Certificates of Insurance •
• L ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(
o�"
PRODUCER 1-210-299-1215 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Marsh USA, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
112 East Pecan, Suite 2625 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
San Antonio, TX 78205 INSURERS AFFORDING COVERAGE
NSUREO INSURER A:American Home Assurance
Clear Channel Outdoor, Inc.
INSURER 3:Insurance Company of the State Of Pennsylvania
c/o 200 East Bases Rd. INSURERC:National Union Fire Insurance Company
San Antonio, TX 08209 INSURERD:
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.
INSRI TYPE OF INSURANCE POLICY NUMBER POLICY
TEY R A11.VDONNYI DATE IMINDOtal LIMITS
A GENERAL LIABILITY 015548724 11/01/04 11/01/05 EACH OCCURRENCE $ 1000000
X COMMERCIAL GENERAL LIABILITY i I FIRE DAMAGE(Any one lire) $ 1000000
CLAIMS MADE X OCCUR I MEDEXP(My one perm,) $
PERSONAL&ADV INJURY $ 1000000
GENERAL AGGREGATE s 2000000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AUG $1000000
—I POLICY PRO.Jul. X LOC
A AUTOMOBILE LIABILITY G3914480 (MA) 11/01/04 11/01/05 COMBINED SINGLE LIMIT
A X ANY AUTO CA1914479 (VA) 11/01/09 11/01/05 (Ea accident/ 12,000,000
A ALL OWNED AUTOS 0A1914481 (TXI 11/01/04 11/01/05 BODILY INJURY
A SCHEDULED AUTOS CA1914482 (ADS) 11/01/09 11/01/05 (PB,Penn) $
fs
X HIRED AUTOS
BODILY accident)
$
X NON-OWNED AUTOS Ter
X COaa%CGL ACV _.D10 PROPERTY DAMAGE
(Peraaideni) $
APP •
GARAGE LIaBILT' BY i 1 _ ^ / AUTO ONLY-EA ACCIDENT $
ANY AUTO 3N10 _ OTHER THAN EA ACC $
GATE AUTO ONLY: AGG $
EXCESS LIABILITY i•IA.i,.Ir% \( EACH OCCURRENCE $
OCCUR CLAIMS MADE ''/ ' AGGREGATE $
/ I
DEDUCTIBLE e
RETENTION S $
B WORKERS COMPENSATION AND IMC5898904 A2,ID,MA,MD,OR,VA 11/01/04 11/01/D5 X TDRYLIMTITS OER
L, EMPLOYERS'LIABILITY ;MC5E198905 ND,OB,WA,WI,WV,WY 11/01/01 11/01/05 E.L.EACH ACCIDENT $1000000
A WC5$98906 (AOS) 11/01/04 11/01/05 E.L DISEASE-EA EMPLOYEE $1000000
A •SEE BELOW 11/01/01 11/01/05 E.L.DISEASE-POLICY LIMIT $1000000
OTHER
f
f
f DESCRIPBON OFOPERA-DONS/LOCATORSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROWSIONS
The certificate holder is included as additional insured on the GL and Auto policy, but only to the extent of
liability assumed by the Named Insured under written contract. Workers Compensation coverage is evidenced for
employees of the Named Insured only.
CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION
SHOULD ANY OFTNE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
County of Monroe DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
Maria Del Rio, Risk Mgmt. Spec. NOTICE TO THE CERBFlCATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
1100 Simonton Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVES.
Rey West, FL 33040 AUTIORIZEDREPRESENTATVE
USA
I
ACORD 25-S(7/97) maribethklnn M ACORD CORPORATION 1988
2194514
PorMe6 BYCert/YlesMeNoww
ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MwOD"M
11/01/03
PRODUCER 1-210-299-1215 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Harsh OSA, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
112 East Pecan, Suite 2625 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
San Antonio, TX 78205 INSURERS AFFORDING COVERAGE
INSURED INSURER A.American Nome Assurance
Clear Channel Outdoor, Inc.
INSURER B:Insurance Company of the State of Pennsylvania
C/O 200 East Basso Rd- INSURER C'.National Union Fire Insurance Company
San Antonio, TX 78209 INSURERO.
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.
�6p TYPE OF HSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
DATEIMMDDIYYI DATE IMEWNLYYI LIMITS
A GENERALLIABILITY GL4806011 11/01/03 11/01/04 EACH OCCURRENCE $1000000
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one•e) 51000000
CLAIMS MADE X OCCUR MED EXP(My one person) $
PERSONAL AADV INJURY $1000000
GENERAL AGGREGATE $2000000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $1000000
—I POLICY PRO.IFCT r LOC
A AUTOMOBILE LLBINTY CA6612634 (HA) 11/01/03 11/01/04 COMBINED SINGLE LIMIT
A X ANY AUTO CA6612635 (VA) 11/01/03 11/01/04 (EaaccdHM) $2 000000
A ALL OWNED AUTOS CA6612636 (TX) 11/01/03 11/01/04
BODILY INJURY E
A SCHEDULED AUTOS CA6612637 (AO8) 11/01/03 11/01/04 (PW Pawn)
X HIRED AUTOS
BOOBY INJURY
..XNONGWNED AUTOS (Pa odder* $x% ''
C0 WICOLL - ACV
APPR Y K ANA E T PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY BY AUTO ONLY-EA ACCIDENT $
ANY AUTO DATE L w
AUTO ONLY:
EA ACC $
�/(\ AUTO ONLY. AGO $
EXCESSLIABILITY w'O'IVE){ WA / Thal EACH OCCURRENCE $
7 OCCUR CLAIMS MADE AGGREGATE $
$
DEDUCTIBLE
RETENTION $
S EMPLOYERS'LIABILITY
TOgY LIMBS Fq
C NC2981487 ND,OK,NA,WI,NV,NY I1/O1/03 11/O1/04 EL.EACH ACCIDENT $1000000
A WC2981488 (AOS) 11/01/03 11/01/04 EL.DISEASE-EA EMPLOYEE $1000000
A *SZE BALM 11/01/03 11/01/04 E.L.DISEASE-POLICY LIMIT $1000000
OTHER
DESCRIPTION OFOPERATIONS/LOCATION&VEHICLES'EXCLUSIONS ADDED BY EICOR6EMENTSPECIAL PROVISIONS
The certificate holder is included as an additional insured on the GL and Auto policy, but only to the extent of
liability assumed by the Named Insured under written contract. Workers Compensation coverage is evidenced for
employees of the Named Insured only.
•
CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION \
ADDITIONAL
SHOULD ANY OF THE MOW DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
County of Monroe DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
Maria Del Rio, Risk Ngnt. Spec. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
1100 91IDo¢LOn StreetIMPOSE NO OBLIGATION OR LIABILITY OF ANY KM UPON WE INSURER.ITS AGENTS OR
REPRESENTATIVES.
Key Nest, FL 33040 MNHORIZEDREPRESENTATNE
OSA
I
ACORD 25-S(T/9T) ienmar O ACORD CORPORATION 1988
1446475Pewe !\
red BYCertifiwfeSNDwn' SD
A R 0/28
10/28CERTIFICATE OF LIABILITY INSURANCE M/DD/YY)
/O5
,PRODUCER 1-210-299-1215 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Marsh USA, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
112 East Pecan, Suite 2625 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
San Antonio, TX 78205 1 INSURERS AFFORDING COVERAGE
INSURED INSURER A: American Home Assurance
Clear Channel Outdoor, Inc.
INSURERB:Ins. Co. State of Pennsylvania
c/o 200 East Basse Rd. INSURER C: National Union Fire Insurance Company of PA
San Antonio, TX 78209 INSURERD:
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.
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATION DATE fMM/DDIYYI
11/01/06
LIMITS
EACH OCCURRENCE
$1,000,000
A
GENERAL LIABILITY
GL5751521
11/01/05
FIRE DAMAGE (Any one tire)
$ 1,000,000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE a OCCUR
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$ 1, 000, 000
X Liquor Liability
GENERAL AGGREGATE
$ 2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2, 000, 000
POLICY PRO- X LOC
A
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
CA5833744 (VA)
CA5833743 (TX)
11/01/05
11/01/05
11/01/06
11/01/06
(a COMBINED LIMIT
accident)
$ 2, 000, 000
A
A
ALL OWNED AUTOS
SCHEDULED AUTOS
CA5833742 (AOS)
CA5833741 (MA)
11/01/05
11/01/05
11/01/06
11/01/06
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
COMP/COLL - ACV
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
APP 'D
E3Y
� SK SINS _
I i�l`°�-�'L-IiI'
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
$
AUTO ONLY: AGG
EXCESS LIABILITY
OCCUR CLAIMS MADE
!�� _
11MVP pa
��
Y
EACH OCCURRENCE
$
AGGREGATE
$
DEDUCTIBLE
RETENTION $
n
p
C
n
$
A
WORKERS COMPENSATION AND
WC6610736 (CA)
11/0 05
11/01/06
X WCRY STATU- O R
B
EMPLOYERS' LIABILITY
WC6610738 (AOS)
11/01/05
11/01/06
E.L. EACH ACCIDENT
$ 1, 000, 000
A
WC6610735 (MN)
11/01/05
11/01/06
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
C
WC6610737 NDNYOSWA, WI, WV, WY
11/01/05
11/01/06
E.L. DISEASE - POLICY LIMIT
$ 1, 000, 000
OTHER
$
$
$
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
The certificate holder is included as an additional insured on the GL and Auto policy, but only to the extent of
liability assumed by the Named Insured under written contract. Workers Compensation coverage is evidenced for
employees of the Named Insured only.
V%C,,"\ C
—• - • •- • — • •����... .,.......vn.a� 11--- maUncn LC Ien: %1M1%1CLLM I IVIV
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
County of Monroe DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
Maria Del Rio, Risk Mgmt . Spec. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
1100 Simonton Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES. _
Rey West, FL 33040 AUTHORRED REPRESENTATIVE
USA
ACORD 25-S (7/97) maribethking O ACORD CORPORATION 1988
Powered ByCertlficatesft,-
ACOR 11/0
1106 CERTIFICATE OF LIABILITY INSURANCE DATEY'
'PRODUCER 1-210-299-1215 I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
-ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Marsh USA, Inc.
112 East Pecan, Suite 2625 RECEIVED
San Antonio, TX 78205
INSURED
Clear Channel Outdoor, Inc.
c/o 200 East Hasse Rd.
Antonio, TX 78209
CERTIFICATE
INSURERS AFFORDING COVERAGE
INSU RB: Natioal Union Fire Insurance Company of PA
lulu Rc Amernican Home Assurance _
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE 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.
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATION
LIMITS
C
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE � OCCUR
X LIQUOR LIABILITY
GL5760929
11/01/06
11/01/07
CURRENCE
$ 1,000,000
DAMAGEire)
$1,000,000
)
$
PERSONALY
NGENERAL
$ 1,000,000
$2,000,000
GG
$2,000,000
GENT AGGREGATE
POLICY
LIMITAPPLIES PER:
PRO X LOC
C
C
C
C
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
COMP/COLL - ACV
CA5836623(VA)
CAS836625 (ADS)
CA5836625 (ADS)
CA5836624 (MA)
11/01/06
11/01/06
11/01/06
11/01/06
11/01/07
11/01/07
11/01/07
11/01/07
COMBINED SINGLE LIMIT
(Eaacc"ent)
$2,000,000
X
BODILY INJURY
IFperson)
$
BODILY INJURY
(Per acc,den0
$
PROPERTY DAMAGE
(Per accident)
$
X
GAR AGE LIABILITY
ANY AUTO
-
I
,
AUTO ONLY - EA ACCIDENT
$
OTHERTHAN EA ACC
AUTO ONLY: AGO
$
$
EXCESS LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
�I )
-
I
EACH OCCURRENCE
$
AGGREGATE
$
$
$
Is
A
e
C
C
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY
WC2920502 (AOS)
WC2920501 NDNYOHWA,WI,WV,WY
WC2920499 (MN)
WC2920498 (CA)
11/O1/O6
11/01/06
11/01/06
11/01/06
11/O1/07
11/01/07
11/01/07
11/01/07
X WC STATUS I X OTH-
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE - EA EMPLOYEd
$ 1,000,000
E.L. DISEASE -POLICY LIMIT
1 $1,000,000
OTHER
$
$
$
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
The certificate holder is included as an additional insured on the GL and Auto policy, but only to the extent of
liability assumed by the Named Insured under written contract. workers Compensation coverage is evidenced for
employees of the Named Insured only.
County of Monroe Maria Del Rio,
Risk Mgmt. Spec.
1100 Simonton Street
Key West, 33040
C G USA
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 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
REPRESENTATIVE
ACORN 25-S (7/971 valerievalle
51461BU
C
1
I -AC-0R CERTIFICATE OF LIABILITY INSURANCE DATE7D YY)
1z/27/0/o7
1-210-299-1215 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
^PflODUCER
4Marsh USA, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1112 East Pecan, Suite 2625 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Antonio, TX 78205
INSURED
Clear Channel Outdoor, Inc.
c/o 200 East Haase Rd.
1.3
Antonia, TX 78209
INSURERS AFFORDING COVERAGE
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
PERTAIN,MAY AGGREGATE LMITS SHOWN MAY HAVE BEPOLICIESREDDESCRIBEDIS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
PAID HERCLAEIN
POLICIES.
INSR POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
TYPE OF INSURANCE
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 111 OCCUR
X LIQUOR LIABILITY
GLI595634
11/01/07
11/01/08
EACH OCCURRENCE
$ 1,000,000
FIRE DAMAGE (An Onefire)
$11000,000
MED EXP (An one person)
$
PERSONAL B ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$2,000,000
PRODUCTS - COMP/OP AGG
$2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY F PRO X LOD
JECT
A
A
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
COMP/LOLL - ACV
CA1607212 (MA)
CA1607213 (ADS)
CA1607211 (VA)
11/01/07
11/01/07
11/01/07
11/01/08
11/01/08
11/01/08
COMBINED SINGLE LIMIT
(Ea accident)
$2,000,000
X
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
X
GARAGE LIABILITY
ANY AUTO-
C- -
AUTO ONLY - EA ACCIDENT
$
OTHERTHAN EA ACC
AUTO ONLY: AGG
$
$
A
EXCESS LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EMPLOYWORKERS COMPENSATION NAND
EMPLOYERS' LIABILITY
r -
wC5144814 (ADS)
' 1t
V
C{
11/01/07
>
11/01/08
EACH OCCURRENCE
$
AGGREGATE
$
$
$
X WC STATU- g DTH-
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE -EA EMPLOYE
$1,000,000
E.L. DISEASE -POLICY LIMIT
$1,000,000
OTHER
s
3
3
DESCRIPTION OF OPERATIONS/LOCATONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
RE: ERECTION &. MAINTENANCE OF BUS STOP SHELTERS
Certificate Holder and Monroe County Board of County Commissioners are additional insureds on the GL and Auto Policy,
but only to the extent of the liabilityassumed under written contract.
workers- Compensation coverage is evidenced for employees of the Named Insured only.
CERTIFICATE HOLDER I X I ADDITIONAL INSURED; INSURER LETTER: \d11Y6`CLLN I rvn
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
County of Monroe DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
Risk Management 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
1100 Simonton St.
REPRESENTATIVES. ley -
USA
Key west, FL 33040 AUTHORIZED REPRESENTATIVE
L7
ACORD 25-S /97) lkriatia O ACORD CORPORATION 1988
7829899
L C. I <ZLw.wC,G
ACORD1o/a6/o7., CERTIFICATE OF LIABILITY INSURANCE DATE/07 YY)
PRODUCER 1-210-299-1215 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
INareh USA, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
112 East Pecan, Suite 2625
San Antonio, TX 78205
INSURERS AFFORDING COVERAGE
INSURED
INSUREH A:
Insurance co yr a
Clear Channel
Communications, Inc.,
INSURER e:
Illinois National Ins Co
Clear Channel
Broadcasting, Inc. &
Clear Channel
Outdoor, Inc.
INSURERC:New
Hampshire Ins Cc
c/o 200 East
Bases Rd.
INSURER D:National
Union Fire Ins Co of PA
San Antonio,
TX 78209
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.
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATION
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$
COMMERCIAL GENERAL LIABILITY
FIRE DAMAGE (An one fire)
$
MED EXP (An one person)
$
CLAIMS MADE ❑ OCCUR
PERSONAL 8 ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
GEN'L AGGREGATE
LIMIT APPLIES PER:
POLICY
PRO LOC
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
(Ea accident)
$
ANY AUTO
ALL OWNED AUTOS
BODILY INJURY
(Per person)
$
SCHEDULED AUTOS`
HIREDAUTOS
Y `( \
n 1
BODILY INJURY
(Per accident)
$
NON -OWNED AUTOS
_
PROPERTY DAMAGE
(Per accitlent)
IS
GAR AGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
ANY AUTO
.� a
$
EXCESS LIABILITY
OCCUR CLAIMS MADE
/
it l-.
EACH OCCURRENCE
$
AGGREGATE
$
$
DEDUCTIBLE
$
RETENTION $
A
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
WC5144812 (CA)/WC5144810 (OR)
WC5144808 (FL)
11/01/07
11/01/07
11/01/08
11/01/08
% WC $TIMIT % GER
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE - EA EMPLOYE
$ 1,000,000
C
WC5144809 (TX)
11/01/07
11/01/08
E.L. DISEASE -POLICY LIMIT
1 $ 1,000,000
D
WC5144811 NDNY/OHWA/WIWV/WY
11/01/07
11/01/08
OTHER
s
8
s
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES'EXCLUSIONS ADDED BY ENDORSEMENTSPECIAL PROVISIONS
This page provides information on all additional Workers Compensation and Employers' Liability Policies.
Workers Compensation is evidenced for employees of the Named Insured only.
to let page for
icate Holder information
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 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
(7/97) valerievalle
7355429
AUTHORIZED REPRESENTATIVE
0
ACORQ. CERTIFICATE OF LIABILITY INSURANCE
DATE
0/30 MIDD YY)
PRODUCER 1-713-276-8663
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Marsh USA, Inc.
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1000 Main Street
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Suite 3000
Houston, TX 77002
INSURERS AFFORDING COVERAGE
INSURED
Clear Channel Outdoor, Inc.
INSURER A. Insurance Cc of The State of PA
INSURER B. Commerce S Industry Ins. Co.
-
INSURER C.
c/o 200 East Hasse Rd.
INSURER D.
San Antonio, TX 78209
INSURER E
CnVFRAGFS
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. _
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATION
MMI
LIMITS
A
GENERAL LIABILITY
GLI872073
11/01/08
11/01/09 1 EACH OCCURRENCE
$110001000
$1, 000, 000
X COMMERCIAL GENERAL LIABILITY
FIRE DAMAGE (Any one fire)
$ExClUded
CLAIMS MADE EX]OCCUR
MED EXP (Any one person)
$ 1,000,000
X LIQUOR LIABILITY
PERSONAL& ADV INJURY
GENERAL AGGREGATE
$2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
$2,000,000
PRODUCTS - COMP/OP AGG
POLICY PRO X LOG
B
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
CA6506024(MA)
CA6506023 (VA)
11/01/08
11/01/08
11/01/09
COMBINED SINGLE LIMIT
11/01/09 Ea accident)
$2,000,000
$
A
ALL OWNED AUTOS
SCHEDULED AUTOS
CA6506025 (ADS)
11/01/08
11/01/09 .BODILY INJURY
(Per person)
$
HIRED AUTOS
NON -OWNED AUTOS
BODILY INJURY
(Per accident)
X
$
COMP/COLL - ACV
PROPERTY DAMAGE
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
'$
OTHER THAN EA ACC
$
ANV AUTO
-
$
AUTO ONLY: AGO
EXCESS LIABILITY
OCCUR CLAIMS MADE
- Y
EACH OCCURRENCE
$
'AGGREGATE
$
$
Is
DEDUCTIBLE
'�/�1•�(A��[,\J
$
RETENTION $
v
A
WORKERS COMPENSATION AND
WC4801110
11/01/OB
11,01,09
X WRY LIMITS R C STATU- OTH-I
EL EACH ACCIDENT $1,000,000
EMPLOYERS' LIABILITY
C
E.L. DISEASE - EA EMPLOYEE
$ 1, 000, 000
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
OTHER
S
S
$
DESCRIPTION OF OPERATIONSILOCAMONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE: ERECTION & MAINTENANCE OF BUS STOP SHELTERS
Certificate Holder and Monroe County Board of County Commissioners are additional insureds on the GL and Auto policy,
but only to the extent of the liabilityassumed under written contract.
Workers- Compensation coverage is evidenced for employees of the Named Insured only.
of Monroe
1100 Simonton St.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 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
West, FL 33040
USA
ACORD25-S(7/97) jkristia
10190001
AUTHORIZED REPRESENTATIVE
o ACORD CORPORATION 1988
ACOR M CERTIFICATE OF LIABILITY INSURANCE 2/16 M/DD/YY)
02/16/09
PRODUCER 1-832-476-6000 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Aon Risk Services Southwest, Inc. FERS NO RIGHTS UPON THE CERTIFICATE
RECI
t :R. THIS ERTIFICATE DOES NOT AMEND, EXTEND OR
1330 Post Oak Boulevard 7��((L� THE CO ERAGE AFFORDED BY THE POLICIES BELOW.
Suite 900 ��_._ __ _� _
Houston, TX 77056-3089 I IN URERS AFFORDING COVERAGE
1 U ns
INSURER B:
INSURED
Clear Channel Outdoor, Inc.
c/o 200 East Basse Rd.
San Antonio, TX 78209
&�n11c o A r±Cc
E:
rancd Comoanv of PA
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.
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MM/DD/YYI
POLICY EXPIRATIONLTR
DATE (MWDDIYY)
LIMITS
A
GENERAL LIABILITY
GL 1872073
11/01/08
11/01/09 EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY
FIREDAMAGE(Anyone fire) $ 1,000,000
_ J CLAIMS MADE LXI OCCUR
MED EXP (Any one person) $ Excluded
X LIQUOR LIABILITY
PERSONAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG $ 2,000,000
POLICY PRO X LOC
•
AUTOMOBILE
LIABILITY
ANY AUTO
CA 6506025 (AOS)
11/01/08
11/01/09 COMBINED SINGLE LIMIT $ 5,000,000
(Ea accident)
X
ALL OWNED AUTOS
SCHEDULED AUTOS
', BODILY INJURY I $
(Per person)
HIRED AUTOS
NON -OWNED AUTOS
BODILY INJURY
(Per accident) $
X
COMP/LOLL - ACV
PROPERTY DAMAGE
I (Per accident) $
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
EA ACC
OTHER THAN
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESS LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
mt
AGGREGATE
$
,H
$
DEDUCTIBLE
'
$
RETENTION $
Y
A
WORKERS COMPENSATION AND
WC 4801110
11/01/08
11/01/09
X WC STATT ER
TOR Y LIMITS ER
I
E.L. EACH ACCIDENT
$ 1,0001000
EMPLOYERS' LIABILITY
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 11000,000
OTHER
$
$
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE: ERECTION & MAINTENANCE OF BUS STOP SHELTERS Certificate Holder and Monroe County Board of County Commissioners are
additional insureds on the GL and Auto policy, but only to the extent of the liabilityassumed under written contract.
Workers' Compensation coverage is evidenced for employees of the Named Insured only.
CERTIFICATE HOLDER
County of Monroe
Risk Management
11100 Simonton St.
ADDITIONAL INSURED: INSURER LETTER
Key West, FL 33040/ -
i C. C USA
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 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-S (7/97) cmulvey O ACORD CORPORATION 1988
11114232
A C"R CERTIFICATE OF INSU�RANC
DATE MM/DD
LIABILITY {
E
PRODUCER 10 / 16 / 0 9
1-832-476-6000 j
CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Aon Risk Services Southwest, Inc. ----- _ _ Y AND CONFERS NO RIGHT
S UPON THE CERTIFICATE
1330 Post Oak Boulevard, Suite 900 A � CERTIFICATE DOES NOT AMEND, EXTEND OR
ER THE
.. �- OVERAGE AFFORDED BY THE POLICIES BELOW.
Houston, TX 77056-3089
f
INSURERS AFFORDING COVERAGE
INSURED OCT
r,Clear Channel Outdoor, Inc. R A: Insur ce Co of The State of PA
c/o 200 East Basse Rd. INSURER B: lnsur, ce Co of The State of PA
INSURER C
San Antonio, TX 78209 r.11101`4r OE OUj1 NtURER D:
RISK MANAU^. COVERAGES ��nn''JJT
`FNBURER E:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS PERIOD INDICATED. NOTWITHSTANDING
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCL CERTIFICATE MAY BE ISSUED OR
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. USIONS AND CONDITIONS OF SUCH
INSR
LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
A GENERAL LIABILITY 6506441 LIMITS
X COMMERCIAL GENERAL LIABILITY 11/01/09 11/01/10 EACH OCCURRENCE $ 1, 000, 000
CLAIMS MADE a OCCUR MAFIRE DAGE (Anyone fire) $ 1,000,000
MED EXP {Any one person $Excluded
PERSONAL $ADV INJURY $ 1, 000, 000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2, 0 0 0, 0 0 0
POLICY X PRO- LOC PRODUCTS - COMP/OP AGG $ 2 , 0 0 0 , 0 0 0
JECT
A AUTOMOBILE LIABILITY CA6647331 (AOS) 11/01/09 11/01/10
X ANY AUTO COMBINED SINGLE LIMIT
(Ea accident} $ 1, 0 0 0, 000
ALL OWNED AUTOS
SCHEDULED AUTOS BODILY INJURY HIRED AUTOS $
(Per person)
NON -OWNED AUTOS BODILY INJURY $
�. {Per accident}
PROPERTY DAMAGE $
' -
GARAGE LIABILITY (Per accident)
ANY AUTO
AUTO ONLY - EA ACCIDENT $
OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY
EACH OCCURRENCE $
FOCCUR � CLAIMS MADE �
AGGREGATE $
DEDUCTIBLE $
C�
RETENTION $ E --$
B WORKERS COMPENSATION AND 004289334 (AOS) 11/01/09 11/O1/10 X $
EMPLOYERS' LIABILITY WCR STATU- OTH-
E.L. EACH ACCIDENT FR $ 11000 , 000
E.L. DISEASE - EA EMPLOYEE $ 1, 000, 000
OTHER E.L. DISEASE - POLICY LIMIT $ 1, 000, 000
$
$
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS $
ERECTION & MAINTENANCE OF BUS STOP SHELTERS Certificate Holder and Monroe County Board
additional insureds on the GL and Auto policy, but only to the extent of the liabili assu of County Commissioners are
tyassu
Workers' Compensation coverage is evidenced for employees of the Named Insured only. med under written contract.
CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
County of Monroe DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO 30
Risk Management MAIL DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
1100 Simonton St . IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Key West, FL 33040 REPRESENTATIVES.
USA AUTHORIZED REPRESENTATIVE
ACORD 25-S /97 Dholden��,g�t�ut;
133d7nn2 =A elk low
Certificate Deliver
y by CertificatesNow - www.ConfirmNet.com - 877.669.8600 19 M.vrcu cUKPORATION 1988
►coRV CERTIFICATE OF LIABILITY INSURANCE
16,�10/26/2010
DATE
10/26/201'YYY)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER 1-832-476-6000
_
Aon Risk Services Southwest, Inc. ) _ y I. -
j (
E ��
CONTACT
NAME:
PHO s FAX
A/C No):
l , ►.y>1
1330 Post Oak Boulevard, Suite 900 N
______.-_
E-MAIL
ADDRESS:
PRODUCER
Houston, TX 77056-3089
F.
INSURER 3 AFFORDING COVERAGE
NAIC #
INSURED 110V-11i0
INS
RERA: Insurance Co of The State of PA
Clear Channel Outdoor, Inc.
INS
RERB:
RERC:
c/o 200 East Besse Rd. ;.,:,'�'-._'_,..._-"`-'
INSURERD:
San Antonio, TX 78209 T F'': 1N_'ir
INSURER F :
COVERAGES CERTIFICATE NUMBER: 18050135 REVISION NUMBER:
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.
1�7R
TYPE OF INSURANCE
In& SU D POLICY NUMBER MPIM/DD/ EFF POLICYEXP
LIMITS
A
GENERAL LIABILITY
4361000
11/01/1
11/01/11
EACH OCCURRENCE
$ 1,000,000
X COMMERCIAL GENERAL LIABILITY
DAMAGE(Ea occurrence RENTS
PREMISESS
$ 1,000,000
CLAIMS -MADE � OCCUR
MED EXP (Any one person)
$ Excluded
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2,000,000
POLICY X PRO- LOC
$
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
CA3976708 (AOS)
11 01 1
11 01 11
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
BODILY INJURY (Per person)
$
ALL OWNED AUTOS
BODILY INJURY (Per accident)
$
X
SCHEDULED AUTOS
HIRED AUTOS
I
PROPERTY DAMAGE
(Per accident)
$
X
NON -OWNED AUTOS
$
i
UMBRELLA LIAB
HCLAIMS-MADE
OCCUR
r
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
V
DEDUCTIBLE
$
$
RETENTION $
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y I N
ANY PROPRIETOR/PARTNERIEXECUTNE
OFFICER/MEMBER EXCLUDED?
N I A
26149822 (AOS)
11/01
11/0 /11
O
X WCSLIMI- TH-
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEd
$ 1, 000, 000
(Mandatory in NH)
If yes describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT 1
$ 1, 000, 000
I
T__
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
RE: ERECTION & MAINTENANCE OF BUS STOP SHELTERS Certificate Holder and Monroe County Board of County Commissioners are
additional insureds on the GL and Auto policy, but only to the extent of the liabilityassumed under written contract.
Workers' Compensation coverage is evidenced for employees of the Named Insured only.
_ van r rrvve� r nvw�r� VAre\rCLW I IVPI
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
County of Monroe THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Risk Management ACCORDANCE WITH THE POLICY PROVISIONS.
1100 Simonton St.
AUTHORIZED REPRESENTATIVE
Rey Nest, FL 33040 /����
USA I,IeYL �ry�pu�wK.o� 4riC.
onoJ.cen 01988-2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD
18050135
C' L Certificate Delivery by CertificatesNow - www.ConfinnNet.com - 877.669.8600
P524U112UI1U2
ACORO CERTIFICATE OF LIABILITY INSURANCE
MMIDONYM
°10 20/ 011
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the Certificate holder is an ADDITIONAL
�a •7on
If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies
y require meIs
certificate does not confer rights to the
certificate holder In lieu of such endorsements .
PRODUCER 1-832-476-6
0
CONTACT
CANT:
Aon Risk Services Southwest, Inc.
O
imL '
FAX
5555 San Felipe, Suite 1500
INSU S AFF
COVERAGE
NAILS
Houston, TX 77056-3089
D�nce Co o
The State of PA
jA
INSURED RIS
llt4lt ifl P.hire nsuranca Caopeny
Clear Channel Outdoor, Inc.
INSURER C :
INSURERD:
c/o 200 Bast Bases Rd.
INSURERE:
San Antonio, TX 78209
INSURER F:
^ 1#0nAn_ee PCDTICIPATC NIIUDCD. 237D753B RFVI%InN NIIYRFR'
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.
WER
TYPE OF INSURANCE
ADDL
SUM
POLICY NUMBER
POLICY EFF
POLICY EXP
MMIDDIYYYYJ
LIYRS
A
GENERALLueILm
GL 2704942
11/01/1
11/01/12
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
PREMISES Ea oomaence
$ 1,000,000
Z COMMERCIAL GENERAL LIABILITY
MED EXP (Any one Person)
f Excluded
CLAIMS -MADE 1-il OCCUR
PERSONAL 4 ADV INJURY
$ 1, 0001000
GENERAL AGGREGATE
$ 2,006,000
GEML AGGREGATE LIMIT APPLIES PER:
-.
_
PRODUCTS - COMP/OP AGG
$ 2. 000, 000
$
POLICY x PRO- LOC
R
A
AUTOMOBILE LIABILITY
CA4309637
COMBINEq GLEDMIT
a done
1,000,000
= ANY AUTO
a
!
BODILY INJURY (Per person)
$
BODILY INJURY (Par accident)
$
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
-bj.� "
```
µ �
.
PROPERTY DAMAGE
Per aoddent
$
HIRED AUTOS z AUTOS
` •
1
$
UMBRELLA LIAR
OCCUR
.-,,
�.
+
EACH OCCURRENCE
$
AGG . ATE
$
EXCESS LIAO
CLAIMS -MADE
�
DED RETENTION
—`
$
+
B
WORKERS COMPENSATION
WC 015684295 (AOS)
11/01
11/4,V12
x srATU- o
E.L. EACH ACCIDENT
f 1,000,000
AND EMPLOYERS' LJABLITY YIN
ANY PROPRIETORIPARTNERIEXECUTIVE
-
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
OFFICER MEMBER EXCLUDED? ❑
(Yrdmkn In NH)
N / A
.,
E.L. DISEASE - POLICY LIMIT
$ 1, 000, 000
Hyes describe under
DESCRIPTION OF OPERATIONS below
r
i9s
r
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AU@ch ACORD 101, AddlNonal Rsmmke edieduN, N man pats Is required)
RE: ERECTION a MAINTEMANCE OF BOB STOP SBSL WS Certificate Holder and Monroe County Board of County Commissioners are
additional insureds on the GL and Auto policy, but only to the extent of the liabilityassumed under written contract.
Workers' Compensation coverage is evidenced for employees of the Named Insured only.
In G : 11� a vJ L_1L
GtK I Ir M:A It KULIJtK %00%n V Gr-L++ r rvn
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
County of Monroe THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Risk Management I ACCORDANCE WITH THE POLICY PROVISIONS.
11100 Simonton St. ( AUTHORIZED REPRESENTATIVE
Fleet, FL 33040 I a#. � ����� ,-C,
I USA
ACORD 25 (2010106)
Dholden
23707538
919WZU10 AGORU GOKFOKAI NUN. All ngnts reservea.
The ACORD name and logo are registered marks of ACORD
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