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AC "R"® CERTIFICATE OF LIABILITY INSURANCE DATE IMM/DDIY 07 / 16 / 20122 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 1 - 304 - 357 - 4520 CONTACT NAME : George H . Friedlander Co . PHONE FAX _LNC No) : PO Box 2466 E-MAIL ADDRESS : 1566 Kanawha Blvd . S . Charleston , WV 25329 INSURERS AFFORDING COVERAGENAICf! INSURER A : Travelers Property Casualty Company of INSURED INSURER B : Travelers Property Casualty Company ~ Ranger Construction Industries , Inc . Travelers Insurance INSURER C : _ PO Box 15065 INSURER D : West Palm Beach , FL 33416 - 5065 INSURERE : INSURER F : COVERAGES CERTIFICATE NUMBER : 28316110 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 , ADDIPOLICY EXP LTR TYPE OF INSURANCE INSR i W D POLICY NUMBER MM/DDY/YYYY) (MMIDD/YYYYI LIMITS A GENERAL LIABILITY CO - 5807B217 - 12 04 / 01 / 1 04 / 01 / 13 EACH OCCURRENCE $ 1 , 000 , 000 X DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $ 500 , 000 CLAIMS-MADEC�i OCCUR MED EXP (Any one person) $ 10 , 000 j X Contractual Liability PERSONAL BADV INJURY 'I $ 1 , 000 , 000 GENERAL AGGREGATE �� $ 2 , 000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2 , 000 , 000 POLICY X PRO LOC $ B AUTOMOBILE LIABILITY CAP - 58078186 - 12 1 1 1 COMBINED SINGLE LIMIT 180001000 Ea accidenl� ! $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) ,, $ AUTOS AUTOS IPROPERTY DAMAGE X NON-OWNED i HIRED AUTOS X AUTOS Per accident) $ A X UMBRELLALIAB - X OCCUR CDP - 5807B198 - 12 04 / 01 / 1 04 / 01 / 13 EACH OCCURRENCE $ 3 , 000 , 000 r EXCESS LIAB ICLAIMS-MADE ! r L AGGREGATE $ 3 , 000 , 000 DED RETENTION $ $ C WORKERS COMPENSATION DB - 6339B488 - 12 04 / 01 / 1 04 / 01 / 13 ' X ' �RYT MIT OTH- AND EMPLOYERS' LIABILITY Y / N B__ ANY PROPRIETOR/PARTNER/EXECUTIVE E� L. EACH ACCIDENT _$ 1 , 000 , 000 OFFICER/MEMBER EXCLUDED? N N / A ----- (Mandatory in NH ) If yes , describe under EA E . L. DISEASE - EA EMPLOYEE $ 1 , 000 , 000 F---- SEA DESCRIPTION OF OPERATIONS below E . L. DISEASE - POLICY LIMIT $ 1 , 000 , 000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES Attach ACORD 101 Additional Remarks Schedule if mores ace is required) Certificate Holder is an Additional Insured but only with respect to work conducted by the insured and at the specified project . Project : 27th Avenue Milling & Resurfacing , From Oslo Road to SR 20 ; Contract No . 2012029 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 ACCORDANCE WITH THE POLICY PROVISIONS, 1801 27th Street AUTHORIZED REPRESENTATIVE Vero Beach , FL 32960 - 3388 USA © 1988-2010 ACORD CORPORATION . All rights reserved . ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD klaplante 28316110