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® CERTIFICATE OF LIABILITY INSURANCE [ 11712013Dkism� ATE '°°"""' ACORO 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 lieu of such endorsement (s). PRODUCER AME; Paaav Broughton Bowen , Miclette & Britt of Florida LLC PHONE FAX AIC No 400 High Point Drive Suite 200 .MAIL Cocoa FL 32926 INSURERS AFFORDING COVERAGE NAIC t INSURER A INSURED BARTHCONST INSURER B Amerisure Insurance Company 19488 Barth Construction III, Inc. INSURER C Barth Construction , Inc. INSURER D 1717 Indian River Blvd #202 Vero Beach FL 32960 INSURERE : INSURER F COVERAGES CERTIFICATE NUMBER: 1248966015 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 POLICY NUMBER MMDD EFF MMIDOIIYYYY LIMITS Y EXPL A GENERAL LIABILITY GL2018953 30/2012 /30/2013 EACH OCCURRENCE 570000.000 DAMAGE TO RENTEU� X COMMERCIAL GENERAL LIABILITY PREMISES IEa rrence $ 100.000 CLAIMS-MADE a OCCUR MED EXP (Any oneperson) $51000 PERSONAL & ADV INJURY $ 110001000 GENERAL AGGREGATE $2.000.000 GEN•L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $2.000.000 POLICY PRO X LOC S B AUTOMOBILE LIABILITY CA2018949 /3012012 130/2013 Es accident 1 *0000000 ANY AUTO BODILY INJURY (Per person) S ALL OWNED SSCCHHEEDDULED BODILY INJURY (Per accident) S AUTOS AUT NON-OWNEO PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS (Per accidenIt S ' A X UMBRELLA LIAB X OCCUR CU2018955 313012012 /30/2013 EACH OCCURRENCE $41000.000 EXCESS UAB CLAIMS-MADE AGGREGATE 546000,000 DED I X I RETENTION E0 1 $ B WORKERS COMPENSATION 02018960 13012012 /30/2013 X NIC sLATULIMITS 0ETHv R AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE Q NIA E.L. EACH ACCIDENT $5000000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E . L. DISEASE - EA EMPLOYE $500.000 If yes, describe under DESCRIPTION OF OPERATIONS below E . L. DISEASE • POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS ! LOCATIONS I VEHICLES (Attaeh ACORD 101 , Additional Remarks Schedule, if more space Is required) Re : South County Park Multi Purpose Fields . When required by written contract, those Parties listed in said contract, including the certificate holder, are added as an Additional Insured with respects to General Liability as afforded by the policy and/or endorsements . CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Indian River County ACCORDANCE WITH THE POLICY PROVISIONS. 1800 27th Street Vero Beach FL 32960 AUTHORIZED REPRESENTATIVE © 1988-2010 ACORD CORPORATION . All rights reserved . ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE