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wt IV1 1 1 <br /> AcoRo - CERTIFICATE OF LIABILITY INSURANCEDATE IMWDDIYYYY ) <br /> llkm� 1 06 /13/ 11 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER . THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND , EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER( S) , AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER . <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy (ies ) must be endorsed. If SUBROGATION IS WAIVED <br />, subject to <br /> the terms and conditions of the policy , certain policies may require an endorsement. A statement on this certificate does not confer <br /> rights to the <br /> certificate holder in lieu of such endorsement (s). <br /> CONTACT <br /> PRODUCER 888 -822- 1173 NAME: Terri Talley <br /> Hawkins 8 Rawlinson , Inc . a334-821 -5801 a334-821 -5800 cP . O. Box 3493 <br />- <br /> /cN : Nol: 334 -821 -5801 <br /> 2515 East Glenn Ave , Ste 101 EMAIL <br /> ADDRESS: ttalley@hrinsurance . com <br /> Auburn , AL 36831 -3493 PRODUCER <br /> Chuck Hawkins &USTOMFRID #: TAGGR - 1 <br /> INSURER(S) AFFORDING COVERAGE NAIL k <br /> INSURED TAG Grinding Services , Inc. INSURER A : Companion Property & Casualty 12157 <br /> JWB Leasing Co. , Inc . INSURER B : <br /> 1113 Horseshoe Bend Road <br /> INSURER C : <br /> Dadeville, AL 36853 <br /> INSURER O : <br /> INSURER E : <br /> INSURER F : <br /> COVERAGES CERTIFICATE NUMBER : REVISION NUMBER : <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY <br />PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE <br /> TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS . <br /> INSR I ADDTYPE OF INSURANCE L POLICY NUMBER SUSH MWDDYYYY MUCY EFF M <br /> LICY EXP <br /> TR /DO/YYYY LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> MA <br /> COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ <br /> CLAIMS-MAOE OCCUR MEO EXP (Any one person) $ <br /> PERSONAL & ACV INJURY $ <br /> GENERAL AGGREGATE S <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG S <br /> POLICY PRO LOC $ <br /> AUTOMOBILE LIABILITY COMBINEO SINGLE LIMIT S <br /> ( Ea accident) <br /> ANY AUTO <br /> BOOILY INJURY (Per person) S <br /> ALL OWNEO AUTOS <br /> SOOILY INJURY (Per accident ) S <br /> SCHEOULEO AUTOS <br /> PROPERTY OHMAGE S <br /> HIREOAUTOS ( Per accident) <br /> NON-OWNEO AUTOS $ <br /> S <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE S <br /> EXCESS LIAR ClAIMS-MAOE AGGREGATE $ <br /> OEOUCTIBLE S <br /> RETENTION S $ <br /> WORKERS COMPENSATION X WCTATU- OTH - <br /> AND EMPLOYERS' LIABILITY T SIT R <br /> A ANY PROPRIETORiPARTNER/EXECUTIVE YIN N / A WC3613878 01 01 07/27/10 07/27/11 E. L. EACH ACCIDENT S 17000, 00 <br /> OFFICER/MEMBER EXCLUOEO? El <br /> (Mandatory in NH ) E. L. OISEASE - EA EMPLOYEE $ 1 , 000100 <br /> It yes, describe under <br /> DESCRIPTION OF OPERATIONS below E. L. (DISEASE - POLICY LIMIT I S 11000100a <br /> DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Anaeh ACORD 101 , Additional Remarks Schedule, If more space Is required) <br /> Grinding I Covered states are Georgia , Alabama , Texas and Florida <br /> I <br /> CERTIFICATE HOLDER CANCELLATION <br /> INDVE02 <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Indian River County Board ACCORDANCE WITH THE POLICY PROVISIONS. <br /> of Commissioners <br /> AUTHORIZED REPRESENTATIVE <br /> 1800 27th Street <br /> Vero Beach, FL 32960 <br /> © 1988-2009 ACORD CORPORATION . All rights reserved . <br /> ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD <br />