Certificates of Insurance
At:ttR.ts
P00194
CERTIFICA IE OF INSURANCE ISS~EOo;~E3(;;/~DIYY)
I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY A-NO" I
-- CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE. I
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE !
POLICIES BELOW. I
-----------..---.-_.__~_____ ___e_ _j
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COMPANIES AFFORDING COVERAGE
PRODUCER
THE PORTER ALLEN COMPANY
513 SOUTHARV STREET
KEY WEST, FLORIVA 33040
(305) 294-2542
~~T~~NY A
CIGNA INSURANCE COMPANY
INSURED
~~T~~NY B
INSURANCE COMPANY OF NORTH AMERICA
JUVY EAVY VBA ACE BUILVING & MAINTENANCE
PO BOX 2763
KEY WEST, FLORIVA 33040
~~T~~NY C
~~T~~~NY D
~~T~~NY E
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COVERAGES
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THIS IS TO CERTIFY THAT 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, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
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ILTR
IA
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TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DDIYY) DATE (MMIDD/YY)
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE X OCCUR. SVP V19993814
OWNER'S & CONTRACTOR'S PROTo
LIMITS
GENERAL AGGREG'ATE'- $ 1 , 000, 000. '1
PRODUCTS.COMP/OP AGG $ 1 , 000, 000 . "
PERSONAL & ADV INJURY $ 1,000,000.
EACH OCCURRENCE $ 1,000,000. j
FIRE DAMAGE (Anyone fife) $ 50,000.
MED. EXPENSE (Anyone person) $ 5 . 000 . _...
~I~~:INED SINGLE $
09/30/90 09/30/91
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AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
X SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
EXCESS LIABILITY
BODILY INJURY $
(Per person) 100,000
10-3-90 10-3-91
BODILY INJURY $
(Per accident) 300,000
PROPERTY DAMAGE $ 100,000
H01079311
'---'-'----"---'EACH ~-'_..'-;--~'------'-i
AGGREGATE $
WORKER'S COMPENSATION
AND
EMPLOYERS' LIABILITY
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$ I
$ .._,..,_..._. ,.w,., __,
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UMBRELLA FORM
OTHER
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~,;: DfPT.~--
OCT 5
l~O
STATUTORY LIMITS
EACH ACCIDENT
DISEASE-POLICY LIMIT
DISEASE-EACH EMPLOYEE
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'''''__'.'O''..",,''.'.~~, ...", .. . ,. ,,"0",'''''''''''_' ,~., """,",""_'''''''''''''. ,,"'-" .,.o~ .'''""""~.,...","-,.""",,,...,,,,,,,,.,...-~;_.,,, ~"'-, ."" ,.___"""...._.....,....__""""_".. .,
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DESCRIPTION OF OPERATIONS/LOCATlONSIVEHICLES/SPECIAL ITEMS
:'CERTIFICA TE HOLDER
CANCELLATION
MONROE COUNTY
VEPT. OF PUBLIC WORKS
WING II, PSB
STOCK ISLAND
KEY WEST, FLORIVA 33040
A TTN : WENDY
ACORD 25-S (7/90)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL --1.Q.... DAYS W EN E TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAl 0 UCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF NY R N THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
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@ACORD CORPORATION 1990 I
A.~..ltlt.. CERTIFICATE OF I
06/30/92
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
ItREVlSEVn
ISSUE DATE (MM/DD/YY)
PRODUCER
THE PORTER ALLEN COMPANY
513 SOUTHARV STREET
KEY WEST, FLORIVA 33040
(305 J 294-2542
COMPANIES AFFORDING COVERAGE
~~T~~~NY A
INSURANCE COMPANY OF NORTH AMERICA
INSURED
~~T~~NY B
JUVY EAVY VBA ACE BUILVING
ANV MAINTENANCE
PO BOX 2763
KEY WEST, FLORIVA 33040
~~T~~~NY C
Received
Risk Mgm~ 1.0
. 55 Conrrol
D^TE 7 ~ /'702
I (4//'?
INITIAL ~
'\
~~T~~~NY D
~~T~~~NY E
COVERAGES ;2../7
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED AB VE F 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DD/YY) DATE (MM/DD/YY)
LIMITS
GENERAL LIABILITY
A X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE X OCCUR.
OWNER'S & CONTRACTOR'S PROTo
SVP V24594324
03/11/92
03/11/93
GENERAL AGGREGATE $ 500,000.
PRODUCTS-COMP/OP AGG. $ 500,000.
PERSONAL & ADV. INJURY $ 500,000.
EACH OCCURRENCE $ 500, 000 .
FIRE DAMAGE (Anyone fire) $ 50, 000 .
MED. EXPENSE (Anyone person) $ 5 000
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
A X SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
HOI079311
COMBINED SINGLE $ 300,000.
LIMIT
BODIL Y INJURY $
10/03/91 10/03/92 (Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
EACH OCCURRENCE $
AGGREGATE $
STATUTORY LIMITS
EACH ACCIDENT $
DISEASE-POLICY LIMIT $
DISEASE-EACH EMPLOYEE $
03/11/92 03/11/93 LIMIT: $5,000.
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION
AND
EMPLOYERS' LIABILITY
A
OTHER
EMPLOYEE VISHONESTY
COVERAGE
SVP V24594324
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/SPECIAL ITEMS JOB SITE: PSB
MONROE COUNTY BOARV OF COUNTY COMMISSIONERS IS LISTEV AS AVVITIONAL INSUREV.
CERTIFICATE HOLDER
CANCEl' A.,..
MONROE COUNTY BOARV OF COUNTY COMMISSION~HOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
WING II, PUBLIC SERVICE BUILVING EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
5100 JUNIOR COLLEGE ROAD MAIL JL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
KEY WEST, FLORIVA 33040 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
TION 1990
ACORD 25-S (7/90)
At~t.III...
CERTIFICATE OF INSURANCE
ISSUE DATE (MM/DD/YY)
5/24/94
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
PRODUCER
REGAN INSURANCE AGENCY, INC.
90144 OVERSEAS HIGHWAY
TAVERNIER, FLORIDA 33070-2298
f~T~~NY A
COMPANIES AFFORDING COVERAGE
OHIO CASUALTY INS CO
INSURED
COMPANY B
LETTER
APPROVED BY RISK MANAGF:MF:NT
'Y~~4T - ~K
DATE ~811 q L( ~J
JUDY BOBICK
DBA: ACE BUILDING MAINTENANCE
1200 20TH. TERRACE
KEY WEST, FLORIDA 33042
COVERAGES
THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH N TICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF A KI D UPON THE C ANY, ITS AGENTS OR REPRESENTATIVES. I
AUTHORIZED RE a- --1
"ACORD CORPORATION l~:t
f~T~~~NY C
f~T~~NY D
f~T~~~NY E
WAIVER:
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DD/YY) DATE (MM/DD/YY)
A GENERAL LIABILITY
XX COMMERCIAL GENERAL LIABILITY
CLAIMS MADE XX OCCUR. BH05071'4420
OWNER'S & CONTRACTOR'S PROTo
2/25/94
2/25/95
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
Recei ved
Risk Mgmt. & Loss Controi
DATE_ 5-3/- ,.y
INITIAL _ ~ 01=-_.
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION
AND
EMPLOYERS' LIABILITY
DEPT.
OTHER
A
BUSINESS SERVICE BOND 3-043-696
EMPLOYEE DISHONESTY BOND
3-3-95
3-3-94
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/SPECIAL ITEMS
JANITORIAL MAINTENANCE
600 WHITEHEAD STREET KEY WEST, FL 33040
ublic service building
CERTIFICATE HOLDER CANCELLATION
MONROE COUNTY BOARD OF COUNTY
COMMISSIONERS/ADDL INSURANCE
5100 COLLEGE ROAD
KEY WEST, FLORIDA 33040
NIA.
YES
LIMITS
GENERAL AGGREGATE $ 1,000,000
PRODUCTS-COMP/OP AGG. $ 1,000,000
PERSONAL & ADV. INJURY $ 1,000,000
EACH OCCURRENCE $ 1,000,000
FIRE DAMAGE (Anyone fire) $ 50,000
MED. EXPENSE (Anyone person) $ 5 . 000
COMBINED SINGLE $
LIMIT
BODIL Y INJURY $
(Per person)
BODIL Y INJURY $
(Per accident)
PROPERTY DAMAGE $
EACH OCCURRENCE $
AGGREGATE $
STATUTORY LIMITS
EACH ACCIDENT
$
DISEASE-POLICY LIMIT $
DISEASE EACH EMPLOYEE $
BOND AMOUNT
$10,000
ACORD 25-S (7/90)
At~t.ltl."
CERTIFICATE OF INSURANCE
ISSUE DATE (MM/DD/YY)
PRODUCER
4/22/94
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
REGAN INSURANCE AGCY
90144 OVERSEAS HWY
TAVERNIER FL 33070
COMPANIES AFFORDING COVERAGE
f~T~~~NY A
OHIO CASUALTY INS CO
APPROVtD BY RISK ~ANAGfMfNT _ ~~
BWU}f::J;{ ~
OATE _ -
WAIVER: N/A::i:-- YES
INSURED
f~T~~~NY B
,JUDY BOBIC~( DBA
fiCE BL.DC MAINT
1200 20 TERF\:
KEY WEST FL. 33042
f~T~~~NY C
COMPANY D
LETTER
f~T~~~NY E
COVERAGES
THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DD/YY) DATE (MM/DDIYY)
LIMITS
A GENERAL LIABILITY E: H 0507 1 "+ 4 2: 8
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE X OCCUR.
OWNER'S & CONTRACTOR'S PROTo
2/2:5/94
2: / 2: 5 / 9 5GENERAL AGGREGATE $ 1 , 000 , 000
PRODUCTS-COMP/OP AGG. $ 1 , 000 , 000
PERSONAL & ADV. INJURY $ 1 , 000 , 000
EACH OCCURRENCE $ 1 ,000,000
FIRE DAMAGE (Anyone fire) $ 50 , 000
MED. EXPENSE (Anyone person) $ 5 , 0 (\ 0
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
,/
COMBINED SINGLE $
LIMIT
BODILY INJURY $
(Per person)
BODILY iNJURY $
(Per accident)
PROPERTY DAMAGE $ I
EACH OCCURRENCE $ i
AGGREGATE $ i
!
I
STATUTORY LIMITS I
EACH ACCiDENT $
DISEASE-POLICY LIMIT $
DISEASE-EACH EMPLOYEE $
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION
AND
EMPLOYERS' LIABILITY
Hecelved
tusk Mgmt. & 58 Control
OTHER
DESCRIPTION OF OPERA TIONS/LOCA TlONSIVEHICLES/SPECIAL ITEMS
JANITORIAL MANINTENANCE
600 WHITEHEAD KEY WEST FL 33040
REISSUED TO SHOW OCCURRENCE
CERTIFICATE HOLDER
CANCELLATION
MONROE COUNTY BOARD OF COUNTY
COMMISSIONERS/ADD INSURED
5100 COL.LEGE F..:D
i KEY WEST FL 33040
I ACORD 25-S (7/90)
C-C I ~ t<J~
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL---LCbAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
'"'"O:'~;:';"~~~}r i ._
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@ACORD CORPORATION 1990!
i::j..^~D..nl.@ ....:.::1::111111111111111:111111111111:1::1111111111. :11&..::.:.:.:.:.:.:.:.I.I..I.l.!.:....:.....::....................... 'I.....'....,....................':..............:.......:...............:.....:..........'..............................................:..,......:..................................................................... ..... ......... ODA2TE/(OMM71D/DIY9Y5)
................................... .............-...-.............-.-..<::;.:-:.:.:.:.:.:.:.:';':-:':'>:-:.:.:.:.:.:.:.;.:.;.:-:.:.:.:.:.:.:.:.;.:.:.:.;.:-:.:-:.;.:-:<.:.:.:-:.:.:.:-:.:-:.:.:.:.:::.:.:.:.:.;.:.:.:::-:......
THIS CERTIFICATE IS ISSUED AS A MATrER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIRCATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICES BELOW.
COMPANIES AFFORDING COVERAGE
PRODUCER
REGAN INSURANCE AGCY
90144 OVERSEAS HWY
TAVERNIER
FL 33070
COMPANY
A S CO
COMPANY
B BY
COMPANY DATE
C
INSURED
JUDY BOBICK DBA
ACE BLDG MAINTENANCE
1200 20 TERR
KEY WEST FL 33042
THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
LTR
TYPE OF INSURANCE
POUCY NUMBER
POUCY EFFECTIVE POUCY EXPIRAnON
DATE (MMIDDIYY) DATE (MMIDDIYY)
LIMITS
GENERAL LlABIUTY BHO 50714428
X COMMERCiAl GENERAL LIABILITY
CLAIMS MADE [R] OCCUR
OWNER'S & CONTRACTOR'S PROT
2/25/95
2/25/96 GENERAl AGGREGATE $1, 000, 000
PRODUCTS. COMP/OP AGG $1, 0 0 0 , 0 0 0
PERSONAl & ADV INJURY $1, 000, 000
EACH OCCURRENCE $1, 000, 000
FIRE DAMAGE (Anyone fire) $ 5 0 , 0 0 0
MED EXP (Any one person) $ 5 , 0 0 0
AUTOMOBILE LIABIlITY
ANY AUTO
All OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON.OWNED AUTOS
COMBINED SINGLE LIMIT $
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE $
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT $
OTHER THAN AUTO ONLY:
EACH ACCIDENT
AGGREGATE
EACH OCCURRENCE
AGGREGATE
$
$
EXCESS UABIUTY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS COMPENSAnON AND
EMPLOYERS' LlABIJTY
THE PROPRIETOR!
PARTNERs/EXECUTIVE
OFFICERS ARE:
OTHER
INCL
EXCL
STATUTORY LIMITS
EACH ACCIDENT
DISEASE. POLICY LIMIT
DESCRlPllON OF OPERAnONSILOCAnONSNEHICLESlSPECIAL ITEMS
JANITORIAL SERVICES
600 WHITEHEAD STREET KEY
PUBLIC SERVICE BUILDING
dbl1jf!<IC.A1S/'~~'.". .. ...
WEST FL 33040
.......................................................................................
.......................................................................................
............................................. .........................................
'.~:tC..kC.ettAfiOl\l.,)),
.........................
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.................................
. . . . . . . . . . . . . . . . . . .. . . . . . . . . . .
...........................
...
...................
...................
....................
...................
...................
MONROE CO BOARD OF COUNTY
COMMISSIONERS/ADDL INS
5100 COLLEGE ROAD
KEY WEST FL 33040
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCEllED BEFORE THE
EXPlRAnON DATE THEREOF, THE ISSUING COMPANY WLL ENDEAVOR TO MAIL
~ DAYS WRITTEN NOnCE TO THE CERnFlCATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NonCE SHALL IMPOSE NO OBUGAllON OR UA8lUTY
AGENTS OR REPRESENTATIVES.
....................................
....................................
...................................
...................................
.... ........ ......
.....................
......................
..........~ ...~~A~.nJ.?,~iilMiMjltii'{jiji
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......................................................
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..................................................
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......................................................................... .............................................................................................................................................................................. ..................................... ............................................. ............. ..............................................................................
THIS BINDER IS A TEMPORARY INSURANCE CONTRACT, SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE SIDE OF THIS FORM.
PRODUCER ':J8N:o Ext;3 0 5 - 8 5 2 - 3 2 3 4 COMPANY BINDER #
REGAN INSURANCE AGCY OHIO CASUALTY INS CO BOBJ50-3
E~cnvE EXP~AnON
nME DATE
X AM
90144 OVERSEAS HWY
TAVERNIER FL 33070
DATE
nME
X 12:01 AM
5/11/95
12:01
PM
6/11/95
NOON
CODE: 09033053
~3:r8~ER ID: ABOBJ50 - 3
INSURED
SUB-CODE:
THIS BINDER IS ISSUED TO EXTEND COVERAGE IN THE ABOVE NAMED COMPANY
X PER EXPIRING POLICY I: 5 0 71442 8
DESCRIPTION OF OPERAnONSNEHICLESIPROPERTY (including LoclltJon)
JUDY BOBICK DBA
ACE BLDG MAINTENANCE
1200 20 TERR
KEY WEST
89 CADILLAC 1G6ELl150KU601257
Received
Risk Mgmt. & Loss Control
TYPE OF INSURANCE
PROPERTY CAUSES OF LOSS
BASIC D BROAD D SPEC
GENERAL UABIUTY
~ !,~ ~/ "~r
GENERAl AGGREGATE $
PRODUCTS - COMP/OP AGG $
PERSONAl & ADV INJURY $
EACH OCCURRENCE $
ARE DAMAGE (Anyone fire) $
MED EXP (Anyone person) $
COMBINED SINGLE LIMIT $
BODILY INJURY (Per person) $
BODILY INJURY (Per accident) $
PROPERTY DAMAGE $
MEDICAl PAYMENTS $
PERSONAl INJURY PROT $
UNINSURED MOTORIST $
on-Stacked $
ACTUAl CASH VALUE
STATED AMOUNT $
OTHER
AUTO ONLY - EA ACCIDENT $
OTHER THAN AUTO ONLY:
300,000
COMMERCIAL GENERAl LIABILITY
CLAIMS MADE D OCCUR
OWNER'S & CONTRACTOR'S PROT
RETRO DATE FOR CLAIMS MADE:
AUTOMOBILE LIABILITY
ANY AUTO
All OWNED AUTOS
X SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
APPROVED BY RISK M~NAGtMENT
~ ~~ b~/~
BY d . C-L..b-?€.K-
[lATE ~ - (, - :is
'rQ.
5,000
10,000
300,000
AUTO PHYSICAL DAMAGE DEDUCTIBLE
X COlliSION: 5 0 0
X OTHER THAN COL: 5 0 0
GARAGE LIABILITY
ANY AUTO
ALL VEHICLES
X SCHEDULED VEHICLES
EXCESS UABIUTY
UMBRELlA FORM
OTHER THAN UMBRELlA FORM
RETRO DATE FOR CLAIMS MADE:
"'t.('.loi~.('Jm1W.T So
AGGREGATE
EACH OCCURRENCE
AGGREGATE
SELF-INSURED RETENTION
STATUTORY LIMITS
EACH ACCIDENT $
DISEASE - POLICY LIMIT $
DISEASE - EACH EMPlOYEE $
WORKER'S COMPENSAnON
AND
EMPLOYER'S UABILITY
SPECIAL
CONDmONS/
OTHER
COVERAGES
MONROE COUNTY BOARD OF COMM
ATT RISK MANAGEMENT AUTHORIZED REPRES AJlvE
5100 COLLEGE RD /./ ,/"
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CONDITIONS
This Company binds the kind(s) of insurance stipulated on the reverse side. The Insurance is subject to the
terms, conditions and limitations of the policy(ies) in current use by the Company.
This binder may be cancelled by the Insured by surrender of this binder or by written notice to the Company
stating when cancellation will be effective. This binder may be cancelled by the Company by notice to the
Insured in accordance with the policy conditions. This binder is cancelled when replaced by a policy. If this
binder is not replaced by a policy, the Company is entitled to charge a premium for the binder according to the
Rules and Rates in use by the Company.
Applicable in Delaware
The mortgagee or Obligee of any mortgage or other instrument given for the purpose of creating a lien on real
property shall accept as evidence of insurance a written binder issued by an authorized insurer or its agent if
the binder includes or is accompanied by: the name and address of the borrower; the name and address of the
lender as loss payee; a description of the insured real property; a provision that the binder may not be canceled
within the term of the binder unless the lender and the insured borrower receive written notice of the cancel-
lation at least ten (10) days prior to the cancellation; except in the case of a renewal of a policy subsequent to
the closing of the loan, a paid receipt of the full amount of the applicable premium, and the amount of
insurance coverage.
Chapter 21 Title 25 Paragraph 2119
Applicable in Nevada
Any person who refuses to accept a binder which provides coverage of less than $1,000,000.00 when proof is
required: (A) Shall be fined not more than $500.00, and (B) is liable to the party presenting the binder as proof
of insurance for actual damages sustained therefrom.