The URL can be used to link to this page

Home My Public Portal AboutCertificates of InsuranceF.] New ❑ Renewal ❑ Rewrite ❑ X -Ref. NS 056170 Policy Number COMMERCIAL LINES PULIUY 1_ V , , , ��t COMMON POLICY DECLARATIONS NAUTILUS INSURANCE COMPANY Scottsdale, Arizona Named Insured and Mailing Address (No., Street, Town or City, County, State, Zip Code) KEY BISCAYNE CHAMBER OF COMMERCE 328 CRANDON BOULEVARD #217 KEY BISCAYNE, F1. 33149 Agent and Mailing Address Agency No. 0922 - (No., Street, Town or City, County, State, Zip Code) GABOR INSURANCE SERVICES, INC. P.O. BOX 524237 MIAMI, FL. 33152-4237 Policy Period: From 05/11/97 to at your mailing address shown above. ts) Policy No. NS :.' THIS INSURANCE IS ISSUED PURSUANT TO THE FLORIDA SURPLUS LINES LAW. PERSONS INSURED BY SURPLUS LINES CARRIERS DO NOI HAVE THE PROTECTION OF THE FLORIDA INSURANCE GUARANTY ACT TO THE EXTENT OF ANY RIGHT OF RECOVERY FOR THE OBLIGATION OF AN INSOLVENT UNLICENSED INSURER 05/11/98 at 12:01 A.M. Standard Time Business Description: OFFICE FOR KEY BISCAYNE CHAMBER OF COMMERCE Tax State FL IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE STATED IN THIS POLICY. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED. THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT. ';',ALD STEVEN GABOR Commercial Property Coverage Part ,A1 79tt. AVENUE >UITE 119 Commercial General Liability Coverage Part':AMI, FLORIDA 33166 Tax & Fee Schedule Policy Fee State Tax DOR Surcharge -;URPLUS ? IE ES AGENT f ''T MORTON D. WEINER i1oBrON D. MIAMI Fr - - $ 25.00 52.15 4.00 PREMIUM $ 500.00 $ 518.00 $ TOTAL ADVANCE PREMIUM $ 1,018.00 TOTAL TAXES & FEES $ 81.15 TOTAL $ 1,099.15 Form(s) and Endorsement(s) made a part of this policy at time of issue*: S944J(05/95), S 492(08/95), S 150 (02/95). *Omits applicable Forms and Endorsements if shown in specific Coverage Part/Coverage Form Declarations. Countersigned: Miami Fl. By GABOR INSURANCE SERVICES, INC. ) 05/27 /97me Authorized Representative THESE DECLARATIONS TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE PART DECLARATIONS, COVERAGE PART COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS, IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY r„aterial of Insurance Seances Office, Inc with its permission Copyright, Insurance Services Office, Inc , 1983, 1984 NAUTILUS INSURANCE COMPANY COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS POLICY NUMBER: NS 068216 Effective Date: 05/11/91 12:01 A.M. Standard Time LIMITS OF INSURANCE General Aggregate Limit (Other Than Products/Completed Operations) $ 600,000. Products/Completed Operations Aggregate Limit $ Excluded Personal and Advertising Injury Limit $ 300,000. Each Occurrence Limit $ 300,000. Fire Damage Limit $ 50.000. Any One Fire Medical Expense Limit $ 1,000. Any One Person Aggregate limits for classifications stating "Including Products/Completed Operations" are included within the General Aggregate Limit BUSINESS DESCRIPTION AND LOCATION OF PREMISES (other than Partnership or Joint Venture) FORM OF BUSINESS: • Individual • Joint Venture • Partnership ■ Organization BUSINESS DESCRIPTION:Office for Key Biscayne Chamber of Commerce LOCATION OF ALL PREMISES YOU OWN, RENT, OR OCCUPY: 328 Crandon Blvd. #217, Key Biscayne, Dade COunty, Fl. 33149 LOCATION OF JOB SITE (If Designated Projects are to be Scheduled): PREMIUM RATE ADVANCE CODE # - CLASSIFICATION * BASE PR/CO All Other PREMIUM # 61226 - Building or Premises a)750 Incl. 529.404 397.00 Office -Other than Not - For -Profit 41669 Club Civic Service/Social t) 90 Incl. 1.342 121.00 #. _ No building or premises owned or leased except for office purposes other Than - Not -For -Profit. # - # - * PREMIUM BASE SYMBOLS a = Area (per 1,000 square feet of area) c = Total Cost (per 81,000 Total Cost) m = Admissions (per 1,000 Admissions) p = Payroll (per $1,000 of Payroll) s = Gross Sales (per $1,000 Gross Sales) t = See Classification u = Units (per unit) PREMIUM FOR THIS COVERAGE PART $ 518.00 FORMS AND ENDORSEMENTS (other than applicable Forms and Endorsements shown elsewhere in the policy) Forms and Endorsements applying to this Coverage Part and made part of this policy at time of issue: S 022(02/95), S 013(02/95), CG 2116(11/85),CG 0001(01/96),S 001(02/95),S 051(02/95), S 007(08/95),S 033(01/92), S 066(01/92). r. 1,M. AIDATIrIMC ARP PART fF THE POLICY DECLARATIONS CONTAINING THE NAME OF THE INSURED AND THE POLICY PERIOD NAUTILUS INSURANCE COMPANY COMMERCIAL PROPERTY COVERAGE PART DECLARATIONS POLICY NUMBER: NS -68216 ❑ Supplemental Declarations is attached. Effective Date: 05/11/97 12:01 A.M. Standard Time BUSINESS DESCRIPTION ' DESCRIPTION OF PREMISES PREMISE # BLDG. # CONST CLASS # LOCATION 1 1 328 Crandon Boulevard#217, Key Biscayne, Dade County, Fl. 33149 On a Two Story, Masonry Non Combustible Building, occupied as an office for Key Biscayne Chamber of Commerce. COVERAGES PROVIDED (INSURANCE AT THE DESCRIBED PREMISES APPUES ONLY FOR COVERAGES FOR WHICH A UMIT OF INSURANCE IS SHOWN) PREMISE # BLDG # COVERAGE - Bldg, Cts, Other UMIT OF INSURANCE COVERED CAI LcFC OF LOSS • COINSUR % RATES 1 1 Contents $10,000. Special X Theft 90Z 1.00 X -Wind • IF EXTRA EXPENSE COVERAGE, UMITS ON LOSS PAYMENT OPTIONAL COVERAGES (APPLICABLE ONLY WHEN ENTRIES ARE MADE IN THE SCHEDULE BELOW) PREMISE # BLDG.# AGREED VALUE COVERAGE AMOUNT REPLACEMENT COSTQQ EXPIRATION DATE BUILDING PERSONAL PROPERTY INCLUDING 'STOCK" INFLATION GUARD (Percentage) •' MONTHLY UMIT OF '• MAXIMUM PERIOD •• EXTENDED PERIOD PREMISE # BLDG. # BUILDING PERSONAL PROPERTY INDEMNITY (Fraction) OF INDEMNITY QQ OF INDEMNITY (Days) •• APPLIES TO BUSINESS INCOME ONLY MORTGAGE HOLDER (s) PREMISE # BLDG. # MORTGAGE HOLDER NAME AND MAIUNG ADDRESS DEDUCTIBLE $ 1,000.00 Exceptions: PREMIUM FOR THIS COVERAGE PART $ 500.00 FORMS AND ENDORSEMENTS (other than applicable Forms and Endorsements shown elsewhere In the policy) Forms and Endorsements applying to this Coverage Part and made part of this policy at time of issue: APPUCABLE TO ALI. COVERAGES. CP 0010(06/95),CP0090(07/88),CP1030(06/95),S 400(02/95),S 403(01/92),S 020(02/95), CP 1033(06/95), Cp1054(06/95). APPUCABLE TO SPECIFIC PREMISES/COVERAGES; PREMISE # BLDG. # COVERAGES FORM NUMBERS -..� .r ,oATvnnie ACM PART nF TI-IP PCN ICY DECLARATIONS CONTAINING THE NAME OF THE INSURED AND THE POLICY PERIOD POLICY NUMBER:NS 068216 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EXCLUSION DESIGNATED PROFESSIONAL SERVICES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Description of Professional Services: 1. CHAMBER OF COMMERCE 2. 3. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) With respect to any professional services shown in the Schedule, this insurance does not apply to "bodily injury;' "property damage;' "personal injury" or "advertising injury" due to the rendering or failure to render any professional service. CG 21 16 11 85 Copyright, Insurance Services Office, Inc., 1984 0 IVHU 11LUJ IIVJUIVAIVIiC lrUMrAIVY POLICY NUMBER: COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DEDUCTIBLE LIABILITY INSURANCE (Including Costs and Expenses) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Coverage Bodily Injury Liability (including Costs and Expenses) Property Damage Liability (including Costs and Expenses) Amount of Deductible $ 500.00 per claim $ 500.00 per claim APPLICATION OF ENDORSEMENT (Enter below any limitations on the, application of this endorsement. If no limitation is entered, the deductibles apply to damages for all "bodily injury" and "property damage", however caused): 1. Our obligation under the Bodily Injury Liability and Property Damage Liability Coverages to pay damages on your behalf applies only to the amount of damages in excess of any deductible amounts stated in the schedule as applicable to such coverages, and the limits of insurance applicable to each "occurrence" for such coverages will be reduced by the amount of such deductible. "Aggregate" limits for such coverages shall not be reduced by the application of such deductible. 2. The deductible amounts stated are on a PER CLAIM BASIS the deductible amount applies: a. Under the Bodily Injury Liability, to all damages because of "bodily injury" sustained by one person; or b. Under the Property Damage Liability, to all damages because of "property damage" sustained by one person or organization; as a result of any one "occurrence". 3. The deductible amount shown in the Schedule applies toward investigation, adjustment and legal expenses incurred in the handling and investigation of each claim, whether or nut payment is made to claimant, compromise settlement is reached or claim is denied. 4. The terms of this insurance, including those with respect to: a. Our right and duty to defend "suits" seeking those damages; and b. Your duties in the event of an "occurrence", claim or "suit", apply irrespective of the application of the deductible amount. 5. We may at our sole election and option, either: a. Pay any part or all of the deductible amount to effect settlement of any claim or "suit" and upon notification of the action taken, you shall promptly reimburse us for such part of the deductible amount as has been paid by us; or b. Upon our receipt of notice of any claim or at any time thereafter, feguest you to pay over and deposit with us all or any part of the deductible amount, to be held and applies per the terms of this policy. All other Terms and Conditions of this Policy remain unchanged. S 022 (02/95) NAUTILUS INSURANCE COMPANY POLICY NUMBER: COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. MINIMUM EARNED PREMIUM ENDORSEMENT If this insurance is cancelled at your request, there will be a minimum earned premium retained by us of $ 255.00 whichever is greater. or 25 % of the premium for this insurance, All other Terms and Conditions of this Policy remain unchanged. S 013 (02/95) ACORD CERTIFICATE OF LIABILITY INSURANCE CSR EB KEYBI-2 DATE (MMIDDIYY) 11/06/01 PRODUCER MORTON D. WEINER/AMPAC CORAL GABLES 362 MINORCA AVENUE CORAL GABLES FL 33134 Phone: 305-444-2324 Fax:305-444-4980 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 INSURED Key Biscayne Chamber Commerce Mr. Bob Brookes 328 Crandon Blvd. #217 Key Biscayne FL 33149 INSURER A Nautilus Insurance Company 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 LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMR)DIYY) POLICY EXPIRATION DATE (MMIDDIYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABIUTY NS082083 05/11/01 05/11/02 EACH OCCURRENCE $1,000,000 FIRE DAMAGE (Any one foe) s 50,000 CLAIMS MADE Z OCCUR MED EXP (Ann, one person) $ 1,000 GEN'L PERSONAL BADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 AGGREGATE UMR APPUES PER POLICY �� PE T LOC PRODUCTS - COMP/OP AGG $ Included AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS COMBINED SINGLE LIMP' (Ea accttlent) $ BODILY INJURY (Per person) $ BODILY INJURY per acc,OefH) $ PROPERTY DAMAGE (Per acutleM) $ GARAGE LIABILITY ANY AUTO AUTO ONLY EA ACCIDENT $ EA ACC OTHER THAN $ AUTO ONLY AGG 5 EXCESS LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION 5 EACH OCCURRENCE $ AGGREGATE $ 5 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC STATU- OTH- TORY LIMITS ER E L EACH ACCIDENT $ E L DISEASE - EA EMPLOYEE $ E L DISEASE POLICY UMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Certificate holder is landlord CERTIFICATE HOLDER 1 N ADDITIONAL INSURED, INSURER LETTER: CANCELLATION VILLAGE THE VILLAGE OF KEY BISCAYNE C. Samuel Kissinger, Village Manager 85 McIntyre Street Key Biscayne FL 33149 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 50 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES ACORD 25-S (7197) C • ■ ' PORATION 1988