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�� OP ID: WH ARD CERTIFICATE OF LIABILITY INSURANCE DA 11/01/12 ) 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 eeltificate holder In lieu of such endorsementls). PRODUCER 863-763-7711 Pritchards &Associates, Inc. 8 1802 S Parrott Ave Okeechobee, FL 34974-6179 Lowell H Pritchard INSURED Close Construction, LLC PO Box 2558 Okeechobee, FL 34973 rnvcReat=c CERTIFICATE NUMBER: NAME:y� Whitne Godwin eHONN F..�, 863-763-7711 FnAiXc. Nel: 863-763-5629 Owners Insurance 32700 Southern Owners 10190 Ins. !10701 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. /NSR LTR - TYPE OF INSURANCE SHOUt.D ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Indian River County 1800 27th Street POLICY NUMBER POLICY EFF MM/DD YYY POLICY EXP MM/DD/YYYY LIMITS _ B GENERAL LIABILITY. X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR X Contractual Liab �� 72637778 06H4112 06114/13 EACH OCCURRENCE S 1,000,00 PREMISES Ea occurrence E 100.00 MED EXP (Any one person) i S,OO PERSONAL b ADV INJURY E 1,000.00 GENERAL AGGREGATE E 2,000,00 J( XCU PRODUCTS - COMP/OP AGG S 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC S A AUTOMOBILE LIABILITY ANY AUTO ALLOWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 4457286400 06/74/12 06H4/13 COMBINED SINGLE LIMIT (Ea accident) S 1,000.00 X _ __ BODILY INJURY (Per person) E BODILY INJURY (Per accident) S PROPERTY DAMAGE (Per aaidenl) _ = E C X UMBREUA LUlB EXCESS LUtB X OCCUR CLAIMS -MADE 457288401 06114/12 06/14/13 EACH OCCURRENCE S 2,000,00 AGGREGATE S 2,000.00 S DEDUCTIBLE RETENTION E 1O OOO E X D WORKERS COMPENSATION ANDEMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUnVE Y � N OFFICER/MEMBER EXCLUDE09 ❑N (Mandatory In NH) If yea, describe under DESCRIPTION OF OPERATIONS below N / A 830-29982 04/01f12 04/01/13 X WC STATU- �' OTH- E.L. EACH ACCIDENT a 1,000,00 E.L. DISEASE - EA EMPLOYEE S 1,000,00 E.L. DISEASE -POLICY LIMIT S 1,000,00 g Equipment Floater 2637778 06N4112 06114/13 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AHach ACORD 101, Additional Remarks Schedule, if more space Is required) included as Additional Insured as required by written contract, but limited to the operations of the Insured under said contract, with respect to the General Liability and Auto.10 Days notice of Cancellation for Nonpayment of Premium CFRTI�ICATF Nnl /IFR CANCELLATION INDIA -3 SHOUt.D ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Indian River County 1800 27th Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Vero Beach, FL 32960 AUTHORIZED REPRESENTATIVE �� ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD