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Blk 15 City of Okee/M Nooruddin - New Am Physical Therapy/AlleyLICENSE AGREEMENT Use of Alley IIIIIIIOhIIVIIIIIIIIVIIIIIIIIIIIIlIIlI1VIIIVIII111 !1111 FILE NUM 20061:108860 OR BK 00599 PG 1918 SHARON ROBERTSON? CLERK OF CIRCUIT COURT OKEECHOBEE COUNTY, FL RECORDED 05/16/2006 t39:57:59 AM RECORDING FEES 27.00 RECORDED BY G Mewbourn Pgs 1918 -- 192(1; (3pss) THIS AGREEMENT, BY AND BETWEEN THE CITY OF OKEECHOBEE, FLORIDA, a Florida Municipal corporation (hereinafter "CITY "), and MUHAMMAD S. NOORUDDIN, (hereinafter "OWNER(S) "), dated this /5 day of Ray 2006. r WHEREAS, OWNER (S) hold fee simple title to the following described real property in Okeechobee County, Florida, to wit: Lot 15 through 18 of Block 15, CITY OF OKEECHOBEE, according to the Plat thereof recorded in Plat Book 5, Page 5, public records of Okeechobee County, Florida; and WHEREAS, City owns the following alleyway: That 15 foot wide alleyway running North to South and located between Lots 15 through 17 of Block 15, CITY OF OKEECHOBEE, according to the Plat thereof recorded in Plat Book 5, Page 5, 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 North to South between Lots 15 through 17of Block 15, CITY OF OKEECHOBEE, according to the Plat thereof recorded in Plat Book 5, Page 5, public records of Okeechobee County, Florida; and WHEREAS, the OWNER(S) desire to make certain improvements in the form of sidewalks, walkways, landscaping and maintaining the alleyway adjoining between the Lots 15 through 17 in said Block 15, 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 alleyway and should it ever become necessary to remove any sidewalk, walkway, pavement, landscaping or any improvement 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 sidewalk, walkway, pavement, landscaping 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 sidewalk, walkway, pavement, landscaping 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 which may occur within the alleyway. 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 NS' "J • f Witness: Se. Addre ' P f Witness:0go3 S ‘3q j e Muhammad S. Nooruddin 52/ (Cidele Pri t Name of Witness: /1/54 ,>. `ddiiJs Address of Witness: 55 SE ,3 /fyp (j? ?e, F2 d7/ STATE OF FLO IDA COUNTY OF i ea -1/deQ The fpregoing instrument was acknowledged before me this /5 day of Ck/ , 20 an by Muhammad S. Nooruddin, who signed in the presence of these witnesses; and who produced as identification or is personally known. d Notary Public Signature I UFL, �a ft /, nos Name of Notary typed, printed or stamped) Commission No. 1)1) 03572. Page 2 of 3 ,tY ei MEUSA M. EDDINGS . %!�, ,� MY COMMISSION N DD 403572 • EXPIRES: March 7, 2009 Bonded Thni Notary Public Underwriters Accepted for the City: (city seal) 49— , Donnie Robertson"-, Works Director Lane Gamiot-a, CMC, City Clerk Reviewed for Legal ufficiency: John R. Cook, City Attor ey Page 3 of 3 Z0 39Vd MAY.19.2 i 4; 4F'T1 CONY a COMELY PR v.2 1050I PAAE1837 I. A>3DUL RAUF )41R, P o dw t of ISLAMIC MEDICAL ABSOCIA.TlON OP NORTH AMERICA, a aonptaf:t, 11011 polldcsl DiglathatioNedSting undot the Itwe oofthe State of Qhinc&s. (the "Corporation"), do hereby certify that the following is a into and comet copy of a resolution adopted by the Directors of tie Corporation ar • duly called Meath* bald on rho A._ day of 414a , 2003, at which s wawa was prima and voting throughout BR 1T RESOLVED titer the Contract for Sale and Pueshase dated April I6, 2003 between 1SIA IIC MEDICAL ASSOCIATION OF NORTH AMERICA, as Seller and MUHAMMAD S. NOORUDDN and SHAFWAZ NOORUDDIN, as Puaehasers, for tba Sala elands in Okeechobee County. Florida dasaihed asp Lots 15, 16,17 and 16, Brock 15, OKEECHOBEE, according au the plat *coot recorded in Plat Book S. Page 5, public records of Okeechobee County, Florida_ for the total purchase price of Shay-one thousandandNd100's Daises (S61.000.00), was *Friend and ILITFAT A. ALAVI, the Ttesataet of the corporation, was sunhwieed to execute the comma on behalf of the corporation and to mecum any and all documents on behalf of the emanation oeocssay to eonnintmIoe the sale and to pay all expenses of the corporation In connections with die sale. I FURTHER CERTIFY that LSLAMIC MEDICAL ASSOCIATION OF NORTH AMERICAN, is in good standing with all license, income, and franchise tams paid and mean ad tbasno peoceedtng tbetbe dissolution orliquidatlano t said Duplication is in cffeetmreoatcmplafed by the co paaiioa'a directors. (Corporate Seal) h ABD •7 ' Prasidcaa IN WITNESS WFIBRBOF, I have affixed my namt as President of this Corporation, and have affixed the , . . - Seal of the Carporartoa this I day of May. 2003. ABDUL RA MIR, 190882 RECORDED AS RECEIVED FILED FQR RECORD OIF LECNOOFL COUNT r.FLA. 03i1AY ZI P$ Z<27 SHARON ROOERTSON CLERK OF CIRCUIT COURT H11t73H 3'IOH BMA SIB ZZELL9VE98 60 :VI 900Z/ 2/Z0 Xed. 't' 0,66 • e- 4A1•0° TW aa.•.a mow O W areas rasoti• i COM=. P.1. ICE ,. COE= 1L1 101 •-1. Ora =Me P .0. Oa1MSR 1JI1 orsiDOaa. 11 30973 -13f7 ar.duNr., 3 -15- 37-95 -0010- 00130-0150 mr.•TS. ear ail TT: eiac0 50 I PAR 1836 Documentary SUM' Paid in the 01110111 of q 2'J o0 C InlanOlVai OWinitkse u* ttl i .S11a1YY1 j(aiib01. O61K OI COMA: M4 atto D.0 Warranty Deed TW lladaa*UR, MiY 11. /Tfh eq• ae Hey .2003 An.. lneaa ISLAMIC 1SDICaL ASSOCIATION maws affi01ica, a oon Profit, noa political organization, existing radar the lew or tho State of Illinois ▪ r Carty w 011 sags sr + s11a..1. . waster. .d remeNHAD S. 10708000111 and mina AZ NOONODOIN, hi. wits .r.r ae... f• 1068 B.$. 230d Btrast, Oka,ChohM, 1T. 30970 r da 0.•4 ae 0k OCWWW 1.4 :lands . ATtirTO F WIn.ii.th nrrawvlaah■r• =1g 1XXIAnl ($101 DWW1. y .W wad r ..41 awaYow. • Or.vaos r Yea 1•• OYAM'EN M wow •••ve i Wed w1aa.14r1. V pd.!. ►,1111 aM NKr ac dig O&AAT110 .a Oda EE1t Y1i. auoa.a r1 rep Yor. o IEEE, aware rrl ,art. *gam 6.11 • or Caro et O1MChob•• W er Plarida WOK Lot. 15, 16, 17 Sad 10. block 1S, OILUCOOAS, according to the plat thereof seta =dad io Plat look 5. Pas 5, public reword. or Oh.sehohno Conner, dories. Sob'act to 1.Itriotio... Zatioo,atid lases sot.. of owe , if ifahar say, which are not ruiaQ0* 31st, 2002. r ad roam Ow 1.dn Fay drug • r • I. Mimes WAese.LY emir r Ya.aa r. SOWS, wiled awl Manta WI wr Nor RECORDED AS REGEJVLD ra r.. aaa was addEa to es Spas YAW urge of .1 pm.. ••••=d• NE Ea ,r de an ra law fey ar wad. ISLA1=C NED/CAL A890CIAT10N Or Imam niorozco ILTIPkT A. ;(r /i. Trsa.aser Pad *IEEE ISI. T1. M••. coda. ..wru STATE OF ILLINOIS COUNTY OF D0 NOM Q�� Ea aoe..e .wirer w awddaad e.r r< a. 77 •+r • laY tiTT.rAS A. maw. Trassurar et IMANIC =DICK. A990C1AS1C11 MCCAICA a....at, Y.da r owl. wy.Aeaa bd air iwr•a Ili oaks, rdrawn PanCPAVAL 'G1'U IC�P...•. `..11 2003 w or MOM BARBARA L DEiift NOTARY PUBLIC. SUREOF ILLINOIS MYc ISSIO11EPINISTCiIIEGA istmor-wozza •Ottry Maas: - __,'1Ef d uT C..•e•rr. c.per. '7-13•vi IaN..rri.w.•w. r WeN \•..I. �r..lrl.� I0 39Vd HI1V3H 3WOH 37141 9IS mac ZZELL9VE98 60:VI 900Z/0Z/Z0 CONELY & CONELY, P.A. OFFICE LOCATION-401 NORTHWEST SIXTH STREET,OKEECHOBEE,FLORIDA 34972 MAILING ADDRESS: POST OFFICE DRAWER 1367 OKEECHOBEE,FLORIDA 34973-1367 T.W. CONELY,JR. 1892-1969 TELEPHONE-(863)763-3825 Tom W.CONELY,III April 20, 2010 FACSIMILE-(863)763-6856 John R. Cook, Esquire P.O. Box 515 Okeechobee, FL 34973-0515 Re: License Agreement(Use of Alley)between the City of Okeechobee and Muhammad S.Nooruddin dated May 8, 2006 and recorded in O.R. Book 599,page 1918,public records of Okeechobee County, Florida Dear John: The Okeechobee Utility Authority ("OUA") recently became aware of the above License Agreement as a result of construction of buildings by Mr. Nooruddin on his lots abutting the alley. The OUA has a 16"water main that is located in the alley and is concerned about its ability to service and maintain that main in view of the fact that the License Agreement is limited to holding the city harmless and also allowing this type of work to be done by the city. It makes no mention of other utility providers owning facilities located within the alley. I would suggest that the License Agreement be amended to afford protection not only the city but also any other public utility provider that has facilities in the alley. I also suggest that in the future that in any additional License Agreements whereby the city allows owners to use alleys or rights-of-way that a similar provision be made affording protection to any other public utility providers having facilities or improvements in the alley or right-of-way. Thank you for your attention and cooperation. Sincerely, \ied,a) To . nel. c: John Hayford Brian Whitehall \cd City of Okeechobee June 8, 2006 Mr. Muhammad S. Nooruddin 7993 Steeplechase Court Port St. Lucie, Florida 34986 Re: Alley Use Agreement Office of the City Clerk Dear Mr. Nooruddin, This notice is to inform you that we have received the recorded copy of the Use of Alley Agreement. It is at this time that we request the recording fee payment men in them received amount a of $27.00 to be payable to the City of Okeechobee. ShouAdtyo payment have any questions, you copy will be forwarded to you for your ecords may contact my office at (863) 763 -3372 ext. 215. With best regards, I am Sincerely, Ong th-674 Lane Gamiotea, CMC City Clerk LG /me 55 S.E. Third Avenue • Okeechobee, Florida 34974 -2903 • (863) 763 -3372 • Fax: (863) 763 -1686 CITY OF OKEECHOBEE, FLORIDA N2 19732 55 S.E. 3rd Avenue,,Okeechobee, FL 34972.2932 (863) 763.3372 20 04 RECEIVED from 7- 4 /A,1,6-14.-/ CLERK ice""1 NEWAM01 OP ID: MB ACC: RO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/17/2013 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: 863-467-0600 CONTACT ISU Lawrence Insurance Agency PHONE FAX PO Box 549 Fax: 863-467-5142 (A/C,No.Ext): (A/C,No): Okeechobee,FL 34973 E-MAIL Heath Lawrence ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Covington Specialty Ins Co INSURED New American Physical Therapy INSURER B: Aquatic&Fitness Center LLC 1204 N Parrott Ave INSURER C: Okeechobee, FL 34972 INSURER D: INSURER E: INSURER F: 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY VBA255120 07/29/2013 07/29/2014 PREMI E RENTED 100,000 PREMISES S((Ea occurrence) $ e 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 $ Included X POLICY PRO- JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) _ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED'? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 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) MEDICAL OFFICES CERTIFICATE HOLDER CANCELLATION CTYOKEE 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 S.E.3rd Avenue Okeechobee, FL 34974 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD ^-■1 NEWAM01 OP ID: MB AFRO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 07/31112 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 863-467-0600 NAME: O ISU Box 549 863-467-5142 Insurance Agency 863-467-5142 (A//C,No,Ext): (AFAX /C,No): Okeechobee,FL 34973 E-MAIL Heath Lawrence ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Century Surety Company INSURED New American Physical Therapy INSURER B: Aquatic &Fitness Center LLC Physical Internet Therapy PA INSURER C: 1204 N Parrott Ave INSURER D: Okeechobee, FL 34972 INSURER E: INSURER F: 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CPP779733 07/29/12 07/29/13 DAMAGE TORENrED 1,000,000 A X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY jECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 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) MEDICAL OFFICES CERTIFICATE HOLDER CANCELLATION CTYOKEE 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 S.E.3rd Avenue Okeechobee, FL 34974 AUTH O RIZED REPRESENTATIVE-I� % I ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 08/09/2011 TUE 11:11 ACC IRE) FAX 18634675141 Lawerence ins Agency CERTIFICATE OF LIABILITY INSURANCE toUl/UUl f DATE (MM/DD/YVYY) 08/09/11 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 POUCIES 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 poliey(ies) mUSt be endorsed. If SUBROGATION IS WAIVED, subject to the terms and condldons 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 Lawrence Insurance Agency, Inc. PO Box 549 Okeechobee, FL 34973 Phone (863) 467 -0600 Fax (863) 467 -5142 CONTACT NAME- PHONE O/C No Est)' E-MAIL ADDRESS: (863) 467 -0600 mar Iencarlawrcncoins.com IFAX (A/C. No): (863) 467 -5142 INSURER(S) AFFORDING COVERAGE INSURED Nesse Management LLC dba Aquatic & Fitness Center. Physical Therapy Internet PA, New American Physical Therapy 1204 N Parrott Ave Okeechobee FL 34972 COVERAGES INSURER A : INSURER B: INSURER C : INSURER D • INSURER E: INSURER F : NAIL American States Insurance Co 19704 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. TYPE OF INSURANCE ADD UBR POLICY EFF POLICY EXP LIMITS gyp POLICY NUMBER (MMIDD /YYYY) IMM/DDIYYYY) INSR GENERAL LIABILITY RI GENERAL LIABILITY I. -,.I CLAIMS -MADE 5 OCCUR II ri GEM_ AGGREGATE UMIT APPLIES PER POLICY LJ .78T- AUTOMOBILE LIABIUTY CI CI ANY AUTO ALL OWNED AUTOS HIRED AUTOS UMBRELLA LIAR EXCESS UAB ❑SCI- IE(K.LED AUTOS r ' NON•OWNED LJ AUTOS n II OCCUR 1 I CLAIMS -MADE ❑ DI;D 17.1 RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? r` (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below 01 013 9721 820 07/29/2011 07/29/2012 EACH OCCURRENCE $ 1.000,000.00 _ DAMAG£ TOR , U 1 �0 Q00 PREMISES (Fa ncnlrmncel $ MED EXP (Anyone person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG COMBINED SINGLE LIMIT (Ea aceidcntl BODILY INJURY (Pet person) BODILY INJURY (Pe, accident) P4OPER DAMAGE IPer erocci occident) ..., $ 10,000.00 s 1,000,000.00 8 2,000,000.00 s 2,000,000.00 $ 5 S E CACH OCCURRFNCE AGGREGATE ❑ TORY UAIMIT S F-1 FRH EL. CACH ACCIDENT t.L. DISEASE . CA EMPLOYE E.L. r fiEA.SE - POLICY LIMIT 5 $ DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (Attach ACORD 101. Additional Remarks Schedule. If mere space is required' CERTIFICATE HOLDER City of Okeechobee 55 SE 3rd Ave Okeechobee, FL 34974 1763 -1686 ACORD 25 (2010105) QF CANCELLATION 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 ®1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD■ CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 3/30/2010 PRODUCER (863)467 -0600 FAX: (863)467 -5142 Lawrence Insurance 2020 9 Parrott Ave PO Box 549 Okeechobee FL 34974 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 # INSURED MOHAMMAD NORUDDIN * *See attached 1103 N PARROTT AVE OKEECHOEIEE FL 34972 INSURER A: American Economy Ins Co 19690 INSURER B: INSURER C INSURER D 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 CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADM NSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMWDIYYYY) POLICY EXPIRATION IDD(VYI DATE (MM W LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY 02B918499670 4/2/2010 4/2/2011 EACH OCCURRENCE $ 1,000,000 X AMAGETO RENTED PREMISES (Ea occurrence) $ 1,000,000 CLAIMS MADE X OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJJRY $ 1,000,000 $ 2,000,000 GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER POLICY JERCT LOC PRODUCTS - COMP /OP AGG $ 2,000,000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) BODILY INJURY (Per accdent) $ PROPERTY DAMAGE (Per acadent) GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS 1 UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ AGGREGATE $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes. describe under SPECIAL PROVISIONS below WC STATU- 1 OTH- TORY LIMITS 1 ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES / EXCLUSIONS ADDED 8Y ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION (863)763 -1686 City of Okeechobee 55 SE 3rd Ave Okeechobee, FL 34974 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WLL 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 Heath Lawrence /MMB �— ACORD 25 (2009/01) INS025 (2009111) ®1998 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 04/18/2011 MON 13:03 FAX 18634675142 Lawerence Ins Agency ?001 /001 CERTIFICATE OF LIABILITY INSURANCE PATE (MM /DDIYYYY) 04/18/11 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(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 Ileu of such endorsements). PRODUCER CONTACT „NAME: MIC No EXt)• FAX . No): E -MAIL ADDRZss; PRobUcER SIISZOMER IDAS Lawrence insurance Agency, Inc, PO Box 549 Okeechobee, FL 34973 Phone (863) 467-0600 Fax (863) 467 -5142 INSURED Nassa Management LLC, Aquatic and Fitness Center Physical Therapy Internet PA, New American Physical Therapy 1204 N Parrott Ave Okeechobee, FL 34972 COVERAGES INSURER(S) AFFORDING COVERAGE INSURER A , American States insurance Co INSURER e; INSURER c ; INSURER D : INSURER E : NAIC 19704 INSURER F : CERTIFICATE NUMBER: REVISION NUMBER: THIS Is TO CERTIFY THAT THE POLICIES QF 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, POLICY EFF POLICY EXP TYPE OF INSURANCE IRLT15� POLICY NUMBER _(MMIDDIYYYYI (MM /DDIYYW) LIMITS C3ENERAL LIABILITY _EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY PRFM yE OlitM t0� 200,000 (Eta occurrence) ❑ ❑ CLAIM;; -MADE ❑ OCCUR MED EXP (Any one person) 3 10,000 PFR DNAL 5 ADV INJURY a 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,00D ❑ LOC 3 11 C3ENL AGGREGATE LIMIT APPLIES PER: W POLICY L{ JFO- AUTOMOBILE LIABILITY. Li ANY AUTO 01 0139721 81 0 07/29/2010 07/29/2011 ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON.OWNED AUTOS UMBRELLA LIAR EXCESS LIAR DEDUCTIBLE RETENTION T. WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEr� OFFICER/MEMBER EXCLUDED? IManoatory In NH) If yea, deberibe Linder DESCFIPTION OF OPERATIONS below I: OCCUR ❑ CLAIMS -MADE COMBINED SINGLE LIMIT (Ea accident) 20DILY INJURY (Por person) S BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) EACH OCCURRENCE AGGREGATE $ $ $ 9 9 9 9 ❑ TORY AMTS 1-1141- EL. EACI-I ACCIDENT E.L. DISEASE . EA EMPLOYE EL, DISEASE - POLICY LIMIT $ 3 $ DESCRIPTION OF OPERATIONS / LOCATIONs / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It more space Is required) CERTIFICATE HOLDER CANCELLATION City of Okeechobee 55 SE 3rd Ave Okeechobee, FL 34974 ACORD 26 (2009/09) QF 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 (01988.2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 03/11/2009 WED 10:42 FAX 18634675142 Lawerence Ins Agency Ej 001 /001 ACORD CERTIFICATE OF LIABILITY INSURANCE 3/11/200 PRODUCER (863) 467 -0600 FAX: (863) 467 -5142 Lawrence Insurance 2020 S Parrott Ave PO Box 549 Okeechobee FL 34974 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 if INSURED MOHAMMAD NORUDDIN 1103 N PARROTT AVE OKEECHOBEE FL 34972 INSURER A: American Economy Ins Co 19690 INSURER B Heath Lawrence /MMB INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOWHAVEBEEN ISSUED TOTHEINSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDINGANY REQUIREMENT, TERM OR CONDITION OF ANYCONTRACT OR OTHER DOCU MENT WITH RES PECTTO WH ICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POL CIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAYHAVE BEEN REDUCED BYPAIO CLAIMS. INSR LTR ADD'L INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDDIYY) POLICY EXPIRATION DATE (MMIDDIYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY 02BP18499660 4/2/2009 4/2/2010 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 1,000,000 MED EXP (Arty one person) $ 10,000 CLAIMS MADE X OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES 1 POLICY JECT PER LOC AUTOMOBILE LIABILITY 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 LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA OCCUR DEDUCTIBLE RETENTION LIABILITY $ CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICERIMEMBER EXCLUDED? If yes. describe under SPECIAL PROVISIONS below WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $ EL DISEASE - EA EMPLOYEE $ EL. DISEASE- POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION (863)763 -1686 City of Okeechobee 55 SE 3rd Ave Okeechobee, FL 34974 SHOULD ANY OF THE ABOVE EXPIRATION DATE THEREOF, 10 DAYS WRITTEN NOTICE DESCRIBED POLICIES BE CANCELLED BEFORE THE THE ISSUING INSURER WILL ENDEAVOR TO MAIL TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE FAILURE TO DO SO SHALL IMPOSE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE _ ,:•" ,... --- --=. Yp, Heath Lawrence /MMB ��.._' ��.�"— ACORD 25 (2001108) ® ACORD CORPORATION 1988 LIABILITY INSURANCE ACORD CERTIFICATE OF PRODUCER (863)467 -0600 Lawrence Insurance Agency, P. 0- Box 549 2020 5 Parrott Ave Okeechobee, FL 34913 -0549 DATE (MM/OD/YYYY) 05/12/2006 X 142 THIS CERTIFICATE 1S1SSUED AS A MATTER C' INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGI; 13, FORDED BY THE POLICIES BELOW. FAX (863)467-5 Inc INSURERS AFFORDING COVERAGE NAIC # INSUReD MOHAMMAD NORUDbIN DBA: NEW AMERICAN PHYSICAL THERAPY 1103 N PARROTT AVE OKEECHOBEE, FL 34972 INBURERA: American Economy Ins Co 19690 INSURER B: INSURER C: INSURER D: INSURER E: 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 LIMIT $ SHOWN MAY HAVt BtEN KtUUGED tlY h'AIU GLAIMS. )NSR LTR AD NSRI� TYPE OF INSURANCE .__ .�OLICXdiW�BER POLICY EFFECT DATE (MWDD)YY CV�EXPIIi%iYRSN DATE (MM/00/ LIMITS A X GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY ICLAIMS MADE 17L f OCCUR t ' 02BP18499630 04/02/2006 ' 1 4/027200 _J EACH OCCURRENCE $ 1.000. 001 ,r r, • e+ . .1 . PREMISES fEn ocardncd) $ 1,000,000 )( MED EXP Any one person) S 10,000 PGRRANAI A Af7V IN II IRY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG S 11 000 .0Q0 GEN'L AGGREGATE LIMIT APPLIES PER 7 POLICY � Te-, LOC AUTOMOBILE UABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS rnrteD AUTOS NON•OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per pcxson) �, BODILY INJURY (Per occident) �— PROPERTY DAMAGE (Per ecclaent) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ U I HLH I HAN GA ACC $ AUTO ONLY: AGO b EXCESS /UMBRELLA LIABILITY EACH OCCURRENCE $ IOCCUR ` CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ �r $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTfVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below TORY LIMITS L ER TORY I U- L ER E.L. EACH ACCIOCNY S E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT' $ CtMtR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLE'S / E (CLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION City of Okeechobee 55 SE 3rd Ave Okeechobee, FL 34974 CHflhIL n ANY OF TWF ARVIVF 11FS ;RIRED 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 MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRE5ENTAT1 5. AUTHORIZED REPRESENTATIVE Heath Lawrence ACORD 25 (2001108) FAX: (863) 763 -1686 I0 /I0 39dd ldNt79Ib3kJ M3N © ACORD CORPORATION 1988 6I99E9LE98 OT :DI 930Z/ST/S0