Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Certificates of Insurance
PRODUCER .CERTIFICATE Q'F INSURANCE Brown & Brown Insurance P.O, Box 153005 Tampa, FL 33684-3005 INSURED George A. Helm III, P,A.; Public Entity Legal Solutions 615 Crescent Executive Ct., Suite 600 Lake Mary, FL 32746 ISSUE DATE (MMIODNY) o 8/21/2009 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS TO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTENDED DR ALTER THE COVERAGE AFFORDED BY THE POLICIES B~lOW. COMPANY LETTER COMPANY LETTER COMPANY LETTER COMPANY lETTER COMPANY LETTER COMPANIES AFFORDING COVERAGE A Evanston Insurance Company B C o E COVERAGES i 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 INHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCe. AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ TYPE OF INSURANCE POLICY NUMBER POLICY EFF. POLICY EXP. OA TE (MMlDOIYY) . DATE (MMlDDIYY) GENERAL LIABILITY COMM. GENERAL LIABILITY CLAIMS MADE D OCC. OINNER'S & CONTRAcrs PROT ; AUTOMOBilE lIABILITY ~- ANY AUTO ALL OWNeD AUTOS SCHEDULED AUTOS HIRED AUTOS ---: NON-OWNED AUTOS 1- GARAGE LIABILITY ANY AUTO ex:;ess LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYER'S LIABILITY THE PROPRIETORlPARTNERlEXECUTIVE . OFFICER ARE: o INeL Cl EXCL OTHER ~ Lawyers Professional liability LA-805096 ; 04/07/2009 0410712010 Deductible ~ $5,000 Each Claim F= JI Y'-.Q/Vl ~ CERTIFICATE HOLDER Monroe County Board of County Commissioners 1100 Simonton Street Key West, FL 33040 ACORD 25.5 (3193) LIMITS GENERAl AGGREGATE PROD-COMP/OP AGG. PERS. & ADV. INJURY EACH OCCURRENCE FIRE DAMAGE MED exp (ONE PER) COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODlL Y INJURY (Per ec:adenl) PROPERTY DAMAGE EACH OCCURRENCE AGGREGATE OISEASE.POUCY LINIlT DISEASE.EACH EMP. 1,000,000 Each Claim 1,000,000 Aggregate CANC,ELLA TION . . SHOULD ANY OF THE ABOVE DESCRIBED POliCIES BE CANCELED 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 K1NQ UPON TH~ COMPANY' S AGENTS OR REPRESENTATIVES AUTHORIZE RE ESENTATlVE i c - CERTIFICATE OF LIABILITY INSURANCE OP ID RM DATE(MM/DD/YYYY) BOLTO -2 04/16/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE B &B Protector Plans, Inc - PSP tt t'• t'I� - .1, E DOES NOT AMEND, EXTEND OR 3101 W. MLK Jr. Blvd, 4th Fir jja jilt • - - FORDED BY THE POLICIES BELOW. Tampa FL 33607 Phone:800- 467 -8734 Fax:813- 222 -4288 INSURERS AFFORD! GCO ERAGE NAIC# INSURED , :.:URA' , least • actSol.ct 25585 INSURER B: ■ I Bolton & Helm, PA INSURERC 723 East Colonial Dr Ste 200 Orlando FL 32803 1 i 1 ''�` i ' COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1 LTR R INSRC TYPE OF POLICY NUMBER DATE (MM /DDICYYYYYYE) POLICY A MWDD/YY EXPIRATION LIMITS LT INSRC INSURANCE GENERAL UABILI Y EACH OCCURRENCE $ UAMAOt IV KtN1bV COMMERCIAL GENERAL LIABILITY PREMISES (Ea ocourence) $ CLAIMS MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GENII AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ POLICY n izei n LOC • AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ -- ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS ( BODILY INJURY NON -OWNED AUTOS 4: (Per accident) $ • �( PROPERTY DAMAGE $ ` ` (Per a GARAGE LIABILITY )(= AUTO ONLY - EA ACCIDENT $ 1ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE _ 3 OCCUR (CLAIMS MADE AGGREGATE $ I $ DEDUCTIBLE $ • • RETENTION 8 $ WORKERS COMPENSATION WC SIAM- OTH- AND EMPLOYERS' LIABILITY TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVEn E.L. EACH ACCIDENT $ • OFFICER/MEMBER EXCLUDED? I ` (Mandatory In NH) I E.L. DISEASE - EA EMPLOYEE $ N yes, describe under } SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER A Prof. Liability 20012200100 -LPL 04/04/10 04/04/11 LIMIT 1,000,000 (Claims Made) 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS $1,000,000/$2,000,000 Limits of Liability (CELL); $5,000.00 Per Claim /Loss and Defense - Law Office CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION MONRO -1 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIA ITY OF ANY KIND U N THE I SURER, ITS AGENTS OR REPRESENTATIVES. Monroe County Risk Management AUTHOR¢EDREPRESENTA . ! < 110 Simonton St . Lourdes M. Mart . P (Key West FL 33040 4 ACORD 25 (2009101) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 3 ACORU® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) F 03/312014 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 pollcy(les) 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 Agency Marketing Services, Inc. 9800 4th Street N, Suite 400 NAME: Debbie Back PHONE 727-384-1036 C No: 727-343-4123 o Ext C No. ADOREss: dback agencymarketing.com INSURERS AFFORDING COVERAGE NAIC 0 INSURERA : Allied World Insurance Company St. Petersburg FL 33702 INSURED INSURER B INSURERC : Bolton & Helm, LLP & George A. Helm, P.A. dba INSURER D : P.O. Box 958464 INSURER E : LEE] 1 INSURERF: s raw arnu urru DCD• Lake Mary FL 32746 COVERAGES CERTIFICATH NIUMISCM: -- - - - -- 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. LTR TYPE OF INSURANCE GENERAL LIABILITY POLICY NUMBER MIDDMYYY MIDDIYYYY LIMITS EACH OCCURRENCE -DAMAGE TO RENI ED COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR PREMISES Ea occurrence MEDEXP (Any oneperson) PERSONAL &ADV INJURY GENERAL AGGREGATE PRODUCTS - COMPIOPAGG GEN'LAGGREGATE LIMITAPPLIES PER'. PRO- POLICY LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED OS AUTOS NAUTOS ON-0WNED HIREDAUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ UMBRELLA LIAB OCCUR OCCURRENCE EACH EXCESS LIAR CLAIMS -MADE AGGREGATE DED I RETENTION WORKERS COMPENSATION WCSTATU- I IOTH- E.L. EACH ACCIDENT AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ (N andato MEn NH) EXCLUDED? If yes, describe under DESCRIPTION OF OPERATIONS below Lawyers Professional Liability NIA 0307-4449 04/012014 04/01/2015 E.L. DISEASE - EA EMPLOYE E.L. DISEASE - POLICY LIMIT 1,00 ,000 per clainV2,000,000 aggregate A DESCRIPTION OF OPERATIONS I LOCATIONS i VEHICLES (Attach ACORD 101, Additional Remari(s Schedule, if more space Is required) ~AG' N �_ t,e Monroe County BCC 1100 Simonton St", Rr,.1.268' _ Uiv 11nUz .1 _1I�y Y� FL c�33040 77- Key West �.:7 IIJ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE rrtt rk na4044_?n4n ernRn rnRPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ACCORD® CERTIFICATE OF LIABILITY INSURANCE I`� DATE(NMIDDIYYYI') 04/02/2015 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(les) 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 endorscment(s). PRODUCER NAME: CONTACT Catherine Koclanes Agency Marketing Services, Inc. PHONE N • r (727)384-1036 Ale No ; 727-343-4123 WAIL ADDRESS; ckocianes@agencymarketing.com 9800 4th Street N, Suite 400 INSURERS) AFFORDING COVERAGE NAIC k INSURER A: Allied World Insurance Company 22730 St. Petersburg FL 33702 INSURED INSURER B ; INSURERC; Bolton & Helm, LLP & George A. Helm, P.A. dba INSURER D : P.O. Box 958464 INSURER E : 1 INSURERF; Lake Mary FL 32746 COVERAGES CERTIFICATE NUMBER: 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 ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER MMIDQ MMIDD LIMITS GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR OAMAAGE TO RENI E PREMISES Ea occurrence W S MED EXP (Any onn persortl $ PERSONAL&ADVINJURY S GENERAL AGGREGATE S GEN'LAGGREGATE LIMIT APPLIES PER: POLICY LOC PECT PRODUCTS - COMP/OPAGG S AUTON0131LE LIABILITY Ea crCOIacr"ED SINGLE LIMIT ideMt BODILY INJURY (Per peraat) S ANY AUTO BODILY INJURY (Par ecdtleln) 3 ' ALL OWNED SCHEDULED AUTOS AUTOS NOWOWNED HIREDAUTO9 AUTOS PROPERTY DAMAGE Per cddcnl S S } UMBRELLAUAB OCCUR EACH OCCURRENCE S HCLAIMS-MADE AGGREGATE S EXCESSUA13 DEb I I RETENTION S S WORKERS COMPENSATION VtC 5TAT U- OTH• FR AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORrPARTNERIEXECUTIVE r E.L. EACH ACCIDENT 3 OFFICEPIMEMBER EXCLUDED? (Mandatary in NH) IN E.L. DISEASE - EA EMPLOYEE $ It yesdescr)c under DESCRIPTION OF OPERATIONS below £ L. DISEASE • POLICY LIMIT S A LWYPFL- Lawyers Professional Liability 0307-4448 04101/2015 04/01/2016 $1,000,000 Per Claim S2,000,00D Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 01, Addillenal Remarks Schedule, If tnore space Is required) APP A EMENT DATE WAIVER N/A YES _ �� cr : -Ff 1 e- d�t��-de-wlr, CERItFtCATE HOLDER CANCELLATION SHOULD ANY OF THE AB PORW BE CANCELLED BEFORE Monroe County BCC 1100 Simonton Street, Room 2-268 THE EXPIRATION DATE THEREOF, Rd WI DEUVERED N ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVO Z 0 pia -- Key West FL 33040 n , �At 13 i ACORD 25 (20101051 E t I { [k ®19a8-2dib ACCORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORa CERTIFICATE OF LIABILITY INSURANCE `� DATE(MMIDDNYYY) 04/18/2016 THIS CERTIFICATE IS ISSUED ASA 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 CONTAci NAME: Catherine KOclane5 Agency Marketing Services, Inc. 9800 4th Street N, Suite 400 ONE arC' N Ext : (727) 384-1036 arc, No): 727-343-4123 E-MAIL ADDRESS: ckoclanes@agencymarketing.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: AttPro RRG Reciprocal Risk Retention Group St. Petersburg FL 33702 INSURED INSURER B INSURER C Bolton &. Helm, LLP &. George A. Helm. P.A. dba INSURER D : P.O. Box 958464 INSURER E : INSURERF: Lake Mary FL 32746 COVERAGES CERTIFICATE NUMBER: 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. NOTWITHSTAN DING 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. LIM ITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE AUULSUBH INSR WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MMIDDNYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ MEDEXP (Ariy one person $ CLAIMS -MADE 1:1OCCUR PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ GEN'LAGGREGATELIMITAPPLIES PER : PRODUCTS-COMPIOPAGG $ $ POLICY F PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY(Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON-OMED HIREDAUTOS AUTOS PROPERTYnt DAMAGE Per accide $ $ r UMBRELLA LAB OCCUR EACH OCCU ENCE 7- AGGREGATE _ EXCESS LIAB CLAIMS -MADE OED RETENTION $ WORKERS COMPENSATION WC STAF - NTH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) NIA E.L. EACH AC C E.L. DISEASE - E 10 PLOYE If yes, describe under DESCRIPTION OF OPERATIONS belore E.L. DISEASE - P ` 1CY LIMIT $-- A Lawyers Professional Liabilty Insurance RLPL100914 04/012016 04/01/2017 $1,000,000 PW claim 4-0 $2,000,000 aggregate DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) APP VE AGEMEM' WAIVER NIA E� �Q�L GANk- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Monroe County BCC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 110 Simonton Street, Room 2-268 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Key West FL 33040 9 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD