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Blk 58/CITY OF OKEE/Freeman-Central Gas/AlleyACORN►° CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD /YYYY) 07/03/2014 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 Phone: (904) 730-0600 Fax (904) 731 -7072 DONOVAN INSURANCE INC P 0 BOX 24960 JACKSONVILLE FL 32241 -4960 Agency Lic# L044912 INSURED CENTRAL GAS COMPANY OF OKEECHOBEE 119 NW 8TH STREET OKEECHOBEE FL 34972 CONTACT Donovan Insurance Inc NAME: PHONE (904) 730 -0600 E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE No);. (904) 731 -7072 NAIC # INSURER A Travelers Indemnity Co of CT INSURER B TRAVELERS IND CO 25682 25658 INSURER C TRAVELERS CASUALTY & SURETY CO 19038 INSURER D: INSURER E : INSURER F COVERAGES CERTIFICATE NUMBER: 37489 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 A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X �'� OCCUR B GEN'L AGGREGATE LIMIT APPLIES PER PRO- X POLICY JECT AUTOMOBILE LIABILITY i X ANY AUTO !ALL OWNED ..'..AUTOS X HIRED AUTOS LOC SCHEDULED AUTOS X NON -OWNED AUTOS UMBRELLA LIAB OCCUR .EXCESS LIAB CLAIMS -MADE DED RETENTION $ `+ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/N ADD'L SUER. INSR WVD N/A POLICY NUMBER 6605235C869 BA6583C260 UB4050T486 POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD /YYYY) LIMITS $ 06/30/14 06/30/15 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED 100,000 PREMISES (Ea occurence) MED. EXP (Any one person) 5,000 PERSONAL & ADV INJURY 1,000,000 ! GENERAL AGGREGATE 2,000,000 !PRODUCTS - COMP /OPAGG $ 2,000,000 06/30/14 06/30/15 COMBINED SINGLE LIMIT 1'000 000 (Ea accident) $ I BODILY INJURY (Per person) • $ BODILY INJURY (Per accident) $ 03/09/13 03/09/14 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) PROPERTY DAMAGE (per accident) $ EACH OCCURRENCE $ AGGREGATE $ WC STATU- OTH TORY LIMITS ER $ E.L. EACH ACCIDENT $ • E. L. DISEASE -EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ 1,000,000 1,000.000 1,000,000 CERTIFICATE HOLDER CANCELLATION CITY OF OKEECHOBEE 55 SE 3RD AVENUE OKEECHOBEE FL 34974 Attention: FAX: 863 - 763 -1686 AND 863 - 763 -3401 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 Larry M. Einbinder ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD .s This agreement entered into this 18th day of February 1992, by and between the CITY OF OKEECHOBEE, a municipal corporation, hereinafter referred to as "CITY and JOANIE HILDERBRAND FRCC PROPERTIES, INC. hereinafter referred to as "PROPERTY OWNERS WHERE the City Council of Okeechobee, in regular session on the 18th day of February, 1992, approved a request to: pave an alleyway in Block 58, City of Okeechobee. The legal description of the property involved is: Lots 1,2 and 3 of Block 58 Joanie Hilderbrana, owner. Lots 11,12 and 13 of Block 58 FRCC Properties, Inc., owner. The subject alley right —of —way runs between the lots of Block 58 as shown below: as IND NM 5111 AK H h UFO �Yr "1 II IMF III V MO MOM O_ O WU o NM7NO C rr� AGREEMENT W I T• N E S S E T H: 11 PARROIT AVE NM 3R0 AK N lL a. n r i. SHAN 1113111 NMI NMI NMI -E r as NORM NM ITN AVE NUM NW 210 AYE SUM v 1- r WHEREAS the named property owners are granted a license, revocable at the will of the CITY OF OKEECHOBEE, for the paving of said 15 foot alleyway, which runs between Lots 1, 2, 3, and 11, 12, and 13 of Block 58, pursuant to the terms and conditions of this agreement as herein set out. THIS license for use is granted with the understanding that the PROPERTY OWNERS shall bear all costs, expense and liability in the paving and maintenance of the alley. In the event it is necessary for the CITY to enter upon the alley in order to allow either the installation, or maintenance of water, sewer, or any other utility line or any other type of installation, or construction, or for any other reason chosen by the CITY, the payment, obstruction, or any improvement, or structure placed thereon shall be removed by the PROPERTY OWNER at the property owners expense within 15 days of being notified by the City. Failing that, it may be removed by the CITY without obligation to the property owners. Further, if CITY must enter the alley and remove improvements on an emergency basis for the purposes of repairs or other need, no notice thereof will be given, and no obligation incurred thereby by the CITY. WHEREAS property owners agree to provide the CITY with a Certificate of Coverage of Operations annually. IT is agreed and understood that the property owners are not requesting exclusive use of the paved portion of the said alleyway, and it will remain open for the use of the public. DATED THIS .M DAY OF 1992. WITNESS: 1 2/(7d/t- ACCEPTED FOR THE CITY: BONNIE S. THOMAS, CMC CITY CLERK PROPERTY OWNER ANIE HILDERBRAND _tom OFFICER RCC PROPERTIES, INC. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD YYYY) ACORO" 06/21/2013 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 Phone: (904)730-0600 Fax: (904)731-7072 CONTACT Donovan Insurance Inc NAME: DONOVAN INSURANCE INC PHONE FA)` 731-7072 (NC,No,Eel): (904)730-0600 (A/C,Nol: (904) P 0 BOX 24960 E-MAIL ADDRESS: -- JACKSONVILLE FL 32241-4960 PRODUCER 2726 CUSTOMER ID: - ---- Agency Lic#:L044912 INSURER(S) AFFORDING COVERAGE NAIC# INSURED INSURERA :Travelers Indemnity Co of CT 25682 CENTRAL GAS COMPANY OF OKEECHOBEE INSURER R :TRAVELERS IND CO 25658 119 NW 8TH STREET OKEECHOBEE FL 34972 INSURER C :TRAVELERS CASUALTY&SURETY CO 19038 INSURER D'. INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 33193 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, FXCI I ISIONS AND CONDITIONS OF SUCH POI ICIFS I MITS SHOWN MAY HAVF BEEN RFDUCED BY PAID CI AIMS INSR ADDS SUER POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSR MD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) A GENERAL LIABILITY 6605235C869 06/30113 06/30/14 _EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED $ 100,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurence) CLAIMS-MADE X 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: PRODUCTS-COMP/OP AGG $ 2,000,000 P I I PRO- POLICY J IF LOC $ r.T B AUTOMOBILE LIABILITY BA6583C260 06130/13 06/30/14 COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ (Per accident) X HIRED AUTOS X NON-OWNED AUTOS $ — $ UMBRELLA LIAB OCCUR EACH OCCURRENCE j EXCESS LIAR CLAIMS-MADE AGGREGATE L__$ DEDUCTIBLE $ RETENTION $ $ -- C WORKERS COMPENSATION UB4050T486 03/09/13 03/09/14 TORYTLIMITS OFRH $ C AND EMPLOYERS' LIABILITY Y/N E.L.EACH ACCIDENT $ 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE 1-1 OFFICER/MEMBER EXCLUDED? N/A E.L.DISEASE-EA EMPLOYEE $ 1,000,000 (Mandatory In NH) If yes,describe under DESCRIPTION OF OPERATIONS bebw E.L.DISEASE-POLICY LIMIT $ 1,000,000 ---- r DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF OKEECHOBEE ACCORDANCE WITH THE POLICY PROVISIONS. 55 SE 3RD AVENUE OKEECHOBEE FL 34974 AUTHORIZED REPRESENTATIVE Attention: FAX:863-763-1686 AND 863-763-3401 r V1. � ACORD 25(2009/09) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD JUL-26-2012 02:43P FROM:CENTRAL GAS 8637633401 TO:7631686 P. 1/1 A�a' CERTIFICATE OF LIABILITY INSURANCE DATE 143RD YYYI 06)4812012 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 Oft PRODUCER.AND THE CERTJFI$TE FtO1,,DER. IMPORTANT: If she certificate holder is an ADDITIONAL INSURED, the poticy(iea) must be endorsed. If SUSROGATUON IS WAIVED, subject to the teams and condition of the policy,certain policies may require an sndorsemenL A statement on this certificate does sal confer rfphts to the certificate holder In Ilea of such endorsement(s). PRODUCER CONFACr Phone (904}7.10.0600 Fat(9d1)Y91ao72 NAME. Donovan Insurance Inc DONOVAN INSURANCE INC IH (904)7364)600 �A�1rAx Wax (904)731-7072 P O BOX 24990 EMAll. JACKSONVILLE FL 322414980 PPuCcrii ' — ' CUSTORIER EX 2136 _. Agencylldl.L044912 INSURERS)AFFORDING COVERAGE NAG e INS MSUflERA s Travelers Indemnity Co of CT 26682 CENTRAL OAS COMPANY OF OKEECHOBEE weuams,TRAVELERS 1140 CO 25658 119 NW 8TH STREET OKEECHOBEE FL 34972 wHmCRc ` INSURER O. INSURERS . ..-.4 PISWIERP: - COVERAGES CERTIFICATE NUMBER:28233 REVISION NUMBER: THIS IS TO CERTIFY THAI INS POLICIES OF INSURANCE LISTED BEWW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDINCS 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, C GI.ISSIflNA APIG t-.rimrlIflDIR etE PIMA Pell It'ES I imp.St(r1WN MAY HAVE RPM RFfur r1 RY PA 11 el AIMS , NM AIM SOW Pow OF POt1CY EXP (fo LIR TYPE OF INSURANCE MR SURAINSURANCE END POLICY Nu Ie1 nnCR arte_ O AS1DI__ A OI *L LIABILITY 66052350169 06130112 06130)13 EACHoccuRRENcs s 1,000,000 DAMAGE 70 RENTED 100,1100 II COMMERCIAL GENERAL LIABILITY FREMIseslaaoorankol S 1 CLAtM3 MADE 1?L I OCCUR MO EXP(NH ens Woos) S 5,000 PERSONAL 8 ADV NA#tY _ g 1,000,000 GENERAL AGGREGATE S 2,000,000 GEM AGGREGATE LIMIT APPLIES PER. PftOOUCT3-COMPlOP AGO 1'S— 2,000,000 PRb }f""1i_7l_. S X PQLICY IFCr B AUrtteOeRE LNeuTY BA6563C260 06)30)12 06/30/13 COMBI EOSINGLEUMIT s 1,000,000 (Cs accident) ANY AUTO IiODLY ODURY(Par peRlDa) s AU.OWNED AUTOS BODILY INJURY(Per accident) S SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Par ) S © NON-OWNED AUTOS S S UMIEEIAA uaa ocwn F.ACHOCM'iR2NCB -.6_—_ prcEss tNS CLAIMS-MADE AGGREGATE S DEDUCTIBLE .-g---- RETENTION S S _ iNC CTATU- CZ AND IMPlooERSMW ury vIN I TORVUMTS Pa li /kW FAOPI*EYORRPAgRENP$ECUM! } NIA E.L.EACH ACCIDENT s OFFICERMEWDt MINIUD, (PA��In NIA E L.DISEASE-EA EMPLOYEE g nyet DESCR1IPTWQ OF O PERA71019 twlav EL-DISEASE-POLICY LIMIT g orscie PVION OP OPERATIONS I LOCATIONS!VEHICLES(Attach ACORD 101,Additional Remarks Sch.e/uls,N mare space I.required) ■ CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIEB BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF OKEECHOBEE ACCORDANCE WITH THE POLICY PROVISIONS. S6 SE 3R0 AVENUE OKEECHOBEE FL 34974 nmmiORae0 RER1ESENrATIVE Attention: FAX:863-763-1588 AND 663.7633401 K T!,4;- ' ACORD 25(2009109) 0 1988.2009 ACORO CORPORATION.All rights reserved. The ACORO name and logo are registered marks of ACORO To Page 2 of 2 2011 -07 -07 07:43:51 EDT 19042140111 From: Cyndi Crews AWRDc CERTIFICATE OF LIABILITY INSURANCE DATE YYYYI 071066/20/20 11 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 Phone: (904) 730-0600 Fax: (904) 731-7072 DONOVAN INSURANCE INC P 0 BOX 24960 JACKSONVILLE FL 32241.4960 Agency Lic#: 1.044912 CONTACT Donovan Insurance Inc Iac. No, Ext: (904) 730 -0600 NO; (904) 731 -7072 E -MAIL PRODUCE. CUSDUCER 2726 CUSTOMER ID: INSURER(S) AFFORDING COVERAGE NAIL M INSURED CENTRAL GAS COMPANY OF OKEECHOBEE 119 NW 8TH STREET OKEECHOBEE FL 34972 INSURERA : Travelers Indemnity Co of CT 25682 INSURERS : TRAVELERS IND CO 25658 INSURERC INSURER DAMAGE TO RENTED PREMISES (Ea recurrence) INSURER E : 100,000 INSURER F : CLAIMS -MADE X OCCUR COVERAGES CERTIFICATE NUMBER: 23095 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE INDICATED. NOTWITHSTANDING ANY REQUIREMENT, CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, FXCI I1SIONS AND CONDITIONS OF SUCH POLIO FS I LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, MITS SHOWN MAY HAVF RFFN RFDLICFD RY PAID CLAIMS INTRR TYPE OF INSURANCE INSR I UB POLICY NUMBER POLICY EFF (MMfDDNYYY) 06/30/11 PORGY EXP (MMIDDNYYY) 06/30/12 LIMITS EACH OCCURRENCE S 1,000,000 A GENERAL X LABILITY COMMERCIAL GENERAL LIABILITY 6605235C869 DAMAGE TO RENTED PREMISES (Ea recurrence) 5 100,000 CLAIMS -MADE X OCCUR MED. EXP (Any one person) s 5,000 PERSONAL R ADV INJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER X I POLICY I JFPRO- 1 1LOC rT_ PRODUCTS - COMP/OP AGG 5 2,000,000 S B AUTOMOBILE X X X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BA6583C260 06/30/11 06/30/12 COMBINED SINGLE LIMIT (Ea accident) s 1,000,000 BODILY INJURY (Per person) S BODILY INJURY (Per accident) s PROPERTY DAMAGE (Pera acid ent) 5 S S UMBRELLA LIAR EXCESS LIAR . OCCUR I EACH OCCURRENCE CLAIMS -MADE AGGREGATE DEDUCTIBLE RETENTION S S S WORKER! COMPENSATOR AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFF CERAEMBER EXCLUDED? (Mandabry In NH) B yes, describe eerier DESCRIPTION OF OPERATIONS Y/N j NIA WC STATU- I TORY LIMITS I OFT S 5 E.L. EACH ACCIDENT Et. DISEASE -EA EMPLOYEE below E.L. DISEASE - POLICY LIMIT s DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION CITY OF OKEECHOBEE 55 SE 3RD AVENUE OKEECHOBEE FL 34974 Attention: FAX: 863. 763.1686 AND 863- 763 -3401 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 (2009/09) © 1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD A X COMMERCIAL GENERALUABBJIY 60(I623a.660 08130/10 06130111 EACH OCCURRENCE sg *lgg ..a4 M._M_ M .N_ CLARISNADE© OCCUR ONAOETOR E ERT PrE NED EXP (Any one parson) PERSONAL AOV INJURY (311$11. AGGREGATE L APPLIES PER: 1 POLICY n n LOC GENERAL AGGREGATE R PRODUCTS COMP/OP AGO AUTCMOeRI X uASm l A U 0'tM D ALL GINNED AUTOS SCHEDULED AUTOS WIRED AUTOS NON OWNED AUTOS BA8683C230 01130110 06130/11 COMDSED SINGLE LIMIT (Ea9Ecldsnq E 1,000 BOGEY INJI/RY (Per person) S X X GODLY INJURY (Perscdtlanq .r PROPERTY Eel S GARAGE UASIUTY ANY AUTO At AUTOONIY.F.A ACCEIENT S 07HER THAN EA ACC AUT ONLY: EXCESS UMBRELLA LIAPIUTY OCCUR 0 CLAIMS MADE DEDUCTIBLE RETENTION i EACH OCCURRENCE IS of AGGREGATE 3 i (NewARary NT� WORRIES dIPLOYERWLIAWNY IATO MY In arrabeOr SaEraAi lsn OTHER commis/mow AND y/N 1T 1 �O R i 11/PARDIIIIV TME 1111 NIO ILL EACH ACCIDENT wow LI DI8EA5$.EA EMPLOYEE 3 Si DISEASE -0POLICY S JUL 21 -2010 11:52A FROM: CENTRAL GAS 8637633401 rwr ,v ACORO' CERTIFICATE OF LIABILITY INSURANCE PRODUCER Ph.. (904) 780,0900 Far (904) 131.7072 DONOVAN INSURANCE INC P 0130X 24960 JACKSONVILLE FL 32242 1-4960 INSURED CENTRAL GAS COMPANY OF OKEECHOBEE 119 NW 8Tif STREET OKEECHOBEE FL 34972 I DATE (MLMOONYVY) 0/11812010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY MW CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. TKO CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER 1)111 COVERAOB AFFORDFO BY THE POLICIES BELOW Agency uoP L044912 L INSURERB AFFORDING COVERAGE NAIL 0 INSURER A. Tr/molars Indemnity Co of CT INSURER e: TRAVELERS IND CO INSURER C: INSURER 0: INSURER E: 23682 238.18 COVERAGES THE. POIJCIES OF N4SURANCE LISTED BELOW RAVE BEEN MUM) TO THE INSURED NAMED ASOV8 FOR THE POI.R,Y PERIOD INDICATED. NOYWITN$TANOING ANY REOUIREMENT, TERM OR CONDITION OP ANY CONTRACT 09 OTHER DOCUMENT WITH RESPECT TO W ICH THIS CERTIFICATE MAY ON ISSUED OR MAY PERTAW, 111E INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OP SUCH POLICIES AGGREGATE.LIMTS SHOWN MAY HAVE BEEN REDUCED BY PAI CLAWS. o..N.W uR TYPE OF INSURANCE GEDERAL MIK TY CERTIICATE HOLDER CITY OF OKEECHOBEE 55 SE 3RD AVENUE OKEECHOBEE FL 34974 1 POLICY NURSER OATS (Mrmorn OATSIMEDIPTO f 'Goer smar B mum EMIRAROPI dk:ol �DI- iCti(PalQa A TO: 7631686 P.2 DESCRIPTION of O PERATIONS /L. ADDED BY ENDORSEMEN'rI SPECIAL PROVISIONS C Tl0N SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUSIG INSURER W(L B1DEAVOR'TO LIMAS DAYS WRrFTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.9UTFALUR670 DO 80 SHALL IMPOSE NO OBUOA11)N OR LIABILITY OF ANY 10ND UPON THE INSURER. ITS AGENTS OR REPRESEUTATIVI3. AUTHORIZED REPRESENTATIVE Attention: FAX: 383_763 -1686 ANO863- 7933101 i�"� ACORD 28 (2009101) CB,I flcate 18833 C 1988 -3009 ACORD CORPORATION. All rights The ACORD name end Nog* are nq)stered marks of ACORD nsened THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWnHSIANUINLS 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. E ADD1 1NSRC TYPE OF INSURANCE POLICY NUMBER PakY EFFECTIVE DATE IMMID0IYY1 POLICY EXPIRATION DATE trsawK YY) LIMITS 1,000,000 A GENERAL LIABILITY COMMERCIAL GENERAL LIAOILf1Y 6605235C869 06130/09 06/30/10 EACH OCCURRENCE X P�e S„�) 100,000 I CLAIMS MADE X OCCUR MED EXP (Any one person) 6,000 PERSONAL &ADV INJURY 1,000,000 GENERAL AGGREGATE 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY n e t n LOC PRODUCTS COMP/OP AGG. 1,000,000 X 1 B AUTOMOBILE LIABILITY ANY AUTO AU. OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BA6583C260 06130/09 06/30110 COMBINED SINGLE LIMIT (EaacaOent) 1,000,000 X BODILY INJURY (Per person) X X BODILY INJURY (Peraccider() PROPERTY DAMAGE (Per accident) GARAGE LIABILITY ANY AUTO AUTO ONLY EA ACCIDENT OTHER THAN EA ACC AUTO ONLY' AGO i EXCESS 1 UMBRELLA LIABILITY EACH OCCURRENCE OCCUR CLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION WORKERS EMPLOYERS' ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MENDER R yes, SPECIAL describe PROVISIONS COMPENSATION AND LIABILITY EXCLUDED? urea below I T ORY UMITC I I OTHER E.L EACH ACCIDENT E.L DISEASE EA EMPLOYEE EL. DISEASE POLICY LIMIT 5 OTHER: DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS 71 39/s AUG -14 -2009 01:40P FROM:CENTRAL GAS ACORD CERTIFICATE OF LIABILITY INSURANCE PRODUCER Phone: (904) 730-0600 Fax (904)731 -7072 DONOVAN INSURANCE INC P 0 BOX 24960 JACKSONVILLE FL 32241 -4960 INSURED CENTRAL GAS COMPANY OF OKEECHOBEE 119 NW 8TH STREET OKEECHOBEE FL 34972 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE GOES NOT AMEND, EXTEND OR TER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER A. Travelers Indemnity Co of CT INSURER 9a TRAVELERS IND CO INSURER C: INSURER 0: INSURER E: DATE (MM/DDIYYYY) 08/2612009 NAIC 25682 25658 COVERAGES CERTIFICATE HOLDER CITY OF OKEECHOBEE 55 SE 3R0 AVENUE OKEECHOBEE FL 34974 Attention: FAX: 863- 783 -1888 AND 863- 763 -3401 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 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 LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIVE ACORD 25 (2001108) Certificate 8637633401 15344 CANCELLATION TO:7631626 P.2 ACORD CORPORATION 1988 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDMON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY TI-E POLICIES DESCRIBED HEREN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWY MAY HAVE BEEN REDUCED BY PAD CLAIMS. [PARR LIR AMYL WPC TYPE OF INSURANCE POLICY NUMBER POUCY EFFECMME ME IIIMOWYYI POLICY EXPMATON DAN OMISSYYI LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABLITY 66052350869 06/30/08 06/30/09 EACH OCCURRENCE S 1,000,000 DAMAGE TO RE1TED PREMISES (Ea occurence) S 100,000 1 CLAIMS MADE X I OCCUR MED. EXP (Arty one person) S 5,000 PERSONAL ADV INJURY f 1,000,000 GENERAL AGGREGATE 5 1,000,000 GEM. AGGREGATE UMff APPLIES PER POLICY n .,EC,_ oc PRODUCTS- COMP/OP AGG. S 1,000,000 A AUTOMOBILE LUABIUTY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BA6583C260 06/30/08 06/30/09 COMBINED SINGLE LIMIT (Ea accident) 5 1,000,000 X BODILY INJURY (Per person) 5 X BODILY INJURY (Per accident) 5 X PROPERTY DAMAGE (Per accident) S GARAGE UABLITY ANY AUTO AUTO ONLY- EA ACCIDENT S OTHER THAN EA ACC AUTO ONLY: AGG 5 EXCESS' UMBRELLAUABLITY EACH OCCURRENCE S OCCUR I I CLAMS MADE AGGREGATE S DEDUCTIBLE RETENTION 5 S S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROP OFFICERIMBIB9[ ElOC1.YDEDT rtaa waeree ender SPECIAL PROVISIONS Maim 17 STLAT 1 0T1160 E L. EACH ACCIDENT S E 1. DISEASE -EA EMPLOYEE S E.L. DISEASE- POLICY LIMIT S OTHER: DESCRIPTION OF OPERATIONS /LOCATONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS COVERAGES CERTIFICATE HOLDER ACORD 25 (2001108) Certificate 11731 J., ..J.,- Iv.... CANCELLATION ...,..I. ..yi,.., C..J ACORD iM CERTIFICATE OF LIABILITY INSURANCE PRODUCER Phone: (904) 730 -0000 Fax (904) 731 -7072 DONOVAN INSURANCE INC P O BOX 24960 JACKSONVILLE FL 32241 -4960 TINS CERTIRICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTRICATE HOLDER TINS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER TIE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIL INSURED CENTRAL GAS COMPANY OF OKEECHOBEE 119 NW 6114 STREET OKEECHOBEE FL 34972 INSURER A. TRAVELERS ND CO INSURER B: INSURER C: INSURER 0: INSURER E: DATE (IAAIDD/YYYY) 06/23/2008 25658 CITY OF OKEECHOBEE 55 SE 3RD AVENUE OKEECHOBEE FL 34974 Attention: FAX: 863- 763 -1685 AND 863-763-3401 SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUNG 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 LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIVE ree44P'"-.4 0 ACORD CORPORATION 1988 Oct 03 06 01:33p Central Gas Co 8637633401 p.2 DATE (MM /DD/YYYY) 0912612006 ACORD TM CERTIFICATE OF LIABILITY INSURANCE PRODUCER Phone: (904) 730 -0600 Fax. (904) 731 -7072 DONOVAN INSURANCE INC P 0 BOX 24960 JACKSONVILLE FL 32241 -4960 INSURED CENTRAL GAS COMPANY OF OKEECHOBEE 119 NW 8TH STREET OKEECHOBEE FL 34972 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 INSURER A: TRAVELERS PROP CAS INS CO INSURER B: TRAVELERS IND CO INSURER C: INSURER D: INSURER E: NAIC 36161 25658 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 PASO CLAIMS INSR ADM. LTR INSRC TYPE OF INSURANCE GENERAL LIABILITY X I COMMERCIAL GENERAL LIABILITY 1 l CLAIMS MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER X POLICY 1 1 EC LOC AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS X HIRED AUTOS X NON -OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESS UMBRELLA LIABILITY OCCUR n CLAIMS MADE DEDUCTIBLE RETENTION WORKERS COMPENSATION AND I EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMgER EXCLUDED? I/ yes, describe under SPECIAL PROVISIONS below CERTIFICATE HOLDER CITY OF OKEECHOBEE 55 SE 3RD AVENUE OKEECHOBEE FL 34974 X POLICY NUMBER 6605235C869 BA6583C260 Attention: FAX: 863- 763 -1686 AND 863- 763 -3401 ACORD 25 (2001/08) Certificate 4825 POLICY EFFECTIVE DATE IMMIDD/YY) 06/30/06 06/30/06 CANCELLATION POUCY EXPIRATION DATE (MMrODIYY) 06/30/07 06/30)07 AUTHORIZED REPRESENTATIVE LIMITS EACH OCCURRENCE is DAMAGE TO RENTED i$ PREMfSES (Ea occurence) MED. EXP (Any one person) PERSONAL 8 ADV INJURY iS GENERAL AGGREGATE PRODUCTS- COMP /OP AGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY Per accident) PROPERTY DAMA3E (Per accident) AUTO ONLY EA ACCIDENT OTHER THAN EA ACC AUTO ONLY EACH OCCURRENCE AGGREGATE AGG WC STATU- TORY LIMITS 1 I OTHER E. EACH ACCIDENT E.L. DISEASE -EA EMPLOYEE E DISEASE POLICY LIMIT DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS is S s S S 5 1,000,000 100,000 5,000 1,000,000 1,000,000 1,000,000 1,000,000 OTHER SHOULO ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. ACORD CORPORATION 1988 ACORD CERTIFICATE OF PRODUCER U.S. PROPANE SERVICES P. 0. BOX 516 RICHMOND, TEXAS 77406 INSURED CENTRAL GAS CO. OF OKEECHOBEE 119 NORTHWEST 8TH STREET OKEECHOBEE, FL. 34972 CO LTR A 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, EXCLUSICNS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COVERAGES OTHER TYPE OF INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE I OCCUR II OWNERS CONTRACTORS PROT AUTOMOBILE LIABILITY ANY AUTO '1 ALL OWNED AUTOS X SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X COVERAGE -BASI X UNISURED MOTORIST GARAGE UABIUTY ANY AUTO EXCESS UABILiTY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' UABIUTY THE PROPRIETOR/ PARTNERS/EXECUTIVE OFFICERS ARE: CERTIFICATE. HOLDER INCL EXCL ATTENTION: LINDA AWAD FAX: 941 763 -5276 ACORD 2S-S (1(95) LIMITS DESCRIPTION OF OPERATIONS A.00ATIONSNEHICLES /SPECIAL ITEMS PROPANE DEALER THE OKEECHOBEE PLANNING DEPT. 499 NORTH WEST 5TH AVE OKEECHOBEE, FL 34972 POLICY NUMBER CK00201864 CK00201864 LIABILITY; INSURANCE DATE (MM/DD/YV) 8,_ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFOI tb,�.�:iION ONLY AND CONFERS NO RIGHTS UPON THE OEM IC ICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EX1 LND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANY A ST PAUL FIRE MARINE INSURANCE CO. COMPANY B COMPANY C COMPANY D POLICY EFFECTIVE POLICY EXPIRATION DATE (MWDD/YY) DATE (MMIDO/YY) 6 -30 -95 6 -30 -96 AUTHORIZED REPRESENTATIVE FOSTER BREWER COMPANIES AFFORDING COVERAGE EXPIRATION DATE THEREOF, THE 10 DAYS WRITTEN NOTICE TO AKICHOLIDIEXECDENDLIEN xuxmMODRIcXIN GENERAL AGGREGATE !$400,000 IPRODUCTS COMP /OPAGG $9_00,000 PERSONAL ADV INJURY i $400 -Q00 EACH OCCURRENCE I $90 I FIRE DAMAGE Any one lire) SQ,..QOn MED EXP (Any one person) 5 n0 n COMBINED SINGLE LIMIT BODILY INJURY 1 (Per person) 6 -30 -95 6 -30 -96 I PROPERTY DAMAGE BODILY INJURY I (Per accident) AUTO ONLY EA ACCIDENT OTHER THAN AUTO ONLY: EACH OCCURRENCE AGGREGATE EL EACH ACCIDENT EL DISEASE POLICY LIMIT E D r EA EMPLOYEE LIMITS EACH ACCIDENT AGGREGATE S WC STATU- OTH- TORY 1 IMITS ER $500,000 CANC cAnON SHOULD ANY OF THE ABOVE DESCRIBED ISSUING BENIXDOM POUCIES BE CANCELLED BEFORE THE COMPANY WILL B$EREC$SECK MAIL HOLDER NAMED TO THE LEFT, KKK suraimancancaumutx mast ACORD CORPORATION 1988 AC;O1:11® CERTIFICA PGa°rag Equipment Dealers Liability e Service Eq P A Risk Retention Purchassiinng g G Groupp" qualified u"rqualified� under the Risk Inc. "Pur Retention Act of 1986; Federal Law 97.45, PO Box 526148 UT 84152 Salt Lake City, INSURED CENTRAL GAS CO. OF OKEECHOBEE 119 N.W. 8TH STREET OKEECHOBEE, FL 34972 DOCUMENT REIN E TO TO L THE WHICH H THIS TERMS, COVERAGES CE THIS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED IS SUBJECT NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER CERTIFICATE MAY ND CONDITIONS OOF R MAY PERTAIN, THE INSURANCE SUCH POLICIES. LIMITS SHOWN MAY BEEN REDUOCED BY PAID CLAIMS. EXCLUSIONS AND POLICY EFFECTIVE DATE (MM /DD /YY) DATE (MM /DDIYY) CO LTR A TYPE OF INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY XX CLAIMS MADE XX OCCUR OWNER'S CONT PROT A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS XX SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GARAGE LIABILITY ANY AUTO _EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS' LIABILITY THE PROPRIETOR/ PARTNERS /EXECUTIVE _OFFICERS ARE: OTHER INCL EXCL PROPANE DEALERS LIABILITY CERTIFICATE HOLDER DIVISION OF LP GAS 200 GAINS STREET TALLAHASSEE, FL 32399 03 00 ACORD25 -S (3/93) TE OF INSURANCE POLICY NUMBER. PPL 1436 PL 1001 004 PCA 0636 CA 1001 004 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES /SPECIAL ITEMS DATE (MM/DD /YY) LCM, 1-2,1)-13 12 -8 -93 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION THE HOLDER. TH S CERTIFICATE DOES NOT AMEND, C EXTEND A OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW COMPANIES AFFORDING COVERAGE !Tag" T CE Coverage is being provided as A part of a MASTER GROUP S PPOLICY es issued to members of the Garage Association of COMPANY ment Dealers Liability B America, Inc. A Risk Retention "Purchasing COMPANY Group" authorized r under the.RiskiRetentior C Act of 1986; COMPANY State of Utah, by Homestead Insurance D Company (PA) 12 -21 -93 12 -21 -94 12 -21 -93 12 -21 -94 POLICY EXPIRATION LIMITS GENERAL AGGREGATE 500,000. PRODUCTS-COMP/OP AGG PERSONAL ADV INJURY EACH OCCURRENCE_ 500,000. FIRE DAMAGE (Any one fire) MEDEXP-(Any one 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 STATUTORY LIMITS EACH ACCIDENT DISEASE POLICY LIMIT DISEASE EACH EMPLOYEE_ 500,000. CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL AYITYWOEFDX 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED EFT �€�rX1AIY S ,IK I IY�+'i� vP ilWLIC lyX AUTHORIZED REPRESENTATIVE of the "Purchasing Group ACORD CORPORATI N 1 'AMU) CERTIFICATE OF INSURANCE PRODUCER INSURED CO LTR To Hoover Okeechobee County Farm Bureau 401 N.W. Fourth Street Okeechobee. FL 33472 Central Gas Company of Okeechobse, Inc. 119 N.V. 8th Street Okeechobee, FL 34972 TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X OCCUR. OWNER'S CONTRACTOR'S PROT. AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GARAGE LIABILITY EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY OTHER CERTIFICATE HOLDER POLICY NUMBER (:L 723057 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES /SPECIAL ITEMS City of Okeechobee 55 SE 3rd Avenue Okeechobee, FL 34974 3 -9 topq }(1 ,4016 ACORD 25 -S (7/90) v 1 VV ISSUE DATE (MM /DD /YY) 3/9/92 uw 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 COMPANY A LETTER COMPANY B LETTER COMPANY G. LETTER COMPANY D LETTER COMPANY E LETTER Empire Indemnity Insurance Co. COVERAGES PERIO THIS IS TO CERTIFY THAT THE INDICATED, NOTWITHSTANDING O ANY I INSURANCE REQUI EME T, TERM OR CONDITION TO ION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO LWHICH THI THE INSURED NAMED ABOVE FOR THE CERTIFICATE MAY BE ISSUED EXCLUSIONS AND CONDIITIONS SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED HEREIN IS SUBJECT TO ALL THE TERMS, ED BY PAID CLAIMS POLICY EFFECTIVE POLICY EXPIRATION DATE (MM /DD /YY) DATE (MM /DD /YY) GENERAL AGGREGATE PRODUCTS COMP /OP AGG. 12/21/91 12/21/92 PERSONAL ADV. INJURY EACH OCCURRENCE FIRE DAMAGE (Any onaiire) MED. EXPENSE (Any one person) Not Cov'd COMBINED SINGLE LIMIT BODILY INJURY (Per person) LIMITS 500.000. 510, 000. 500, 000. 500, 000. Not Cov'd BODILY INJURY (Per accident) PROPERTY DAMAGE EACH OCCURRENCE AGGREGATE STATUTORY LIMITS EACH ACCIDENT DISEASE POLICY LIMIT DISEASE —EACH EMPLOYEE CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 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 uuLL ANT OA ATION 1990