DED. COMPo $500 DED. COLL. -.. ... . - . : POLICY MESSAGES: ThiB policy Bhown above BupersedeB policy' 8905775-59F. The policy includes a 10BB payable clause protecting the additional insured'B interest in the deBcribed car to the extent of the inBurance provided and subject to all policy proviBionB. The additional inBured will be given 10 days notice if the policy is terminated. Until such notice is provided, it Bhall be preBumed that the required renewal premiumB have been paid. The additional inlured mUlt notify us within 10 days of any change of intereBt or ownership coming to their attention. Failure to do so will render thil policy null and void. POLICY EFFECTIVE OCT 21 2005 UNTIL TERMINATED /\;.JP:"!~.) .~.,'. ,;;srr.iV1A'.NAGEMENl o .11 I. 1 . -"_. -'TL~~'.~~-- --- \Ii/\ v \'1=" ... -f>-.-. I .~.... ---- ~ / (, K rM\ ril C GeL cc t:'; ., Q. t'\ Cc FRT ACORDm CERTIFICATE OF LIABILITY INSURANCE OP ID AMERI32 09/07/05 THIS CERTIFICATE IS ISSUED AS A MAHER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTlFICA TE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. DATE (MMIDDIYYYY) PRODUCER The Plastridge Agency-SO 710 S. E. Ocean Blvd. Stuart FL 34994-2427 Phone:772-287-5532 Fax:772-287-5572 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A Great Amer~can Insurance Co_ American Underwater Contractor LLC & Inc. 17536 SE Conch Bar Ave. Tequesta FL 33469 INSURER B 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 ',l\nIJL; . L TRINSRO TYPE OF INSURANCE GENERAL LIABILITY POLICY NUMBER POLICY EFFECTIVE 'poLIcY EXPIRATION DATE (MMIDDIYY) DATE (MM/DDIYY LIMITS GENERAL AGGREGATE $ 1000000 ;$_50 g.Q.Q____ $ 5000 $ 1000000 $ 2000000 AI X COMMERCIAL GENERAL LIABILITY OMH250095907 08/30/05 08/30/06 EACH OCCURRENCE ~ DAMAGt: IUHt:NIt:U 1J>~EMISES (Ea occurence) I MED EXP (Anyone person) ,. PERSONAL & ADV INJURY CLAIMS MADE OCt;UR : PRODUCTS - COMPJOP AGG ' $ 1000000 LOC ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS ~.'--1 COMBINED SINGLE LIMIT (Ea aCCident) I $ BODILY INJURY (Per person) $ CLAIMS MADE i BODILY INJURY , (Per accident) f------. i PROPERTY DAMAGE _ i (Per accident) ; $ NON,OWNED AUTOS AUTO ONL Y - EA ACCIDENT I $ ANY AUTO , OTHER THAN I AUTO ONLY EA ACC $ '----r-- AGG $ ~EXCESS/UMBRELLA LIABILITY l..-__--" OCCUR I EACH OCCURRENCE L____ ._____~_.._ AGGREGATE '$ $ , DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY I ANY PROPRIETOR/PARTNER/EXECUTIVE I OFFICER/MEMBER EXCLUDED? , If yes. describe under SPECIAL PROVISIONS below OTHER A i Equipment Floater 1__ i TORY LIMITS I E.L. EACH ACCIDEN:_ . E.L. DISEASE - EA EMPLOYEE, $ ER , EL DISEASE - POLICY LIMIT $ I OMH250095907 08/30/05 08/30/06 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Monroe County Board of County Commissioners is an additional insured. Fax 305-295-4364 CG: ~a"c <-. CERTlFICA TE HOLDER CANCELLA TION 0000000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1 C DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBlIGA nON OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTA TIVES. AUTHORIZED REPRESENTATIVE Monroe County Board of County Commissioners Maria Slavik/Risk Mgmt 1100 Simonton St., Rm 268 Key West FL 33040 ACORD 25 (2001/08) TION 1988 ACORJ)N CERTIFICATE OF LIABILITY INSURANCE OP ID DATE (MMIDDIYYYY) AMERI32 09/07 05 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICA TE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PRODUCER The Plastridge Agency-SO 710 S. E. Ocean Blvd. Stuart FL 34994-2427 Phone:772-287-5532 Fax: 772-287-5572 INSURED ------.------------------.- ._~----- ________+INSURERS AFF~RDING COVERAGE I INSURER A Great American Insurance Co. __H ---.---- _ _ -- -.----- t --__ _ __.___ c '.N_~U~~B ____ __ I I I I NAIC# - - - .-------_L__ j American Underwater Contractor LLC & Inc. 17536 SE Conch Bar Ave. Tequesta FL 33469 INSURER C: INSURER D INSURER E -------------------- ! COVERAGES -- '-'---~'r---- THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUtREMENT. 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 A X TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY I CLAIMS MADE OCCUR I T I POLICY NUMBER I POLICY EFFECTIVE I POLICY EXPIRATION - . DATE MM/DDIYY) . DATE (MM/DDIYY) LTRINSR OMH250095907 08/30/05 08/30/06 LIMITS EACH OCCURRENCE ! $ 1000000 DAMAGE TO REmRJ----.---r------ PREMISESJEa_occurence) I $ 50000 MED EXP (Any ona person) I $ 5000 ~~~sO~~-;:-~-:;;DV I~URY T$ioooooo---- ----_._-_._._~----- GENERAL AGGREGATE 1$2000000 ----.---- --------___ ___'n PRODUCTS - COMP/Of' .<\(;<?+~1000000 LOC ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS I I _______1 CLAIMS MADE PROPERTY DAMAGE , (Per aCCident) i AU:rOO_NL'I'..- EA ACCIDENT $ EA ACC $ OTHER THAN AUTO ONL Y AGG $ OCCUR I EACH OCCURRENCE $ AGGREGATE I DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND II EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERlEXECUTIVE OFFICERlMEMBER EXCLUDED? I tf yes. describe under SPECIAL PROVISIONS below OTHER , TORY LIMITS ' I ER . E L -~ACH ACCIDEN--;:-- ! $ I > -------. I E L DISE~E~_~EMPLOYEEI $ E L DISEASE - POLICY LIMIT $ A Equipment Floater OMH250095907 08/30/05 08/30/06 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Diving; Monroe County BOCC is listed as an additional insured cc -r::: a..., C e--. CERTIFICATE HOLDER CANCELLATION Monroe County BOCC Fax: 305-289-2536 Attn: Ali Trivette 1100 Simonton St. Rm#268 Key West FL 33040 0000000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRA nON 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 TION 1988 ACORD 25 (2001/08) THE POLICIES OF INSURANCE lISTEO 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 ~A~EiMM/DDNYJ '-DA~tt~DD~T' LIMITS GENERAL LIABILITY EACH OCCURRENCE , 1000000 A ~ COMMERCIAL GENI::RAL LIABILITY OMH250095910 08/30/08 08/30/09 PREMiSES (Ea occuren~ , 50000 _I CLAIMS MADE [!J OCCUR MEO exp (Anyone person) , 5000 PERSONAL & ADV INJURY , 1000000 GENERAL AGGREGATE , 2000000 GEN'l AGGREGATE LIMIT APPLIES PER: PRODUCTS-COM~OPAGG '1000000 Q DpRo- D POLICY JEer LOe AUTOMOBILE LIABILITY COMBINED SINGLE liMIT c- , ANY AUTO (EaaccidentJ r- All OWNeD AUTOS f--- BaDrI. Y INJURY , SCHEDULED AUTOs {Per person) c- HIReD AUTOS BODilY INJURY C- (Peraccidenl) , NON-QWNED AUTOS r- PROPERTY DAMAGe , (Parsec/denl) GARAGE LIABilITY n.~Q AUTO ONI. Y - fA ACCIDENT , 9 ANY AUTO ^~( OTHER THAN fA Ace , ~ AUTO ONI. Y: AGG , EXCESs/UMBRELLA LIABILITY ljllq ~fPL, -- EACH OCCURRENCE , o -OCCUR 0 CU~IMS MADE ,- .,' AGGREGATE , r-. _ , 8,DEDUCTlBLE jj , RETENTION , JL" , WORKERS COMPENSATION AND JX' l I To"RY LIMITS ! IUER- EMPLOYERS' LIABILITY ( , . ANY PROPRIETORlPARTNERlEXECUTIVE ~'~ :L E.L. EACH ACCIDENT , OFFICERlMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE , If yes, describe under Q. : \.u [? E.L. DISEASE - POLICY LIMIT , SPECIAL PROVISIONS below OTHER (0LrA 11 S rr 4JY1h [') 7.) OESCRlPTlON OF OPERATIONS! LOCATIONS I VEHICLES I EXCLUSIONS ADDEO BY ENDORSEMENT I PE;"~ PROVISIONS Insured Monroe County Board of County Commisioners is listed as Additional with respects to General Liability. *10 days written notice for non-payment, 30 days all other reasons. ('(: \~~ \ y~\ G"\II. C.\._ -' ACORD, CERTIFICA TE OF LIABILITY INSURANCE OPID LF J DATE (MM/DDIYYYY) AMERI32 OU1/V08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Plastridge Agency-STO HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 710 S. E. Ocean Blvd. ALTER THE COVERAGE AFFORDED 8Y THE POLICIES BELOW. Stuart FL 34994-2427 Phone: 772-287-5532 Fax: 772-287-5572 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A GrClat: Anworican Insurance Co. INSURER B: American Underwater Contractor INSURER C' 17536 SE Conch Bar Ave. INSURER 0: Tequesta FL 33469 INSURER E' COVERAGES CERTIFICATE HOLDER Monroe County BOCC Fax #305-295-3179 Attn: Risk Mngmnt 1100 Simonton St., Room 268 Key West FL 33040 CANCELLATION 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 REPRESENTATIVE TION 1988 ICORD 25 (2001/08)