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® DATE (MM/DD/YYYY) AC� �. CERTIFICATE OF LIABILITY INSURANCE 01 /02/2013 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(ies) 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 CONTACT KAREN BEARD NE SURETY AGENCY, LLC A/C No Ext): 828=236-1000 aC No): 828-236- 1001 552-B NEW HAW CREEK ROAD ADDRESS: KAREN 110 BELLSOUTH . NET ASHEVILLE, NC 28505 INSURER(S) AFFORDING COVERAGE NAIC # 828-236-1000 FAX 828-236-1001 INSURER A: CHARTER OAK FIRE INS . CO. INSURED INSURER B: TRAVELERS INDEMNITY COMPANY DICKERSON FLORIDA, INC . INSURER C: TRAVELERS PROPERTY CAS . CO. OF AMERICA P . O . BOX 910 INSURER D: FT, PIERCE , FL 34954-0910 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 100067 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 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE IANSR SVWD POLICY NUMBER MM/LDD/YYEYYY MMIDDIYYYY LIMITS LTR B GENERAL LIABILITY X 8280B629 07/01 /201207/01 /2013 EACH OCCURRENCE $ 11000 , 000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea RENTED $ 300 , 000 CLAIMS-MADE OCCUR MED EXP (Any one person) $ 1 O 000 _ PERSONAL & ADV INJURY $ 11000 ,000 _ GENERAL AGGREGATE $ 21000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2 OOO 000 POLICY FX PROJECT F LOC $ C AUTOMOBILE LIABILITY 8280B630 07/01 /201207/01 /2013 (E COMBINED LE LIMIT $ 11000 , 000 X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident) $ AUTOS AUTOS ( ) X HIRED AUTOS X AUTOSWNED (Per ardent)DAMAGE $ C UNI BRELLALIAB X OCCUR ; 828OB654 07/01 /201207/01 /2013 EACH OCCURRENCE $ 3 , 0001000 EXCESS LIAR CLAIMS-MADE AGGREGATE $ 3 ,0001000 DED I RETENTION $ $ WORKERS COMPENSATION A AND EMPLOYERS' LIABILITY Y / N 828OB549 07/01 /2012 07/01 /2013 X TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDEN / A E. L. EACH ACCIDENT $ 500; 000 D? (Mandatory In NH) E. L. DISEASE - EA EMPLOYEE $ 500, 000 If yes, describe under DESCRIPTION OF OPERATIONS below E. L. DISEASE - POLICY LIMIT $ 500, 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) PROJECT : 66TH AVENUE ROADWAY IMPROVEMENTS (SR 60 TO NORTH 49TH STREET) INDIAN RIVER COUNTY IS ADDITIONAL INSURED WITH A THIRTY (30) DAY NOTICE OF CANCELLATION CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE INDIAN RIVER COUNTY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1801 27TH STREET ACCORDANCE WITH THE POLICY PROVISIONS. VERO BEACH , FL 32960-3388 AUTHORIZED REPRESENTATIVE I © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010/05) The ACORD name and logo are registered marks of ACORD