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2008-353
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2008-353
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Last modified
4/18/2016 10:55:54 AM
Creation date
10/1/2015 12:47:23 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
11/04/2008
Control Number
2008-353
Agenda Item Number
8.U.
Entity Name
Timothy Rose Contracting
Subject
Contract and Specifications 12th St. Sidewalk
Area
12th St. - 16th Ave. to 11th Place
Project Number
0216
Bid Number
2008081
Supplemental fields
SmeadsoftID
7689
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ACORD CERTIFICATE uF LIABILITY INSURANCE OP ID TJ DATE (MIryDDIYYYY) <br /> PRODUCER TIMOR- 1 11 06 / 08 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Stuart Insurance , Inc , ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 3070 S W Mapp HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> Palm City FL 34990 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW- <br /> Phone : 772 - 286 - 4334 Fax : 772 -286 - 9389 <br /> INSURED INSURERS AFFORDING COVERAGE NAIC # <br /> INSURER A: Harleysville Insurance Group <br /> Timothy Rose INSURER B: BridgeLield Employers Ins . Co . <br /> Contracting , Inc , <br /> & Haulin Trash Inc . INSURER C: <br /> 1360 Old Dixie Hwy SW <br /> Vero Beach FL 32912 INSURER D: <br /> COVERAGES 11 INSURER E: <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br /> ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES , AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> pl)'I,r — <br /> LTR NSRD TYPE OF INSURANCE POLICY NUMBER DATE TUCYTIFFECT1W <br /> DATE MM/DD LIMITS <br /> GENERAL LIABILITY <br /> EACH OCCURRENCE $ 110001000 <br /> A X COMMERCIAL GENERAL LIABILITY GL00000049465A 06 / 06 / 08 06 / 06 / 09 PREMISES (aaooccurence) $ 100 , 000 <br /> CLAIMS MADE F OCCUR MED EXP (Any one person) $ 5 , 000 <br /> — — PERSONAL 8 ADV INJURY $ 110001000 <br /> L--.J • 10 DAYS NOTICE NON-PAY GENERAL AGGREGATE $ 2 , 000 , 000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s 2 , 000 , 000 <br /> POLICY JECOT LOC <br /> AUTOMOBILE LIABILITY <br /> A I X ANY AUTOCOMBINED SINGLE LIMIT <br /> BA00000049464A 06 / 06 / 08 06 / 06 / 09 (Ea accident) $ 1 , 000 , 000 <br /> i ALL OWNED AUTOS <br /> r SCHEDULED AUTOS BODILY INJURY $ <br /> (Per person) <br /> HIRED AUTOS <br /> I X NON-OWNED AUTOSBODILY INJURY <br /> . $ <br /> 10 DAYS NOTICE NON-PAY (Per accident) <br /> PROPERTY DAMAGE <br /> (Per accident) $ <br /> GARAG;LIABILITY AUTO ONLY - EA ACCIDENT S <br /> ANOt—'-1I OTHER THAN EA ACC $ <br /> AUTO ONLY : AGG S <br /> EXCESRELLA LIABILITYEACH OCCURRENCE $ 3 , 000 , 000A j �� OCCLAIMS MADE CHB00000049462A 06 / 06 / 08 06 / 06 / 09 AGGREGATE s <br /> 3000 r 000 <br /> * 10 DAYS <br /> ii, <br /> DEDUCTIBLE NOTICE RETENTION $ NON PAY <br /> WORKERS COMPENSATION AND X TORY LIMITS ER <br /> B EMPLOYERS' LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE 08. 30 28562 02 / 01 / 08 02 / 01 / 09 E. L. EACH ACCIDENT $ 1000000 <br /> OFFICER/MEMBER EXCLUDED? <br /> If <br /> • 10 DAYS NOTICE NON-PAY E. L. DISEASE - EA EMPLOYEE $ 1000000 <br /> y <br /> SPes. describe under ECIAL PROVISIONS below E. L. DISEASE - POLICY LIMIT S 1000000 <br /> OTHER <br /> A CI241676 06 / 06 / 08 06 / 06 / 09 Rented 50 , 000 <br /> • 10 DAYS NOTICE NON-PAY Equipment 5 % DED <br /> DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br /> Grading of Land/ Site Prep - State of Florida RE : JOB 2008 - 081 / 12th Street SW <br /> ( 16th Ave to 11th Ave ) Indian River County is additional insured for <br /> general liability <br /> CERTIFICATE HOLDER CANCELLATION <br /> IRCBD — 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> Indian River County IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> 1801 27th St REPRESENTARtES, <br /> Vero Beach FL 32960 NORME=E3 E <br /> ACORD 25 (2001108) ® ACORD CORPORATION 1988 <br />
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