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Blk 200 City of Okee/NEMEC LLC/AlleyAC_'C) "Rani r_. CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 07/16/14 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 Sun State Insurance 623 Northlake Blvd North Palm Beach, FL 33408 Phone (561) 848 -1886 Fax (561) 842 -9996 CONTACT NAME: PHONNo ExtI: (561) 848 -1886 FAX No): (561) 842 -9996 ADDRESS: diana @sstins.net INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Old Dominion Insurance Company INSURED Nemec LLC 608 Harbour Pointa Way Greenacres, FL 33413 (561) 271 -8534 INSURER B : 04/10/2014 INSURER C : EACH OCCURRENCE INSURER D : V COMMERCIAL GENERAL LIABILITY ❑ ❑ CLAIMS -MADE d OCCUR ❑ INSURER E : $ 500,000.00 INSURER F : $ 5,000.00 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 ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDLSUBR INSR WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS A GENERAL LIABILITY BPG53334 04/10/2014 04/10/2015 EACH OCCURRENCE $ 1,000,000.00 V COMMERCIAL GENERAL LIABILITY ❑ ❑ CLAIMS -MADE d OCCUR ❑ DAMAGE TO RENTED PREMISES (Ea occurrence) $ 500,000.00 MED EXP (Any one person) $ 5,000.00 PERSONAL &ADVINJURY $ 1,000,000.00 ❑ GENERAL AGGREGATE $ 2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: V POLICY ❑ PRO - V LOC JECT PRODUCTS - COMP /OP AGG $ 2,000,000.00 $ AUTOMOBILE LIABILITY ❑ ANY AUTO ALL OWNED SCHEDULED ❑ AUTOS ❑ AUTOS NON -OWNED ❑ HIRED AUTOS ❑ AUTOS ❑ ❑ COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ ❑ UMBRELLA LIAB ❑ OCCUR ❑ EXCESS LIAB ❑ CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ ❑ DED ❑ RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR /PARTNER /EXECUTIVE N / A ❑ TORY LIMITS T ❑ EOTH E.L. EACH ACCIDENT $ OFFICER /MEMBER EXCLUDED'? (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Lot 7 -9 , 18 -20 Block 200 City of Okeechobe CERTIFICATE HOLDER CANCELLATION City of Okeechobee Attn: Lane Gamiotea 608 Harbour Pointe Way Green Acres, FL 33413 Fax 863- 763 -1686 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 ( Je y e ACORD 25 (2010/05) QF ©1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 111111111111111111111111111111111111111111111111111111111111 FILE HUM 200601442:• :• OR P K 00608 6a_68 F= G 1489 SHARON Rf1pJRT'Of CLERK. OF CIRCUIT (s OKEECHOBEE COUNTY? FL RECORDED 02/18/2006 1040 c' A RECORDING FEES 27.00 RECORDED BY R PoTrish LICENSE AGREEMENT Use of Alley THIS AGREEMENT, BY AND BETWEEN THE CITY OF OKEECHOBEE, FLORIDA, a Florida Municipal corporation (hereinafter "CITY "), and NEMEC, LLC, a Florida Limited Liability Corporation, 444 Bunker Road, Suite 207, West Palm Beach, Florida 33405, (hereinafter "OWNER(S) "), dated this f) day of fl LtSLLS —t , 2006. WHEREAS, OWNER (S) hold fee simple title to the following described real property in Okeechobee County, Florida, to wit: Lots 7 to 9 and 18 to 20 of Block 200, CITY OF OKEECHOBEE, according to the Plat thereof recorded in Plat Book 1, Page 10, public records of Okeechobee County, Florida; and WHEREAS, City owns the following alleyway: That alleyway running East to West located between Lots 1 through 26 of Block 200, CITY OF OKEECHOBEE, according to the Plat thereof recorded in Plat Book 1, Page 10, public records of Okeechobee County, Florida; and WHEREAS, OWNER (S) wish to use, maintain, and make improvements to the following portion of the above described alleyway, owned by the City: The portion of the alleyway that runs East to West between Lots 7 to 9 and 18 to 20 of Block 200, CITY OF OKEECHOBEE, according to the Plat thereof recorded in Plat Book 1, Page 10, public records of Okeechobee County, Florida; and WHEREAS, the OWNER(S) desire to make certain improvements in the form of paving or concreting and maintaining the alleyway adjoining between Lots 7 to 9 and 18 to 20 in said Block 200, which is an open, unimproved alleyway, owned by the CITY. NOW, THEREFORE, in consideration of the mutual promises and covenants set forth herein, the parties agree as follows: 1. The CITY hereby grants this revocable license for use of the alleyway with the understanding the OWNER(S) will maintain the improvements in the form of but not limited to pavement or concrete and should it ever become necessary to remove any of the improvements thereon, in order to allow either the installation, or maintenance of water, sewer, or other utility lines or any other type of installation or construction, or for any other reason chosen by the CITY, the pavement or any improvement thereon, will be removed by the OWNER(S) or their agents and /or assigns at the OWNER(S) expense within seven days of receipt of written request by the CITY for such removal. Should the CITY, for valid reasons, require the removal of the pavement, I or any improvements thereon less than seven days notice, the OWNER agrees to exercise reasonable efforts to comply with such requests. Page 1 of 3 2. OWNER(S) agree to contact their insurance company and require a rider be added to their insurance policy with a certificate furnished to the CITY showing the portion of the alleyway as herein described, to be used by them, insures the CITY against any liability arising out of alleged injuries or other activities as a result of owners permissive use. In any event, OWNER(S) agree and shall hold the CITY harmless for any and all action, suit, claim, injury or cause of action of any nature arising out of owner's permissive use, and indemnify CITY for such, including costs and attorney fees. 3. That OWNER(S) shall not, by such improvements made to that described alleyway, obstruct, close or otherwise restrict access to the alleyway for travel thereon by the CITY or the general public. 4. That the OWNER(S) agree that this license is non - assignable without the express written consent of the CITY; and if transferred, the covenants herein shall bind themselves, their heirs and assigns, and said covenants shall run with the land. 5. The City Clerk shall cause this agreement to be recorded in the public records of Okeechobee County, Florida. IN WITNESS WHEREOF, the parties hereto set their hands and seals on the aforesaid date. Signed, sealed and delivered in presence of: Print Name of Witnet jc r. s nyo.�- Address of Witness: v 2 Print Name of Witness: r1-)1 Address of Witness: STATE OF FLORIDA :7 / COUNTY OF , e; Deborah N. Tyner, Manage NEMEC, LLC The foregoing instrument was acknowledged before me this /0 day of , 200+ , by Deborah Nemec Tyner as1n ryager of N MEC, LLC, who signed in The presence of these witnesses; and who p o4 iced as identification or is personally known. ' CARLOS RICARDO Notary Public, State of Florida Commission# DO 380826 My comm. expires Dec. 20, 2008 ary Public Signature Name of Notary typed, printed or stamped) Commission No. Page 2 of 3 Accepted for the City: —J0t•-- /44— Donnie Robe son, Public Works Director Reviewed for Legal Sufficiency: '`Its, John R. Cook, City Attorney (city seal) Page 3 of 3 ckia Lane Ga iotea, CMC, City Clerk 03/20/2012 14:20 (FAX) P. 001 /001 `I oRrY CERTIFICATE OF LIABILITY INSURANCE I I DATE(MMIOD/YYYY) 03/20/12 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 T 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 Sun State Insurance - 623 Northlake Blvd North Palm Beach, FL 33408 Phone (561) 848 -1886 Fax (561) 842 -9996 CONTACT NAME: PHONE I ( ) ( FAX , Not: ( ) 561 848 -1886 561 842 -9996 No_ Eutl: NC _(NC ADDRESS: 1 diana®sstins.net I I INSURER(S) AFFORDING COVERAGE NAIC # INSURER A Old Dominion Insurance Company INSURED Nemec LLC 608 Harbour Pointa Way Greenacres, FL 33413 (561) 271 -8534 • INSURER B 04/10/2011 INSIURER C 04/10/2013 INSIURER 0 5 1,000,000.00 S 500,000.00 INSURER E COMMERCIAL GENERAL LIABILITY INSURER F :I S 5,000.0 0 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 ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE INSR lA Bp POLICY NUMBER I (MM DD/YYYYY) EXP UMITS A GENERAL LIABILITY i I BPG53334 ; 04/10/2011 04/10/2013 EACH OCCURRENCE 5 1,000,000.00 S 500,000.00 DAMAGE TO RENTED PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY MEDEXP(Anyoneperson S 5,000.0 0 El • CLAIMS -MADE rn OCCUR PERSONAL & ADV INJURY S 1,000,000.00 • GENERAL AGGREGATE S 2,000,090.00 GEML AGGREGATE LIMIT APPLIES PER: IN POLICY • ,PjF O in LOG PRODUCTS - COMP /OP AGG S 2,000,000.00 S AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT (Ea accident) S BODILY INJURY (Per person) S IN ANY AUTO ❑ALL OWNED SCHEDULED AUTOS • AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS U AUTOS PROPERTY DAMAGE per accident) S ❑ ■ s UMBRELLA L1AB OCCUR • EXCESS LIAR U CLAIMS -MADE EACH OCCURRENCE S AGGREGATE S 1. DED ❑ RETENTIONS S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N AND PROPRIETOR/PARTNER/EXECUTIVE NIA i I i • WC STA'R!- OTH- TORY mat W- EL. EACH ACCIDENT s OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ IDEeSs C RPO under P ERATIONS below E.L. DISEASE - POLICY LIMIT S - I DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Scli edule, If more space Is required) 1 CERTIFICATE HOLDER CANCELLATION City of Okeechobee Attn: Lane Gamlotea 608 Harbour Pointe Way Green Acres, FL 33413 'Fax 863 - 763 -1686 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 ACORD 25 (2010/05) QF © 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 05/04/2011 10:36 (FAX) P. 001 /001 ACORD. CERTIFICATE OF LIABILITY INSURANCE 4 05/03/M/D Ol ) TYPE OF INSURANCE PRODUCER (561) 848 -1886 Sun State Insurance Agency 623 Northlake Blvd North Palm Beach, FL 33408- THIS CERTIFICATE IS ISSUED AS A MATTER OF INFOR ATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW: INSURERS AFFORDING COVERAGE NAIC # INSURED Nemec LLC 3089 NW 26th Ave Boca Raton FL 33434- INSURER A: Old Dominion Insurance COMMERCIAL GENERAL LIABILITY INSURER B: 04/10/2011 / / / / INSURER C: EACH OCCURRENCE INSURER D: X INSURER E: $ 500, 0 0 0 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 LTR INSRD INSRD TYPE OF INSURANCE POUCY NUMBER POUCY (IIM/DDIYY) POUCY AE (MWDDNY)N LIMITS A - GENERALUABIUTY COMMERCIAL GENERAL LIABILITY BP053334 04/10/2011 / / / / 04/10/2012 / / / / EACH OCCURRENCE 5 1,000,000 X PREMISES (Ea occuru rents) $ 500, 0 0 0 OKEECHOBEE CLAIMS MADE I X I OCCUR MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN 'L AGGREGATE LIMIT APP�LIESPER: PRODUCTS. COMP/OP AGO $ ?,000,000 il POLICY I G I JEC I j ' LOC AUTOMOBILE UABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS / / / / / / / / / / / / / / / / COMBINED SINGLE LIMIT (Ea accident) S — BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ ^— PROPERTY DAMAGE (Per accident) $ GARAGE UABILITY ANY AUTO / / / / AUTO ONLY - EA ACCIDENT 5 OTHER THAN EA ACC S AUTO ONLY: AGO S EXCESS/UMBRELLA LIABILITY / / / / / / / / EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION S $ $ S WORKERS COMPENSATION AND EMPLOYERS' UABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? II yes, describe under SPECIAL PROVISIONS below / / / / / / / / 7U ( I TORY LIMITS I I ER E.L. EACH ACCIDENT S E.L DISEASE - EA EMPLOYEE S E DISEASE - POLICY LIMIT 5 OTHER / / / / / / / / / / / DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS SUBJECT TO POLICY TERMS AND CONDITIONS. fax to 863-763-1686 . ("..,),.. ^ •` ■ v -`v"' ( ) — SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ATTN: LANE GAMIOTEA EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 010 DAYS WRTITEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT CITY OF OKEECHOBEE FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABIUTY OF ANY KIND UPON THE 55 SE THIRD AVENUE INSURER, ITS AGENTS OR REPRESENTATIVES. OKEECHOBEE FL 34974- . AUTHORIZED REPRESENTATIVE ���� ila r t ACORD 25 (2001/08) INS025 (Owa).os ELECTRONIC LASER FORMS, INC. - (800)327.0545 Page 1 of 2 04/27/2010 12:52 (FAX) P. 001/002 ACORP CERTIFICATE OF LIABILITY INSURANCE DATE assoon ""' 04/27/2010 TYPE OF INSURANCE PRODUCER (561) 848 -1886 Sun State Insurance Agency �� y 623 Northlake Blvd North Pal= Beach, FL 33408 - THIS CERTIRCATE 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. INSURERS AFFORDING COVERAGE NAIC I SAStl� Nemec LLC 3089 NW 26th Ave Raton FL 33434- INSURER A Old Dominion Insurance G@6RALLABLDY INSURER B BPG53334 INSURER C 04/10/2011 / / / / / / INSURER D $ 1,000.000 INSURER E. DAMAGE TO RENTED PREMISES (Ea occurrence) 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. MR LTV ADM INSRD TYPE OF INSURANCE POLICY NUIBER POLICY EFFECTIVE DATE Immoorro POLICY EPIRATION DAIS IWImITIR LIMITS A G@6RALLABLDY COMMERCIAL GENERAL LIABILITY BPG53334 04/10/2010 / / / / / / 04/10/2011 / / / / / / EACH OCCURRENCE $ 1,000.000 I DAMAGE TO RENTED PREMISES (Ea occurrence) $ 500,000 CLAIMS MADE I OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000.000 GEN'L AGGREGATE LIMIT APPLIES PER. 1 POLICY n JECT n LOC PRODUCTS - COMP /OP AGG $ 2,000,000 I AUTOMOBILE LIABIUiY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS / / / / / / / / / / / / / / / / COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABRIIY ANY AUTO / / / / AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY'. AGG $ EXCESSIUINIRELLA —I / / / / / / / / EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATOR AVM EMPLOYERS' UABIUIY ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below / / / / / / / / I TORY LIMITS I ICI R E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E DISEASE - POLICY LIMIT $ ODER / / / / / / / / / / / / DESCRIPTION SOBJIU1Ci fax OF OPBRA71QN &LOG71ONSIVBICLESIERCLUSWNA ADDED BY EMORSBLIENTISPECIAL PROVISIONS TO POLICY T®IS AND CONDITIONS . 863 -763 -1686 to CERTIFICATE HOLDER CANCELLATION ( ) ATPN: LANE GANNIO+IEA CITY OF OKEECHOBEE 55 SE 'THIRD AVENUE OKEECHOBEE FL 34974- SHOULD ANY OF THE ABOVE DESCIiSTED POLICIES BE CANCELLED BEFORE DE BPIRA11ON DATE DEREOF, 11E ISSUING INSURER YAU. @OEAVOR TO MAIL 010 DAYS WRITTEN NOTICE TO THE CE RIFICATE HOLDER NAMLO TO TFE LEFT, BUT FAILURE 10 DO SO SHALL IMPOSE NO OBLIGAT1ON OR !LABILITY OF ANY KIND WON EYE INSURE R, ITS AGENTS OR REPRESENT/11M8. AUTHORIZED R RTAIIVE ACORD 25 (2001$18) c._ INS025 (0108) 05 ELECTRONIC LASER FORMS, INC.- (800)327 -0545 o ACORD CORPORATION 1988 Page 1 of 2 03/13/2009 15:21 Sun State Insurance Agency (FAX) 5618929996 P. 001/002 ACORa, CERTIFICATE OF LIABILITY INSURANCE PROD (561) 848 -1886 Sun State Insurance Agency 623 Northiake Blvd North Pals Beach, FL 33408- NSUR® Nemec LLC 2131 Powerline Road Boca Raton COVERAGES L DATE (INWOryYM 03/13/2009 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_ INSURERS AFFORDING COVERAGE NAIC IIt FL 33433- INSURER A: Old Dominion Insurance INSURER B INSURER C: INSURER D: INSURER E 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 CONDMONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR AWL iR NERD A TYPE OF INSURANCE GENERAL LMBIIIY POLICY NtMN)EI POLICY EFFECTIVE DATE piwirporef) POIBRPRATION PernDIre, WETS I COMMERCIAL GENERAL LIABILITY 1 CLAIMS MADE © OCCUR GEN'L AGGREGATE LIMIT APPLIES PER POLICY n JECT n LOC AULONOBIE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BPG53334 BP(753334 04/10/2009 04/10/2008 / / / / 04/10/2010 04/10/2009 / / / / EACH OCCURRENCE s 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) s 500,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 PRODUCTS - COMP /OPAGG s 1,000,000 / / / / / / / / / / / / / / / / COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) BODILY INJURY (Per accident) S PROPERTY DAMAGE (Per accident) $ GARAGE UABILfIY ANY AUTO / / / / AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY EXCESSAMBRELLA LINNITY OCCUR DEDUCTIBLE RETENTION $ CLAIMS MADE WONO3IS COMPENSATION AND EMPLOYERS I.IABII.BY ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS belay 071132 PRIDP / / / / / / / / EACH OCCURRENCE EA ACC AGG s S AGGREGATE S $ / / / / / / / / I TORY IMITS IOER S E . EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE S BPG53334 04/10/2008 / / / DESCRIPTION OF OP171OIISLOCA DS AD) BY / � mammas SUBJECT TO POLICY TERMS MD CONDITIONS_ CERTIFICATE HOLDER ( ) 04/10/2009 / / / / E . DISEASE - POLICY LIMIT S CANCELLATION AZTN: LANE GARQO'1'EA CITY OF OKEECHOBEE 55 SE THIRD AVENUE OKEECHOBEE ACORD 25 (2001108) INS025 (0108) 05 SHOULD ANY OF 11E ABOVE DESCRIBED POUCHES BE CANCEL' S/ BEFORE THE SIPRAT10N DATE 11 31EOF, THE ISSUED INSURER WILL EOFAVOR 10 NAIL 010 DAYS MIN TON NOTICE 70 TIE CBRTFIGUE HOLDER NAME) 7011E LEFT, BUT FALIRE 70 DO SO SHALL BPoSE NO OBLIGATION OR LIABILITY OF ANY KM UPON THE INSURER, ITS AGENTS ORRE RESENTA71VE8. AUTHORIZED REP T'ATTIE FL 34974- ELECTRONIC LASER FORMS. INC. - (800)327 -0545 1a Y Jw�e�l ACORD CORPORATION 1988 Page 1 of 2