Certificates of Insurance
I~II~ Ili~* ~~6 REPLBLlC BUSINESS SERVICES BONO
1m.. *' I. COMPANY
I WliEvt ~ ATTACHIf! Old Republic Surety Company 0 Old Republic Insurance Company
''f.lOLlCY TO BE ASSURED THAT 0
Y~U HAVE THE ~OVERAGE '{ OU (CHECK APPLICABLE COMPANY HEREINAFER REERRED TO AS THE COMPANY)
REQUESTE~ ~ II. AGREEMENT
In consideration of an agreed premium, the Company indicated in I. above (hereinafter called" Surety") hereby agrees to indemnify
ALFREDO VAZQUEZ
BOND NO. OBS-449675
ReceIved
R1Sk Mgmt. & Loss Control
, .~ / /{) / Cl(;
[JA J L -.-------'--7, /
( U
iNITIAL ________---
of 3616 NORTHSIDE DR., KEY WEST, FLORIDA 33040 ,(hereinafter called "Obligee"),
against direct loss of money or other property, from the premises of any and all subscribers (hereinafter called "Subscriber") to its
services, and belonging to the Subscriber, or in which the Subscriber has a pecuniary interest or for which the Subscriber is legally
liable, which the Subscriber shall sustain as the result of any employee dishonesty, as hereinafter defined, of an Employee or Employees
of the Obligee and for which the Obligee is liable, to an amount not exceeding TWENTY FIVE THOUSAND AND NO/100---
------------------------------------oOlLARS ($ 25.000. OO------------------i, the limit of the bond.
THE FOREGOING AGREEMENT IS SUBJECT TO THE FOllOWING CONDITIONS AND LIMITATIONS:
THE FLORIDA AMENDATORY RIDER HERETO ATTACHED BECOMES AN INTEGRAL PART OF THIS DOCUMENT.
^rf)p'~'TD R\i PiSh \~.'\~~~\GF~!lENT
r\~(T~~ v
/-/0 -f(;._
/'
V
TERM OF BOND:
SECTION 1. The term of this bond begins with the 30TH day of .lHTr.TT~'1' ,19 -9-5- ,
12:00 o'clock night, standard time at the address of the Obligee above given, and ends at 12:00 o'clock night, standard time, on the
effective date of the cancellation of this bond in its entirety,
.
DISCOVERY PERIOD:
SECTION 2. loss is covered under this bond only (a) if sustained through any act or acts committed by an Employee of Obligee while
this bond is in force as to such Employee, and (b) if discovered prior to the expiration or sooner cancellation of this bond in its entirety
as provided in Section 14, or from its cancellation or termination in its entirety in any other manner, whichever shall first happen.
LIMIT OF BOND:
SECTION 3. The most the Surety will pay for loss for anyone occurrence is the applicable limit of bond shown above.
DEFINITION OF EMPLOYEE:
SECTION 4. The word Employee or Employees, as used in this bond, shall be deemed to mean, respectively, one or more of the
natural persons (except directors or trustees of the Obligee, if a corporation, who are not also officers or employees thereof in some
other capacity) while in the regular service of the Obligee in the ordinary course of the Obligee's business during the term of this
bond, and whom the Obligee compensates by salary, or wages and has the right to govern and direct in the performance of such
service, and who are engaged in such service within any of the States of the United States of America, or within the District of Columbia,
Puerto Rico, the Virgin Islands, or elsewhere for a limited period, but not to mean brokers, factors, commission merchants, consignees,
contractors, or other agents or representatives of the same general character.
DEFINITION OF EMPLOYEE DISHONESTY:
SECTION 5. Employee dishonesty shall mean only the fraudulent or dishonest occurrences causing loss during the time the Employee
is engaged in services on the premises of the Subscriber or Subscribers and which is punishable under the Criminal Code in the
jurisdiction within which the occurrence took place, for which said Employee(s) is tried and convicted by a court of proper jurisdiction
and only in an amount not to exceed the amount stated in the conviction.
DEFINITION OF OCCURRENCE:
SECTION 6. Occurrence means allloss(es) caused by or involving one or more Employees whether the result of a single act or a
series of acts without regard to the number of Subscribers involved.
DEFINITION OF PREMISE:
SECTION 7. Premise shall mean only the interior of the Subscriber's building or structure or any part thereof for which the Subscriber
is the tenant or owner and for which the Obligee is rendering a service to the Subscriber but shall not include driveways, parking
spaces, or appurtenant structures for which the Obligee is not performing a service.
MERGER OR CONSOLIDATION:
SECTION 8. If any natural persons shall be taken into the regular service of the Obligee through merger or consolidation with some
other concern, the Obligee shall give the Surety written notice thereof and shall pay an additional premium on any increase in the
number of Employees covered under this bond as a result of such merger or consolidation computed pro rata from the date of such
merger or consolidation to the end of the current premium period.
NON-ACCUMULATION OF LIABILITY:
SECTION 9. Regardless of the number of years this bond shall continue in force and the number of premiums which shall be pay-
able or paid, the liability of the Surety under this bond shall not be cumulative in amounts from year to year or from period to period.
LIMIT OF LIABILITY UNDER THIS BOND AND PRIOR INSURANCE:
SECTION 10. With respect to loss or losses caused by an Employee or which are chargeable to such Employee as provided in Sec-
tion 5 and which occur partly under this bond and partly under other bonds or policies issued by the Surety to the Obligee or to any
predecessor in interest of the Obligee and terminated or cancelled or allowed to expire and in which the period for discovery has
not expired at the time any such loss or losses thereunder are discovered, the total liability of the Surety under this bond and under
such other bonds or policies shall not exceed, in the aggregate, the amount carried under this bond on such loss or losses or the
amount available to the Obligee under such other bonds or policies, as limited by the terms and conditions thereof, for any such
loss or losses, if the latter amount be the larger.
ORse 21360 (1,90)
TRANSFER OF RIGHTS OF RECOVERY:
SECTION 11. The Obligee, as a condition to coverage under this bond, must transfer to the Company all rights of recovery, to the
extect that a loss is paid by a Company against any person or organization for any loss the Obligee sustains and for which we have
paid or settled the claim. The Obligee must also do everything necessary to secure those rights and do nothing after loss to impair them.
SALVAGE:
SECTION 12. If the Obligee shall sustain any loss or losses covered by this bond which exceed the amount of coverage provided
by this bond, the Obligee shall be entitled to all recoveries, except from suretyship, insurance, reinsurance security and indemnity
taken by or for the benefit of the Surety, by whomsoever made, on account of such loss or losses under this bond until fully reim-
bursed, less the actual cost of effecting the same; and any remainder shall be applied to the reimbursement of the Surety.
CANCELLATION AS TO ANY EMPLOYEE:
SECTION 13. This bond shall be deemed cancelled as to any Employee: (a) immediately upon discovery by the Obligee, or by any -
partner or officer thereof not in collusion with such Employee, of any fraudulent or dishonest act on the part of such Employee; or
(b) at 12:00 o'clock night, standard time, upon the effective date specified in a written notice served upon the Insured or sent by mail.
Such date, if the notice be served, shall be not less than ten days after such service, or, if sent by mail, not less than fifteen days
after the date of mailing. The mailing by Surety of notice, as aforesaid, to the Obligee at its principal office shall be sufficient proof
of notice.
CANCELLATION AS TO BOND IN ITS ENTIRETY:
SECTION 14. This bond shall be deemed cancelled in its entirety at 12:00 o'clock night, standard time, upon the effective date speci-
fied in a written notice by the Obligee upon the Surety or by the Surety upon the Obligee, or sent by mail. Such date, if the notice
be served by the Surety, shall be not less than ten days after such service, or if sent by the Surety by mail, not less than fifteen days
after the date of mailing. The mailing by the Surety of notice, as aforesaid, to the Obligee at its principal office shall be sufficient proof
of notice. The Surety shall refund to the Obligee the unearned premium computed pro rata if this bond be cancelled at the instance
of the Surety, or at short rates if cancelled or reduced at the instance of the Obligee.
PRIOR FRAUD, DISHONESTY OR CANCELLATION:
SECTION 15. No Employee, to the best of the knowledge of the Obligee, or of any partner or officer thereof not in collusion with such
Employee, has committed any fraudulent or dishonest act inthe service of the Obligee or otherwise. If prior to the issuance of this
bond, any fidelity insurance in favor of the Obligee or any predecessor in interest of the Obligee and covering one or more of the
Obligee's employees shall have been cancelled as to any of such employees by reason of (a) the discovery of any fraudulent or dis-
honest act on the part of such employees, or (b) the giving of written notice of cancellation by the insurer issuing said fidelity insur-
ance, whether the Surety or not, and if such employees shall not have been reinstated under the coverage of said fidelity insurance,
or superseding fidelity insurance, the Surety shall not be Iiabl,e under this bond on account of such employees unless the Surety
shall agree in writing to include such employees within the coverage of this bond.
LOSS-NOTICE-PROOF-LEGAL PROCEEDINGS:
SECTION 16. At the earliest practical moment, and at all events not later than fifteen days after discovery of any fraudulent or dis-
honest act on the part of any Employee by the Obligee, or by any partner or officer thereof not in collusion with such Employee, the
Obligee shall give the Surety written notice thereof and within four months after such discovery shall file with the Surety affirmati~
proof of loss, itemized and duly sworn to, and shall upon request of the Surety render every assistance, not pecuniary, to fa~itate
the investigation and adjustment of any loss. No suit to recover on account of loss under this bond shall De brought before the expira-
tion of two months from the filing of proof as aforesaid on account of such loss, nor after the expiration of fifteen months from the
discovery as aforesaid of the fraudulent or dishonest act causing such loss. If any limitation in this bond for giving notice, filing claim
or bringing suit is prohibited or made void by any law controlling the construction of this bond, such limitation shall be deemed to
be amended so as to be equal to the minimum period of limitation permitted by such law. .
EXCWSIONS:
SECTION 17. This Bond does not apply:
(a) to the defense of any legal proceeding brought against the Obligee or Subscriber, or to fees, costs or expenses incurred or paid
by the Obligee or Subscriber in prosecuting or defending any legal proceeding whether or not such proceeding results or would result
in a loss to the Obligee or Subscriber covered by this Bond.
(b) to potential income including but not limited to interest and dividends, not realized by the Obligee or Subscriber because of a
loss covered under this Bond.
(c) to damages of any type for which the Obligee or Subscriber is legally liable, except direct compensatory damages arising from
a loss covered under this Bond.
(d) to costs, fees and other expenses incurred by the Obligee or Subscriber in establishing the existence of or amount of loss covered
under this Bond.
SIGNED, SEALED AND DATED
~F.PTF.MRF.~ ~ lqq~
on this bond is S 183 . 00
payable upon delivery.
TH~COMPANY. . ERRE 0 IN, SECTION I
By: ~~. . ~
/'
FLORIDA LICENSED RESIDENT AGENT
Attorney-in-fact
The initial ~year premium
THIS BOND HAS AN EMPLOYEE
CONVICTION REQUIREMENT TO
SUBSTANTIATE ANY LOSS OR CLAIM.
FLORIDA AMENDATORY RIDER
To be attached to and form part of Business Services Bond No. ,OBS-449675
issued to
ALFREDO VAZQUEZ
Section 14. of the bond is deleted in its entirety and the following added in its place:
CANCELLATION AS TO BOND IN ITS ENTIRETY:
SECTION 14. This bond shall be deemed cancelled in its entirety at 12:00 o'clock night, standard time, upon the effective date
specified in a written notice by the Obligee upon the Surety or by the Surety upon the Obligee, or sent by mail. Such date,
if the notice be served by the Surety, shall be not less than forty-five days after such service, or if sent by the Surety by mail,
not less than fifty days after the date of mailing. The mailing by the Surety of notice, as aforesaid, to the Obligee at its principal
office shall be sufficient proof of notice. The Surety shall refund to the Obligee the unearned premium computed pro rata if
this bond be cancelled at the instance of the Surety, or at short rates if cancelled or reduced at the instance of the Obligee.
Section 16. of the bond is deleted in its entirety and the following added in its place:
LOSS-NOTICE-PROOF-LEGAL PROCEEDINGS:
SECTION 16. At the earliest practical moment, and at all events not later than fifteen days after discovery of any fraudulent
or dishonest act on the part of any Employee by the Obligee, or by any partner or officer thereof not in collusion with such
Employee, the Obligee shall give the Surety written notice thereof and within four months after such discovery shall file with
the Surety affirmative proof of loss, itemized and duly sworn to, and shall upon request of the Surety render every assistance,
not pecuniary, to facilitate the investigation and adjustment of any loss. No suit to recover on account of loss under this bond
shall be brought before the expiration of ninety days from the filing of proof as aforesaid on account of such loss, nor after
the -expiration of five years from the discovery as aforesaid of the fraudulent or dishonest act causing such loss. If any limitation
in this bond for giving notice, filing claim or bringing suit is prohibited or made void by any law controlling the construction
of this bond, such limitation shall be deemed to be amended so as to be equal to the minimum period of limitation permitted
by such law.
All other conditions remain the same.
-4
SIGNED, SEALED AND DATED
SEPTEMBER 5, 1995
OLD REPUBLIC SURETY CO.
~
Surety
FLORIDA LICENSED RESIDENT AGENT
Attorney-in-Fact
ORSC 22458
DISHONESTY BOND RIDER
SOLE PROPRIETOR OR PARTNERSHIP
To be attached to Business Services Bond No.
OBS-449675
It is agreed that:
In the event that the Insured's Customer or Subscriber shall sustain a loss by reason of the dishonest act or acts (as defined in
Section 5) committed by the Insured or any partner of the Insured, if a partnership, then and only then, the Insured shall be considered
an Employee and the Customer or subscriber as additional Insured, subject to all terms and conditions hereof.
SIGNED, SEALED AND DATED
SEPTEMBER 5, 1995
~co.
Su rety
Attorney-in-Fact
FLORIDA LICENSED RESIDENT AGENT
....
ORSC 22383
Received
Risk Mgmt. & Loss Control
DATE /2 - l-q~~
~
GEICO Indemnity Company
~ .;~)~ ",
. ,
.
,,'
~t' ~ '0
Rc.\.J, U~ \S?,'J
UE.C
INITIAL
ADDITIONAL INSURED ENDORSEMENT
Named Insured and Address:
ALFREDO VAZQUEZ
3616 NORTHSIDE DR
KEYWEST FL 33040-4268
'1"'"
Effective Date of Endorsement: 12~.~~ ..".... '
Policy Number: J6-77-81
Policy Period 12-27-95
(12:01 A,M. Standard Time)
to UNTIL TERMINATED
(12:01 A.M. Standard Time)
The policy indicated above includes the Bodily Injury Liability, Property Damage Liability and Uninsured Motorist and
Personal Injury Protection Coverage limits shown on this endorsement.
Description of Vehicle #1: 93 FORD
COVERAGE
lFTFE24Y7PHB15567 APPROVED BY RISK MAN.~GE~FNT
~ "1/7 / ~,.f' tJl#!!..( G;
BY__ :Jft/~~
DATE /;J-7-p
WAIVER: N/A /' YES
LIMITS OF COVERAGE
Description of Vehicle #2:
Description of Vehicle #3:
Vehicle #1
Vehicle #2
Vehicle #3
Bodily Injury Liability
$ 100 M and $ 300 M
(each person) (each occurrence)
$ M and $ M
(each person) (each occurrence)
$ M and $ M
(each person) (each occurrence)
Property Damage Liability
$ 50M
(each occurrence)
$
(each occurrence)
$
(each occurrence)
Uninsured Motorist
(Bodily Injury)
$ 10 M and $ 20 M
(each person) (each occurrence)
$ Mand$ M
(each person) (each occurrence)
$ Mand$ M
(each person) (each occurrence)
Personal Injury Protection
$ BASIC
$
$
ADDITIONAL INSURED
We agree that Bodily Injury Liability, Property Damage Liability. Uninsured Motorists and Personal Injury Protection cover-
ages provided by this policy also apply with respect to each interest named here as an Additional Insured; but the limit of
our liability is not increased by the inclusion of the Additional Insured
We agree to provide you with written notice of termination in the event this policy becomes cancelled. Notice provided
may be more than ten (10) days. but not less than ten (10) days.
Name and Address of Additional Insured:
.
MONROE CO BD OF
COMMISSIONERS
500 WHITEHEAD ST
KEY WEST FL 33040
.
Countersigned by Authorized Representative
CRUE-168D (12-88)
cc
,~~~-
~
ACOflDTlI
T~E PORTER ALLEN COMPANY
513 SOUTHARD STREET
KEY WEST, FLORIDA 33040
-" -.-..-.- ,-- ,... -. -...... .... ". . .. , " . . ," .........-.'.....-.... '.--....
eSRfl',~ATIiOfl...;l~l3ll...lniINBIB*111i
~-_._,-..__._-,--~_.~ -,~ ~lL--:2.9,-.9.5
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.
..-.--.------,--.- .------.-.--------- -----
COMPANIES AFFORDING COVERAGE
DATE (MMlDDNY)
PRODUCER
: 1-305-294-2542
!INSURED
i
i
i
COMPANY
A
AMERICAN EQUITY INSURANCE COMPANY
ALFREDO VAZQUEZ, INC.
3616 NORTHSIDE DRIVE
KEY WEST, FLORIDA 33040
COMPANY
B
1{Lcej'Vf::j"1
. ,
,,_.._,_,L;L'(:":;,.~:!;r(~~
,._-_._.,P~~~----,..
COMPANY
C
l, "'m..._..'..m.. "H ...,
:COva:J4GSS
: 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.
Ico
iLTR
COMPANY
D
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MMlDDNY) DATE (MMlDDIYY)
CLAIMS MADE X OCCUR AC05832
OWNER'S & CONTRACTOR'S PROT
8-31-95
8-31-96
LIMITS
GENERAL AGGREGATE $ 300,000
PRODUCTS, COMP/OP AGG $ INCLUDED
PERSONAL & ADV INJURY $ 3QO,000
EACH OCCURRENCE $ 300,000
FIRE DAMAGE (Anyone fire) $ 50,000
MED EXP (Anyone person) $ 1..000_
COMBINED SINGLE LIMIT $
BODILY INJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
AUTO ONLY - EA ACCIDENT $
OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE $
EACH OCCURRENCE $
AGGREGATE $
$
We STATU- OTH, '
TORY LIMITS ER
EL EACH ACCIDENT $
EL DISEASE, POLICY LIMIT $
EL DISEASE - EA EMPLOYEE $
GENERAL LIABILITY
AX
COMMERCIAL GENERAL LIABILITY
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
^prpG'TD [1" RISK vrN~J~F~E~T
rv -~~tJ'2zl~
I_~_fe.- ,l~__
/
GARAGE LIABILITY
ANY AUTO
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELILA FORM
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
THE PROPRIETOR!
PARTNERs/EXECUTIVE
OFFICERS ARE:
OTHER
INCL
EXCL
i DESCRIPTION OF OPERATIONSIlOCATIONSIVEHICLESISPECIAL ITEMS
CEFmFfCATEHOLDER ..& ADDITIONAL' INSUR.ED
CAtlCEl.LATfOff
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
5100 COLLEGE ROAD, PUBLIC SERVICE
STOCK ISLAND
KEY WEST, FLORIDA 33040
SHOULD ANY OF TIlE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TIlE
EXPIRATION DATE TIlEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
-.l.Q DAYS WRITTEN NOTICE TO TIlE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON TIlE
_._._---~-"--_.~---_...__._~._._-
AUTIlORIZED REPRESENTATIVE
OR REPRESENTATIVES.
, ACOFl025-S(1195)
1988
.l. .....'1. :"n~E".:"'...".R:.....'"I';I."...~I"" .':...":' "T"E.' ',' "i;/lkiS:.:'....:'.'...I5Ak'l?-e.':.:'..: .o:-.....fiY ...:..,"::>0'04'()"9.)::(:.. 1;.~~~;.,.'(fI~'.7. "
^~.... ..",..t 17 ,."',.,., I"............,:.,.:...,..:.....,...:.:.',...:"',..,..:,.,:,:",':,':,.,:,..,..v..::::,, :.,,: ,...:~.g~~.lI.~. .':.::':::::::':: ..."., ::::::::::(}\.(..\..(..}::.:::::",. . 12 28 95
..-.......................................-......<.;.;1.-:.:-:.:.:.:.:::::::>.;.:::::-:'.... .............................'.......:..-:.:-:...
PRODUc;ER 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
POUCIES BELOW.
Contra! COMPANIES AFFORDING COVERAGE
YS INSURANCE AGENCY
.0. BOX 500280
THON FL 33050
Received
l\.JSK Mgmt. & Los
OAT!: /- A -
COMPANY A PCA PROPERTY & CASUALTY INS. CO.
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY D
LETTER
COMPANY E
~t,IT!AL
Ifredo Vazquez
anitorial Services
Ifredo Vazquez, Inc DBA
616 Northside Drive
ey West, FL 33040
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
CERTlFICA'tE MAY BE ISSUED OR MAY PERTAI~ THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO All THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POU...IES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
POUCY EfFECTIVE POUCY EXPIRAnoN
lYPE 01' INSURANCE POUCY NUMBER UIIITS
TE (MMIDOIYV) DATE (MMIDDIYV)
GENERAL LlABIUlY GENERAL AGGREGAlE .
MMERClAL GENERAL UASlUTY PROOUCTS-COMPIOP AGG. .
MS MADE DOCCUR. PERsoNAL & ADV, INJURY .
OWNER'S & CONTRACTOR'S PROT. EACH OCCURRENCE .
FIRE DAMAGE (My one II..) .
MED.EXP. (My one peNOn) S
AUTOMOBILE LIA8IUlY ArPRO','ED BY RISK M~N~r.fMFNT COMBINED SINGLE
ANY AUTO UMIT .
AU. OWNED AUTOS BOOIL Y INJURY
SCHEDULED AUTOS (Per ~) .
HIRED AUTOS DATE BODlL Y INJURY
NON-OWNED AUTOS (Per IlCCldenI) .
GARAGE UASlUlY ~""'''fR: N/"
PROPERTY DAMAGE
.
EXCESS LlABIUlY EACH OCCURRENCE .
UMBREUA FORM AGGREGAlE .
<miER THAN UMBRELlA FORM
WORKER'S COMPENSATION BINDER4003 2/20/96
EACH ACCIDENT . 100
AND
OISEASE-POIJCY UMIT . 500
EMPLOYERS' LIA8IUlY
DISEASE-EACH EMPLOYEE . 100
OlllER
DESCRIPTION OF OPERAnoNSlLOCATlONSlVEHICLESlSPECIAL ITEMS
LEANING SERVICE
~:~~!'-!';tIQ~"l~::.:::;:~~i(jjj~}::~:~:~:{::~~'....::::::::::::;:;::::::::::::::::
MONROE CNTY PUBLIC WORKS
FACILITIES MAINTENANCE
ATT: CINDY SAWYER
3583 S. ROOSEVELT BLVD.
KEY WEST FL 33040
>;:t)))t::{}.::;;}}i/i:m}::}:m}P.MRfn::~!9H.:::).:}....:...;...tt.t..;.;tmt':;i::m{t:'.":'}=i=it=itt;:.tit...ttttt:=ii}:))i:t:::'f{.}))::tt"
';:i:: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
',::: EXPIRATION DATE THEREOF, THE ISSUING COMPANY Will ENDEAVOR TO
.. MAIL..3..0...- DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
:: LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHA~ IMPOSE NO OBLIGATION OR
LIABILITY OF ANY. KIND UP THE C PANY, IT AGENTS OR REPRESENTATIVES.
..
.'::::: AUTHO EPR~ TATlV
" ,.........,...-..-....--'..-.-..........,........
ACORI125'S(7190)'
:.;..':-:.>;.:-:...;.;...;.'<-:-....:.;.:-:-:.:.:.:.:-:.;...........
.. .. :-:-:-::-';"':::::':';';':-:-:-:-:::::'::::::;'<-::::::::':':';':';","
.........................................................
.. . ......... ........
\
INSURANCE BINDER
DATE PAGE 1.
01./05/96 /
AME AND ADDRESS OF AGENCY
YS INSURANCE AGENCY 1t1()
.0. BOX 500280
THON FL 33050
INSURANCE COMPANY
BANKERS INS CO
360 CENTRAL AVE
ST PETERSBURG FL
RisK Mgmr. & Loss Comrc
, ,. C'
DATE ,-/tJ - 7~
33701. x..;',/
INITIAL ,k7(,l..
AGENCY CODE
84-701.
ME AND MAIUNG ADDRESS OF INSURED
Ifredo Vazquez
anitorial Services
Ifredo Vazquez, Inc DBA
61.6 Northside Drive
West FL 33040
POUCY NUMBER
BINDER4033
BOUND
01/05/96
01./05/96
POUCY TYPE
COMMERCIAL AUTO
TO 01/05/97
TO 02/04/96 12:01 AM
CAT I ON
I N FOR MAT ION
LOCATION OF PROPERTY
361.6 NORTHSIDE DRIVE
KEY WEST, FL 33040
S E C T ION
SYMBOLS
INSURANCE 7
5
BI :
PD :
PIP:
BI
PD
MP
OM
UND:
SEE SCHEDULE
LIMITS OF LIABILITY
50,000/ 1.00,000
50,000
1.0,000 DED:O
P.I.P.
UTO MED. PAYMENTS
INSURED MOTORIST 7
ERINSD MOTORIST
OMPREHENS lVE . 7
PECIFIED PERILS
OLLIS ION 7
OWING & LABOR
DED:
PER PERSON
10,000/ 20,000
SEE SCHEDULE
NDORSEMENTS :
IS NON-STACKED
AfTPo:m 8" RISK Mr,Nf,(~E~ENT
r..~~
~~ .-
\., - ~ --...---. ---
',' /-/() ,-?~
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1 INSD'S#
:1993
: FORD
: ECONOLINE
: VAN
1
VIN/SERIAL#:1FTFE24Y7PHB1.5567
ACV
COMPREHENSIVE DED. : 250
COLLISION DED.: 250
~
SIGNATURE OF AUTHORIZED REPRESENTATIVE
INSURANCE BINDER
INSURANCE COMPANY
YS INSURANCE AGENCY
.0. BOX 500280
THON FL 33050
BANKERS INS CO
360 CENTRAL AVE
ST PETERSBURG FL 33701
AGENCY CODE
84-701
ME AND MAIUNG ADDRESS OF INSURED
Ifredo Vazquez
anitorial Services
Ifredo Vazquez, Inc DBA
616 Northside Drive
West FL 33040
POUCY NUMBER
BINDER4033
POUCY TYPE
COMMERCIAL AUTO
)
BOUND
01/05/96
01/05/96
TO 01/05/97
TO 02/04/96 12:01 AM
2 INSD'S#
:1985
: CHEVROLET
: UTILITY
: VAN
2
VIN/SERIAL#:2GBHG31M2F4166974
ACV
COMPREHENSIVE OED.:
COLLISION OED.:
o 0 I T ION A L I N T ERE S T S
INTEREST APPLIES TO ALL VEHICLES
ONROE CNTY PUBLIC WORKS
ACILITIES MAINTENANCE
TT: CINDY SAWYER
583 S. ROOSEVELT BLVD.
EY WET, FL 33040
INTEREST: Addl Insured
LOAN NO:
CERT REQUIRED
APPP0VFf1 BY RI~l( Mt.I.,'f.(;FMENT
BV_
pr',iE
\t'/'IIFQ: N/~ v!=:~
SIGNATURE OF AUTHORIZED REPRESENTATIVE
G
DATE PAGE 3 V
01/05/96
INSURANCE BINDER
INSURANCE COMPANY
YS INSURANCE AGENCY
.0. BOX 500280
THON FL 33050
BANKERS INS CO
360 CENTRAL AVE
ST PETERSBURG FL 33701
AGENCY CODE
84-701
ME AND MAIUNG ADDRESS OF INSURED
Ifredo Vazquez
anitorial Services
Ifredo Vazquez, Inc DBA
616 Northside Drive
West FL 33040
POUCV NUMBER
BINDER4033
POLICY lVPE
COMMERCIAL AUTO
BOUND
01/05/96
01/05/96
TO 01/05/97
TO 02/04/96 12:01 AM
CONDITIONS
IS COMPANY BINDS THE KIND (S) OF INSURANCE STIPULATED ABOVE. THIS INSUR-
CE IS SUBJECT TO THE TERMS, CONDITIONS AND LIMITATIONS OF THE POLICY (IES)
N CURRENT USE BY THE COMPANY.
IS BINDER MAY BE CANCELLED BY THE INSURED BY SURRENDER OF THIS BINDER OR
Y WRITTEN NOTICE TO THE COMPANY STATING WHEN CANCELLATION WILL BE EFFECTIVE.
IS BINDER MAY BE CANCELLED BY THE COMPANY BY NOTICE TO THE INSURED IN AC-
ORDANCE WITH THE POLICY CONDITIONS. THIS BINDER IS CANCELLED WHEN REPLACED
Y A POLICY. IF THIS BINDER IS NOT REPLACED BY A POLICY, THE COMPANY IS EN-
ITLED TO CHARGE A PREMIUM FOR THE BINDER ACCORDING TO THE RULES AND RATES
N USE BY THE COMPANY.
APPLICABLE IN NEVADA
PERSON WHO REFUSES TO ACCEPT A BINDER WHICH PROVIDES COVERAGE OF LESS
$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
NSURANCE FOR ACTUAL DAMAGES SUSTAINED THEREFROM.
SIGNATURE OF AUTHORIZED REPRESENTATIVE
CERTIFICATE OF INSURANCE
GLC"
00409
ISSUE DATE (MM/DDIYY)
EYS INSURANCE AGENCY
.0. BOX 500280
THON FL 33050
01 17 96
THIS CERTIFICATE IS ISSUED AS A MA ITER 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.
COMPANY
LETTER
COMPANY B
COMPANIES AFFORDING COVERAGE
A PCA PROPERTY & CASUALTY INS.
CO.
Ifredo Vazquez
anitorial Services
Ifredo Vazquez, Inc DBA
616 Northside Drive
ey West, FL 33040
LETTER
COMPANY C
LETTER
COMPANY D
LETTER
COMPANY E
APPROVED BY RISK MANAGEMENT
RY
o/€ /(;'
C lA/A
S
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED NOlWlTHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICAtE MAY BE ISSUED OR MAY PERTAI~ THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLl",IES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
ATE IMM/DDIYY) DATE (MM/DDIYY)
iNITIAl
LIMITS
GENERAL AGGREGATE $
PRODUCTS-COMP/OP AGG, $
PERSONAL & ADV, INJURY $
EACH OCCURRENCE $
FIRE DAMAGE (Anyone fire) $
MED,EXP, (Anyone person) $
COMBINED SINGLE
LIMIT $
BODILY INJURY
(Per person) $
BODILY INJURY
(Per accident) $
PROPERTY DAMAGE
$
EACH OCCURRENCE $
AGGREGATE $
OMMERCIAL GENERAL LIABILITY
LAIMS MADE DOCCUR.
OWNER'S & CONTRACTOR'S PROT,
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
Received
RlS" M me '-'" Loss C ntrol
DATI: __'_
.~-L'L: 7
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION
AND
EMPLOYERS' LIABILITY
09032802095
12/20/95 12/20/96
DISEASE-POLICY LIMIT $
DISEASE-EACH EMPLOYEE $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
MONROE COUNTY BOARD OF
COUNTY COMMISSIONERS
5100 COLLEGE ROAD
STOCK ISLAND
KEY WEST FL 33040
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL...l.O.- DAYS 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.
LEANING SERVICE
EYS INSURANCE AGENCY
.0. BOX 500280
THON FL 33050
BANKERS INS CO
360 CENTRAL AVE
ST PETERSBURG FL
Risk Mgmt. & Loss Comro
". (""
DATE - /rJ - / (,~
33701 '}f/
INITIAL k [,.-v_____._
AGENCY CODE
84-701
AME AND MAILING ADDRESS OF INSURED
Ifredo Vazquez
anitorial Services
Ifredo Vazquez, Inc DBA
616 Northside Drive
West FL 33040
POLICY NUMBER POLICY TYPE
BINDER4033 COMMERCIAL AUTO
(EXPI ON)
TO 01/05/97
01/05/96 TO 02/04/96 12:01 AM
CAT ION
I N FOR MAT ION
LOCATION OF PROPERTY
3616 NORTHSIDE DRIVE
KEY WEST, FL 33040
S E C T ION
SYMBOLS
INSURANCE 7
BI :
PD :
PIP:
BI
PD
MP
UM
UND:
SEE SCHEDULE
LIMITS OF LIABILITY
50,000/ 100,000
50,000
10,000 DED:O
. I.P. 5
DITIONAL P.I.P.
UTO MED.PAYMENTS
INSURED MOTORIST 7
DERINSD MOTORIST
OMPREHENSIVE 7
PECIFIED PERILS
OLLIS ION 7
OWING & LABOR
DED:
PER PERSON
10,000/ 20,000
SEE SCHEDULE
NDORSEMENTS:
IS NON-STACKED
PTf',',TD rr piS!', \'f,~W~FJF'n
, ~d:~~
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',;;',:' t _'~'_..__~~_~_._._..-.____._.____~._____
~,}. .V"-:-r:,
1 INSD'S#
:1993
: FORD
: ECONOLINE
: VAN
1
VIN/SERIAL#:lFTFE24Y7PHB15567
ACV
COMPREHENS IVE DED.: 250
COLLISION DED.: 250
~
SIGNATURE OF AUTHORIZED REPRESENTATIVE
INSURANCE BINDER
INSURANCE COMPANY
EYS INSURANCE AGENCY
.0. BOX 500280
THON FL 33050
BANKERS INS CO
360 CENTRAL AVE
ST PETERSBURG FL 33701
AGENCY CODE
84-701
AME AND MAILING ADDRESS OF INSURED
Ifredo Vazquez
anitorial Services
Ifredo Vazquez, Inc DBA
616 Northside Drive
West FL 33040
POLICY NUMBER
BINDER4033
POLICY TYPE
COMMERCIAL AUTO
( PIRATION)
BOUND
01/05/96
01/05/96
TO 01/05/97
TO 02/04/96 12:01 AM
2 INSD'S#
:1985
: CHEVROLET
:UTILITY
: VAN
2
VIN/SERIAL#:2GBHG31M2F4166974
ACV
COMPREHENSIVE DED.:
COLLISION DED. :
D D I T ION A L I N T ERE S T S
INTEREST APPLIES TO ALL VEHICLES
ONROE CNTY PUBLIC WORKS
ACILITIES MAINTENANCE
TT: CINDY SAWYER
583 S. ROOSEVELT BLVD.
EY WET, FL 33040
INTEREST: Addl Insured
LOAN NO:
CERT REQUIRED
~prp(\\'F['l R\ pl<\1( Mnur,FMFNT
pv__ ,
fi riTE
',!.',' I\!rq:
N /~
ves
SIGNATURE OF AUTHORIZED REPRESENTATIVE
INSURANCE BINDER
INSURANCE COMPANY
EYS INSURANCE AGENCY
.0. BOX 500280
THON FL 33050
BANKERS INS CO
360 CENTRAL AVE
ST PETERSBURG FL 33701
AGENCY CODE
84-701
AME AND MAILING ADDRESS OF INSURED
Ifredo Vazquez
anitorial Services
Ifredo Vazquez, Inc DBA
616 Northside Drive
ey West FL 33040
POLICY NUMBER
BINDER4033
POLICY TYPE
COMMERCIAL AUTO
BOUND
01/05/96
01/05/96
TO 01/05/97
TO 02/04/96 12:01 AM
CONDITIONS
HIS COMPANY BINDS THE KIND(S) OF INSURANCE STIPULATED ABOVE. THIS INSUR-
CE IS SUBJECT TO THE TERMS, CONDITIONS AND LIMITATIONS OF THE POLICY (IES)
N CURRENT USE BY THE COMPANY.
HIS BINDER MAY BE CANCELLED BY THE INSURED BY SURRENDER OF THIS BINDER OR
Y WRITTEN NOTICE TO THE COMPANY STATING WHEN CANCELLATION WILL BE EFFECTIVE.
HIS BINDER MAY BE CANCELLED BY THE COMPANY BY NOTICE TO THE INSURED IN AC-
ORDANCE WITH THE POLICY CONDITIONS. THIS BINDER IS CANCELLED WHEN REPLACED
Y A POLICY. IF THIS BINDER IS NOT REPLACED BY A POLICY, THE COMPANY IS EN-
ITLED TO CHARGE A PREMIUM FOR THE BINDER ACCORDING TO THE RULES AND RATES
N USE BY THE COMPANY.
APPLICABLE IN NEVADA
PERSON WHO REFUSES TO ACCEPT A BINDER WHICH PROVIDES COVERAGE OF LESS
HAN $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
NSURANCE FOR ACTUAL DAMAGES SUSTAINED THEREFROM.
SIGNATURE OF AUTHORIZED REPRESENTATIVE
"REVISED"
DATE (MMlDDIYY)
,."""""",.,."': 09/20/96
R 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.
COMPANIES AFFORDING COVERAGE
PRODUCER
THE PORTER ALLEN COMPANY
513 SOUTHARD STREET
KEY WEST,FLA. 33040
COMPANY
B
COMPANY
A AMERICAN EQUITY INSURANCE COMPANY
INSURED
ALFREDO VASQUEZ, INC.
3616 NORTHSIDE DRIVE
KEY WEST,FLA. 33040
COMPANY
C
COMPANY
D
uuuTHisulSufOCERTIFVTHAf THE POLlClESOFINSURANCE 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 I
DATE (MM/DDIYY) DATE (MMlDDIYY)
GENERAL LIABILITY
A COMMERCIAL GENERAL LIABILITY
CLAIMS MADE [!] OCCUR ACC 9620
OWNER'S & CONTRACTOR'S PROT
08/31/96 P8/31/97
I
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON,OWNED AUTOS
GARAGE LIABILITY
ANY AUTO
:\..TTi,.', ~
C/-.:t_
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
~~ ' ,'. '.,
THE PROPRIETOR/
PARTNERS/EXECUTIVE
OFFICERS ARE:
OTHER
INCL
EXCL
DESCRIPTION OF OPERA TIONSlLOCA TIONSNEHICLESlSPECIAL ITEMS
LIMITS
GENERAL AGGREGATE $300,000
PRODUCTS - COMP/OP AGG $INCLUDED
PERSONAL & ADV INJURY $300,000
EACH OCCURRENCE $300,000
FIRE DAMAGE IAny one fire) $ 50,000
MED EXP (Anyone person) $ 1,000
COMBINED SINGLE LIMIT $
BODILY INJURY
(Per person)
-t-
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE $
AUTO ONLY - EA ACCIDENT $
OTHER THAN AUTO ONLY:
EACH ACCIDENT
AGGREGATE
EACH OCCURRENCE
AGGREGATE
$
EL DISEASE, POLICY LIMIT $
EL DISEASE - EA EMPLOYEE $
",.,."..,:"":;".;:;.;.;,;.;.;',,,.;::::,:':,1;,;',"".:.,.,:,:,;iiI:iii!iI::iI!!M:ii:i!iI!:!I:ii:i:iii:I::i:i::::IIii:iI:i:i:i:i:i:::!IIII:i:i:i:i:!:!lm:iI!ii!:iI:i:!iii:i:W:i:i:i:iI:iIiENI:i:iIlmmi:iiiii:i:::iIi:::i!:i:::!ii:i:::::iI:
& ADDITIONAL INSURED
MONROE COUNTY
5100 COLLEGE ROAD
KEY WEST,FLA. 33040
ATTN: RISK MANAGEMENT
ii!...r:liDllli:El?""<""""':!!iIr
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 NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY, .ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
WILLIAM FREEMAN II
....""..."", ""...""...."".::::l!:ll!;!l!!i!!~i!:!!!i!::::i::i!::i:il:::iiii::iiii:il:._i::,.::,:::,;.,:,.",.,."",:~".':,.,::"Jflll::Ji.::i:
.....C..fi.Ff...,..~lcuA__....QF=.....I..tt$.~.FfA.t4.e&... ..G40........'.. ......0..0.4..0.9
ISSUE DATE (MMlDDIYY)
EYS INSURANCE AGENCY
.0. BOX 500280
THON FL 33050
01 30 97
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.
FREDO VAZQUEZ
ANITORIAL SERVICES,INC
616 NORTHSIDE DRIVE
EY WEST, FL 33040
COMPANY
LETTER
COMPANY
LETTER
COMPANY C
COMPANIES AFFORDING COVERAGE
A ZC INSURANCE COMPANY
B BANKERS INS CO
INSURED
LETTER
COMPANY D
LETTER
COMPANY E
LETTER
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATEDt NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICA E MAY BE ISSUED OR MAY PERTAIN..{ THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLll,;IES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
0 POLICY EFFECTIVE POLICY EXPIRATION
TYPE OF INSURANCE POLICY NUMBER LIMITS
TR ATE (MM/DDIYY) DATE (MM/DDIYY)
GENERAL LIABILITY GENERAL AGGREGATE $
OMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG, $
LAIMS MADE DOCCUR. PERSONAL & ADV, INJURY $
OWNER'S & CONTRACTOR'S PROT. EACH OCCURRENCE $
FIRE DAMAGE (Anyone fire) $
MED,EJ(P, (Anyone person) $
09941684000 01/05/97 01/05/98 COMBINED SINGLE
LIMIT $
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS IPer person) $ 50
HIRED AUTOS BODILY INJURY
NON-OWNED AUTOS (Per accident) $ 100
GARAGE LIABILITY
PROPEFITY DAMAGE
$ 50
EXCESS LIABILITY EACH OCCURRENCE
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION 19732802096 12/20/96 12/20/97
AND ---~----"--~---_.
DISEASE-POLICY LIMIT
EMPLOYERS' LIABILITY
DISEASE-EACH EMPLOYEE
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/sPECIAL ITEMS
LEANING SERVICE
ERTIFICATEHOLDER LISTED AS ADDITIONAL INSURED ON AUTOMOBILE POLICY
MONROE COUNTY BOARD OF
COUNTY COMMISSIONERS
5100 COLLEGE ROAD
STOCK ISLAND
KEY WEST FL 33040
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL...3..0..-... DAYS 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.
A.~..ln." ....
'cJ.E.Ff~I.F=I.~J\..,.I......t;1.F=.....I.NS.I.J.BAR.e&..........~Bd............. .....O..O.4..0.9'..
1'()
EYS INSURANCE AGENCYt
.0. BOX 500280
THON FL 33050
11 11 96
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
COMPANY
LETTER
COMPANIES AFFORDING COVERAGE
A PCA PROPERTY & CASUALTY INS.
CO.
/111"1
Ifredo Vazquez ;r
anitorial Services
Ifredo Vazquez, Inc DBA
616 Northside Drive
ey West, FL 33040
COMPANY B
LETTER
COMPANY C
APPROVED BY RISK MANAGEMENT
~~
LETTER
BY
COMPANY D
r~
i' ~,TE__.../L /...$ -?? ___
LETTER
COMPANY E
"')
~: '~
vrc:-
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 PERTAI~ THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLl",IES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
ATE (MM/DD/YY) DATE (MM/DD/YY)
LIMITS
OMMERCIAL GENERAL LIABILITY
LAIMS MADE DOCCUR.
OWNER'S & CONTRACTOR'S PROT,
GENERAL AGGREGATE $
PRODUCTS-COMP/OP AGG, $
PERSONAL & ADV, INJURY $
EACH OCCURRENCE $
FIRE DAMAGE (Anyone fire) $
MED,EXP, (Anyone person) $
COMBINED SINGLE
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
'<':;."<. ~: i \::'t'~'
LIMIT
BODILY INJURY
$
(Per person)
BODILY INJURY
$
(Per accident)
$
PROPERTY DAMAGE
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
EACH OCCURRENCE
AGGREGATE
$
$
$
WORKER'S COMPENSATION
AND
EMPLOYERS' LIABILITY
09032802096
12/20/96 12/20/97
DISEASE-POLICY LIMIT
DISEASE-EACH EMPLOYEE
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
MONROE COUNTY BOARD OF
COUNTY COMMISSIONERS
5100 COLLEGE ROAD
STOCK ISLAND
KEY WEST FL
Cc
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL..3...0.....- DAYS WRITrEN 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,
. . , . . , , . . , , . , , , . . , . . . . . . . . , , , , , , , , , , . , . , , . , , . . . . ',' . . , .
. ,...".. ..,.,...,.,..,.........."""""".."".., .......,.
l>EB'tll=lraA'EOF=IR$IJFI~t4ee
GLP
...."...".""....
. ,....""",,----.
. --"""""....
00409
ISSUE DATE IMMIDDIYY)
EYS INSURANCE AGENCY
.0. BOX 500280
THON FL 33050
12 02 96
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.
COMPANY
LETTER
COMPANY B
COMPANIES AFFORDING COVERAGE
A ZC INSURANCE COMPANY
LETTER
COMPANY C
LETTER
COMPANY D
LETTER
COMPANY E
LETTER
APPPOVFf1 BY PI~K w~lt.rntplT
o etc;
c.~tL-
Ifredo Vazquez
anitorial Services
Ifredo Vazquez, Inc DBA
616 Northside Drive
ey West, FL 33040
BY
OAIF
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 Issum OR MAY PERTAI~ THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLl"IES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
o
TR
TYPE OF INSURANCE
POLICY NUMBER LIMITS
POLICY EFFECTIVE POLICY EXPIRATION
ATE (MM/DDIYY) DATE (MM/DDIYY)
GENERAL LIABILITY
OMMERCIAL GENERAL LIABILITY
LAIMS MADE DOCCUR.
OWNER'S & CONTRACTOR'S PROT.
GENERAL AGGREGATE $
PRODUCTS-COMP/OP AGG, $
PERSONAL & ADV, INJURY $
EACH OCCURRENCE $
FIRE DAMAGE IAny one fire) $
MED,EXP, (Anyone person) $
COMBINED SINGLE
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
LIMIT
BODILY INJURY
$
(Per person)
$
BODILY INJURY
:;\,i ~ , ; /, (
(Per accident)
$
PROPERTY DAMAGE
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
EACH OCCURRENCE
AGGREGATE
$
$
$
WORKER'S COMPENSATION
AND
EMPLOYERS' LIABILITY
19732802096
12/20/96 12/20/97
DISEASE-POLICY LIMIT
DISEASE-EACH EMPLOYEE
OTHER
DESCRIPTION OF OPERATlONS/LOCATIONSNEHICLES/sPECIAL ITEMS
LEANING SERVICE
MONROE COUNTY BOARD OF
COUNTY COMMISSIONERS
5100 COLLEGE ROAD
STOCK ISLAND
KEY WEST FL 33040
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL...3...0.- DAYS 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,
:i("A'.""""",..C.,""",.,.,(j,..,'.'.'.R""'""""D"""""""""""\Mf.:"':::::::"':.'::::::::::::.:::':::::'::".:::::':':::'1::::::.:::'::::::::I::\}::::::
.... .... '" ........... ......
iiiii:i::,:,:,:,:,:,:.:,::.:.:,:.:,:,::,:,:::,."r.~:,:.:ii1i:i'I::;"':';:;:i:,:,:;;:;;;::,i:::,:,:i:i,,:::::1:":,:,:):I::I:",i,:;:::::,:,:,:,::,:,:,:,::::::::,,,
PRODUCER
DATE (MM/DDIYV) .....
...: 09/18/96
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.
COMPANIES AFFORDING COVERAGE
:::::;:
THE PORTER ALLEN COMPANY
513 SOUTHARD STREET
KEY WEST,FLA. 33040
INSURED
COMPANY
A AMERICAN EQUITY INSURANCE COMPANY
COMPANY
B
ALFREDO VASQUEZ, INC.
3616 NORTHSIDE DRIVE
KEY WEST,FLA. 33040
COMPANY
C
COMPANY
D
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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
LTR DATE (MMlDDIYY) DATE (MM/DDIYY)
GENERAL LIABILITY
A COMMERCIAL GENERAL LIABILITY
CLAIMS MADE [!J OCCUR ACC 9620 08/31/96 08/31/97
OWNER'S & CONTRACTOR'S PROT
THE PROPRIETOR!
PARTNERS/EXECUTIVE
OFFICERS ARE:
OTHER
INCL
EXCL
LIMITS
GENERAL AGGREGATE $
PRODUCTS, COMP/OP AGG $ ,
PERSONAL & ADV INJURY $
EACH OCCURRENCE $ ,
FIRE DAMAGE (Anyone fire) $ ,
MED EXP (Anyone person) $ ,
,
COMBINED SINGLE LIMIT $
, BODILY INJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
AUTO ONLY, EA ACCIDENT $
OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE $
EACH OCCURRENCE $
AGGREGATE $
$
$
EL DISEASE, POLICY LIMIT $
EL DISEASE, EA EMPLOYEE $
APPROVED BY RISK,
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
8'''.
;e/C
L~
GARAGE LIABILITY
ANY AUTO
1>: i_1--j /\ t
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
DESCRIPTION OF OPERATIONSIlOCATIONSNEHICLESlSPECIAL ITEMS
i.;::::.:.:.:.:::::.~:.:;~.;~~:~.;:.~.~..;~~;:~..;...t;::.:.~:.:;;.~;;~.~~:;:::~.::;.I~1tj~~il~i!tI~~!~iii1jli!j!i!i!i~i!i~i!i!j!i!!ji!!!!!i!i!i!fi!i!i!i!i!ir!i!i!j!j!i!i!i!i!ijiim!i!f:ti!i!i~1ij~i!i!j!j!i!!!i!ti!i!i~!i!i!i!!!j!i!i~t!i!iiiii!i!iHili!j!j!i~ri~~~jt..
& ADDITIONAL INSURED
MONROE COUNTY BOARD OF COUNTY COMMISSIONER
5100 COLLEGE ROAD, PUBLIC SERVICE BLDG
KEY WEST,FLA. 33040
Cc ~po S~_ ~$(,~
:IBEI,!),il:B,IRr:W::n:H:'::::ii:::::::::::::::::;i:;:::I:::i1:;:I::::i:m::~::mm::::!m::m:::::i:iWm:ii:;:::::::::::m:::iiI::;:::::::L....
Ji~~~[fj~i~~i~~~~~~~~1rt[ilj~~~j~f~~~j~)~~1[it[lt111i
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 NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMP N ,
AUTHORIZED REPRESENTATIVE
WILLIAM A.FREEff.U, III
OR REPRESENTATIVES.
:::::::::::::::::::::::::::::::::::::::::::::::::::::::::;:::::::::::::::::::::::::::::::::::::::;:;:::::.::::::<:::::>:::::::::::::::::;:;:;:;:;:;:;:;:;:;:;:;:;:;:::;:;:::;::::::::::;:;::::.;:::;:;:::::;:::::::::::::>::::>:<<:::::::-:
..CIiFl"lIr:ICAmBQf=I"'llJm~~~fiGl1C
· ...0 0409
ISSUE DATE (MM/DD/YY)
EYS INSURANCE AGENCY
.0. BOX 500280
THON FL 33050
11 18 97
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.
COMPANIES AFFORDING COVERAGE
Ifredo Vazquez
anitorial Services,Inc
616 Northside Drive
ey West, FL 33040
COMPANY
LETTER
COMPANY
LETTER
COMPANY C
A ZC INSURANCE COMPANY
B BANKERS INS CO
INSURED
LETTER
COMPANY D
LETTER
COMPANY E
LETTER
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED N01WITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICAtE MAY BE ISSUED OR MAY PERTAI~ THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLl",IES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
0 POLICY EFFECTIVE POLICY EXPIRA nON
TYPE OF INSURANCE POLICY NUMBER LIMITS
TR ATE (MM/DD/YY) DATE (MM/DD/YY)
GENERAL LIABILITY GENERAL AGGREGATE $
OMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG, $
LAIMS MADE DOCCUR, PERSONAL & ADV, INJURY $
OWNER'S & CONTRACTOR'S PROT, EACH OCCURRENCE $
FIRE DAMAGE IAny one fire) $
MED,EJ(P, (Anyone person) $
09941684000 01/05/97 01/05/98 COMBINED SINGLE
LIMIT $
ALL OWNED AUTOS I,U BODILY INJURY
SCHEDULED AUTOS (Per person) $ 50
HIRED AUTOS BY ('.<< BODILY INJURY
NON-OWNED AUTOS (Per accident) $ 100
GARAGE LIABILITY
$ 50
EXCESS LIABILITY CH OCCURRENCE $
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION 19732802097 12/20/97 12/20/98
AND ------
DISEASE-POLICY LIMIT
EMPLOYERS' LIABILITY
DISEASE-EACH EMPLOYEE $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
LEANING SERVICE
ERTIFICATEHOLDER LISTED AS ADDITIONAL INSURED ON AUTOMOBILE POLICY
MONROE COUNTY BOARD OF
COUNTY COMMISSIONERS
5100 COLLEGE ROAD
STOCK ISLAND
KEY WEST FL 33040
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 NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES,
Bankers Insurance Company
St. Petersburg, Florida 33701
BBAP99.001 0895
000013673
12/02/97
DECLARATION PAGE
BANKERS
INSURANCE GROUP
5000 00000 NSCA SCA AMENDED
Business Auto
EFFECTIVE: 11/18/97
Date of Issue
[....'............ ...........'.....'......'PoliliX...NumbeiJ.,........................,..,..,
[ .,'.'...,. .'.~.~.()O~~~4i684"..Q~~
Page 1
dl...entts...Phijne....
(305)743-0494
Insured
ALFREDO VAZQUEZ JANITORIAL SERVICE
ALFREDO VAZQUEZ
3616 NORTHSIDE DRIVE
KEY WEST FL 33040
v/
MONROE CNTY REGIONALSVC CTR BLDC D
E 300
2798 OVERSEAS HIGHWAY
MARATHON FL 33050
Organization Type Corporation
..r
i
Bodily Injury
Property Damage
Personal Injury Protection
Medical Payments
Uninsured Motorist
Comprehensive
Collision
$50,000 Pers/$100,000 Occur.
$50,000 Per Occur.
$10,000 Per Person / 0000 Dedu
$2,000 Per Person
$10,000 Pers/$20,000 Occur.
See Premo By Veh. Section For Deduct.
See Premo By Veh. Section For Deduct.
NI
$456
$270
$71
$38
$77
$70
$139
NSTK
* Premium Includes 3 Additional Insured(s)
TOTAL PREMIUM:
TOTAL CHANGED PREMIUM:
$1,121
$0
BY
.mJJ
~"
C(~
om
\'. "B: NfA /' YES
1<.
Discounts
H R R2
"'-"":->:'-:-:':-"':_'--:.'-""":-:-:-"::-':""'":.:-:.:..-.::.:.::..::...>:>:-:-.:...:..:,..'-:-....:.:-:"':,":':.:"':":"'::-::"::-:::"':.",-,"--"
.'.'....< >< }lrexuiuti:f Ac:l.btst:mepts> ......... ...
Surcharges
PS
,. ".....1
1>F'd..ii$:.iJij14p~im~ij,ls> ,...
BBAP99.101 0396 CA 21 78 0594
BBAP09.1040396 CA 99 03 1293
CA 21 72 0794
It is agreed that this insurance is provided in consideration of the commercial use of the auto(s) described in the policy within
the stated mile radius of the city or town of principal garaging of the auto(s) during the policy period Commercial use of the
described auto(s) beyond the radius listed above may result in additional premium charges for such use.
.. .....,
Signed
Ray Adams
Date
12/02/97
cc: As indicated on the back.
00847010900009416849733600009