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,eco CERTIFICATE OF LIABILITY INSURANCE D 02 / 116/206/20 YYYY) 0212 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 NAME : Mark van Wert PHONE MAIL TFAX c/o Willis of Florida , Inc . (866) 293- 3600 Ext . 623 A/c No : ( 888) 225 -4049 E- 3000 Bayport Drive , Suite 300 ADDRESS :_ Tampa , FL 33607 _ INSURER(S) AFFORDING COVERAGE __ NAIC # INSURERA : American Zurich Insurance Company 40142 INSURED INSURER B Workforce Business Services . Inc . Alt . Emp : Mancils Tractor Services Inc INSURERC : 1401 Manatee Ave . West Ste 600 -- --- —_ - Bradenton , FL 34205- 6708 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER : 11FL079807825 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 INSURANCEIADDLISUBRI POLICY EFF POLICY EXP LTR I INSR WVD 1 POLICY NUMBER MMIDO/YYW 1 (MM/DDfYYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO ATN7 PREMISES Ea occurrence $ ; CLAIMS -MADE i�� OCCUR MED EXP (Any one person) $ PERSONAL 8 ADV INJURY ll $ r— GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER . PRODUCTS - COMP/OP AGG $ MPOLICY 71 PRO - LOC j $ AUTOMOBILE LIABILITY COMBINED IN LIMI Ea accident) $ i 1_ ANY AUTO BODILY INJURY ( Per person) $ I ALL OWNED SCHEDULED AUTOS AUTOS ! BODILY INJURY ( Per accident) $ I I' NON-OWNED ! PROPERTY DAMA HIRED AUTOS GE AUTOS ! Per accident $ S , UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS - MADE AGGREGATE 5 DED RETENTIONS $ WORKERS COMPENSATIONX 1 WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N Y I IT ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $ 11000 , 000 A OFFICER/MEMBER EXCLUDED? ❑ N / A I WC 90.00-81 &01 12/31 /2011 12/31 /2012 L . ( Mandatory in NH ) I E L DISEASE - EA EMPLOYEE $ 11000 , 000 If yes describe under DESCRIPTION OF OPERATIONS below E DISEASE - POLICY LIMIT S 11000 , 000 Qualifier : Don Mancil Jr Location Coverage Period : 12/31 /2011 12/31 /20121 Client# 051157 II DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101 , Additional Remarks Schedule, if more space is required ) Mancils Tractor Services Inc Coverage is provided for 4551 SE Hampton Ct only those employees Stuart , FL 34997 leased to but not subcontractors of. CERTIFICATE HOLDER CANCELLATION Indian River County Building Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1801 27th Street THE EXPIRATION DATE THEREOF , NOTICE WILL BE DELIVERED IN Vero Beach , FL 32960 ACCORDANCE WITH THE POLICY PROVISIONS , AUTHORIZED REPRESENTATIVE /nx U0� /I - © 1988 -2010 ACORD CORPORATION . All rights reserved .