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CERTIFICATE OF LIABILITY INSURANCE - RFQ 24-16 (2)OP ID: JL �� TI�I � �� DATE(MM/DDIYWY) 03/24/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR PJEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURAPICE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE I5SUING IfVSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. if this certificate is being prepared for a party who has an insurable interest in the property, do not use this farm. Use ACORD 27 or ACORD 28. PRODUCER NAMEACT Janis M. Layco�k Brown Insurance Services PNONE &50-215-5347 FAx 8 1418 W. 23rd Street Suite 200 nrc No Ext : A/C, No : 50-215-5340 Panama Cit , FL 32405 E-MAI� la cock browninsuranceservices.net Y ADDRESS:� Y � Mike W. Brown PRODUCER �ATHE-1 ri �cmnnFO �n� INSURED Cathey Construction & Development, LLC P O Box 13107 Mexico Beach, FL 32410 COVERAGES CERTIFICATE NUMBER: INSURER(S) AFFORDING COVERAGE NAIC # wsuReRa:Underwriters at Lloyds 15792 INSURER B : INSURER C : INSURER D : INSURER E : REVISION NUMBER: A�AT�NA�I�L�S�`Al2��RA $899 CAPE�SANa�rLn�cq�RR�t�/�ddiPo�aRT�aT j�E,d��e��t32��aceisrequired) T H STONE STATE PARK THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BE�OW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY COPITRACT 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 A�L THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH PO�ICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 7ypE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRA'PION COVERED PROPERTY LIMITS LTR DATE (MM/DD/YYYY) DATE (MM1�DtYYYY) A X PROPERTY BRAUFL001262 03/25/2016 01/25/2017 }( BUILDING g 293,766 CAUSES OFLOSS DEDUCTIBLES PERSONAI.PROPERTY e� BUI�DING BASIC � �OOO BUSINESS INCOME � BROAD Contents gUILDERS RISK PQLICY EXTRA EXPENSE . e� � SPECIAL RENTAL VA�UE � EARTHQUAKE B�ANKET BUILDWG g )( WIND rj°�p B�ANKET PERS PROP r� FLOOD B�ANKET BLDG & PP � S S INLAND MARWE TYPE OF POLICY s� CAUSES OF IOSS � NAMED PERILS POLICY NUMBER � S CRIME 5 TYPE OF POLICY S $ BOILER & MACHINERY / $ EQUIPMENT BREAKDOWN 5 � S SPECIA� CONDITIONS / OTHER COVERAGES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) FLQRI11 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCE��ED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DE�IVERED IN Florida Dept of �nvironmental ACCORDANCE WITH THE POLICY PROVISIONS. Regulations 2600 Blair Stone Road AUTHORIZED REPRESENTATIVE Tallahassee, FL 32399 �tt�-�--�t� (/U`-"C�C.�---- O 1995-2009 ACORD CORPORATION. All rights reserved. ACORD 24 (2009/09) The ACORD name and logo are registered marks of ACORD �� DATE (MMIDD/YYYY) 1°IF'IC °T F t�l ILIT'Y I� � 05l16/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS U�ON THE CERTIFICATE HO�DER. 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to tFoe 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 NAMEACT Jayme Martina Marks Insurance Agency, Inc. AHO Na Ext: 850-653-2161 A/c No: 850-653-8946 P.O. BoX 129 no�Ress: jayme@marksinsurance.com Apalachicola, FL 32329-0129 INSURER(S)AFFORDINGCOVERAGE NAIC# iNSUReRa: Southern Owners Insurance Company INSURED �.��,,,�.,,�,. A..a.. /1........a.. 1 .................. r+,..«.......,.. Cathey Const & Development INSURERC: PO Box 13107 INSURERD: tVlexico Beach, FL 32410-3107 INSURERE: COVERAGES CERTIFICATE NUMBER: 00000000-0 REVISION NUMBER: 41 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 C�,41MS. WSR 7ypE OF INSURANCE ADDL SUBR POLICY EFF I POLICY EXIP LTR INSD WVD PO�ICYNUMBER MMIDD/YYYY MM/DD/YYYY �IMITS A X COMMERCIALGENERALLIABILITY II 0$4622-78120197-16 01/01/2016 01/01/20'�7 EACHOCCURRENCE $ ��00.��0�0 CLAIMSMADE � OCCUR PREM SES�Ea occur ence $ 3�0 0�� .... ... _.. MED EXP (Any,one person).... $ __ � O��Q . . ..____ ____ .... . .. .. .... ..... PERSONAL&ADVINJURY � ��OOO�OOO GEN'LAGGREGATELIMITAPPLIESPER: GENERALAGGREGATE $ Z,OOO�OOO __�(_ POLICY n jECT (____J LOC PRODUCTS-COMP/OPAGG S 7 OOO OOO -_---- ----- --------- --- --�- -�— -- OTHER: � B AUTOMOBILELIABILIiY 4i32839101 01/01/2016 �'�/��/Z�'�% E�aaacdeDtSINGLELIMIT � ,� 0�0,000 X ANYAUTO BODILYINJURY(Perperson) $ OWNED SCHEDULED BODI�Y INJURY (Per accidentj $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY �AMAGE $ X AUTOS ONLY � AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ S WORKERS COMPENSATION I PER OTH- C 0830-47903 01/01/2016 01/01/2017 X STATUTE Ert AND EMPLOYERS' �IABI�ITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y❑ E.L.EACHACCIDENT $ ��OOO�OOO OFFICER/MEMBEREXCLUDED? N/A (Mandatory in NH) E.L. DISEASE- EA EMPLOYE $ ��Q��Q If yes, describe under ��""" """"�" ��-- -��-- �� DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 7�OOO�OOO �� I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) �ERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEL�ED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN For Informational Purposes Only ACCORDANCE WITH THE PO�ICY PROVISIONS. AUTHORIZED REPRESE�1\ATIVE � --�°��'=� (JPM) O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Printed by JPM on May 16, 2016 at 01:42PM