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ACCIRO819 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 01 THIS CERTIFICATE IS ISSUED AS A MATTER OF / 2011INFORMATION 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 ), REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, AUTHORIZED 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 : Peggy Roaf Collinsworth , Alter , Lambert , Inc PHONE ( 561 ) 776 - 9001 23 Eganfuskee Street EMAIL JA/iC No : ( 561 ) 427 - 6730 ,e,OD�S : sroaf@calinc . com Suite 102 PRODUCERCUSTOMrR 00000904 Jupiter FL 33477 INSURED INSURER 5 AFFORDING COVERAGE NAIC # INSURER A :Ameri sure Insurance Co 19488 lNsuRER a : Libert Mutual Fire Insurance I Bill Bryant Associates Inc . INSURER C :Ameri sure Mutual Ins Co 1550 Old Dixie Highway 123396 INSURER D : Vero Beach FL 32960 INSURERS : i INSURER F COVERAGES CERTIFICATE NUMBER : 10 / 11 INCR LIMB 7048 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 I ADOL UBR I LTR TYPE OF INSURANCE I l POUCY NUMBER # MMIDD/YYYY MMID�NYYY LIMITS GENERAL LIABILITY ( ( EACH OCCURRENCE S 1 , 000400 X COMMERCIAL GENERAL LIABILITYAMA TO RE IrD PREMVjEjfEaoccurrence) $ 50400 A CLAIMSMADE FX7 OCCUR PL2019790 10 /24 / 201010 /24 / 2011 MED EXP (Any one person) S 51000 HF trop Darn XCD PERSONAL BADV INJURY s 11000 , 000 X Contractual I GENERAL AGGREGATE S 20 000 , 000 G_E_N'L AGGREGATE LIMIT APPLIES PER: PRO- i j PRODUCTS - COMPIOPAGG S 21000 , 000 I I POLICY I X jErT LOC ( f S AUTOMOBILE LIABILITY I , i COMBINED SINGLE LIMIT S1 , 000 , 000 i X l ANY AUTO I i ( Ea accident) `CA2009088 BODILY INJURY ( Per person) S A I ALLOWNEDAUTOS i 10 / 24 / 2010 10 / 24 / 2011 -� BODILY INJURY (Per accident) S X SCHEDULED AUTOS i I ! _ PROPERTY DAMAGE S HIRED AUTOS (Per accident) -- X ' NON•OWNEOAUTOS ! I I PIP•Basic S 100000 I Medical payments S 5 000 X UMBRELLA LIAB X OCCUR I 3rmbrelle, Extends Over I I ! EACH OCCURRENCE S 7 , 000 , 000 EXCESS LIAB CLAIMS-MADE All Coverage tI ---- I ! , AGGREGATE $ 710000000 DEDUCTIBLE I If $ B X I RETENTION S 0 TH2651290138010 f 0 / 13 / 201010 / 24 / 2011 $ A WORKERS COMPENSATION ` WC STATU- OTrI- ' AND EMPLOYERS' LIABILITY Y ! N X OZL' LIMITS AVY PROPRIETORIPARTNERIEXECUTIVE I FR ' OFFVCER/MEMBEREXCLUDED? ❑ NIA1 E .L. EACH ACCIDENT $ 1 000 OOO (Mandatory In NH) iC2004559 0 / 24 / 201010 / 24 / 2011 1' yes, describe under E.L. DISEASE - EA EMPLOYEE $ 1 000 000 DESCRIPTION OF OPERATIONS below I E .L. DISEASE - POLICY LIMIT S 1 f 0 00 1 000 C 11 Rented or Leased I PF2009087 0 / 24 / 201D 10 /24 / 2011 $25,000 EquipmentNEI Ded $ t ,aoo DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101 , Additional Remarks Schedule, if more space Is required) Indian River County Board of County Cormissioners is named as additional insured with respect to General Liability as required per written contract . 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 PROVISIONSo �? Board of County Commissioners T 1801 27th Street AUTHORIZED REPRESENTATIVE Vero Beach , FL 32960 MEN ACORD 25 ( 2009/09) i © 1988-2009 ACORD CORPORATION . AI rights reserved. INSD25 .;2oo9c9) The ACORD name and logo are registered marks of ACORD