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10��•'a'1 OP ID: WH A��..,oRow CERTIFICATE OF LIABILITY INSURANCE DAT11/01D/YYYY) 11/01/12 THIS CERTIFICATE, IS ISSUED ASA 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 PRODUCER 863-763-7711 Pritchards & Associates, Inc. Bi 1802 S Parrott Ave Okeechobee, FL 349744179 Lowell H Pritchard INSURED Close Construction, LLC PO Box 2558 Okeechobee, FL 34973 COVERAGES CERTIFICATE NUMBER: 863-763-5629 CLOSE -3 INSURER A : OWnerB InsuranC@ 32700 INSURER 8: Southern Owners 10190 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 LTR TYPE OF INSURANCE ADOL SUB POLICY NUMBER POLICY MM DDIYYYY POLICY EXP MM DD/YYYY LIMITS B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X Contractual Llab AUTHORIZED REPRESENTATIVE 72637778 06/14/12 06/14/13 EACH OCCURRENCE $ 11000,00 DAMAGE TO RENTED� PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 51000 PERSONAL & ADV INJURY $ 110001000 X XCU GENERAL AGGREGATE $ 21000900 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY F7 J`ERCOT F7 LOC PRODUCTS - COMP/OP AGG $ 2,000100 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 4457286400 06/14/12 06/14/13 COa BI dEDt) SINGLE LIMIT $ 1/000100 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ $ C X UMBRELLA LIAB EXCESS LU1B X OCCUR CLAIMS -MADE 4457286401 06114112 06114113 EACH OCCURRENCE $ 2,000A0 AGGREGATE $ 2,000,00 RETENTION $ 10,000 $ XdDEDUCTIBLE $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDEI ❑N (Mandatory In NH) It yes, describe under DESCRIPTION OF OPERATIONS below N I A 830499$2 04/01/12 04/01/13 X WC STATU- I TORY I IMM OTH- ER E.L. EACH ACCIDENT $ 11000900 E.L. DISEASE - EA EMPLOYEEI $ 19000,00 E.L. DISEASE - POLICY LIMIT $ 11000100 B JEquipment Floater r2637778 06/14/12 1 06/14/13 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace 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 CERTIFICATE NOI nFR CANCELLATION INDIA -3 ©1988-2009 ACORD CORPORATION. All rights reserv SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Indian River County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1800 27th Street ACCORDANCE WITH THE POLICY PROVISIONS, Vero Beach, FL 32960 AUTHORIZED REPRESENTATIVE czalw i ed. ACORD 25 (2009109), The ACORD name and logo are registered marks of ACORD