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From Tani Jacobson FaXID: STUINS- FAX01 Page 2 of 2 Date : 01 /17/ 11 11 : 32 AM Page : 2 of 2 AEOR CERTIFICATE OF LIABILITY INSURANCE OPID TJ LDATE (MM/DD/YYYY) THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER . T7S17 / 11 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 certcats holder Is aFMITIONAL INSURED, the policy(les) must be endorsed. , 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 NAME : Stuart Insurance , Inc , INC, No, Ext ) : (A/C. No ) : 3070 S W Mapp ADDRESS : Palm City FL 34990 cusTOMERIDs: TIMOR- 1 Phone : 772 - 286 - 4334 Fax : 772 - 286 - 9389 INSURER( S ) AFFORDING COVERAGE NAICs INSURED INSURER A : Harleysville Insurance Group 14168 Timothy Rose Contracting , Inc . INSURER B 1360 old Dixie Hwy SW INSURER C : Vero Beach FL 32952 INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER : 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 CONTRACTOR 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 LTR TYPE OF INSURANCE INSR Vii POLICY NUMBER (MM/DD/YYW) ( MM/DDlYYW) LIMBS GENERAL LIABILITY EACH OCCURRENCE $ 11000 , 000 A X COMMERCIAL GENERAL LIABILITY GL00000049465A 06 /06 /10 06 /06 /11 PREMISES ( Ea occurrence ) $ 100 , 000 CLAIMS-MADE F_X] OCCUR MED EXP (Any one person ) $ S1000 X Contractual Liab X PERSONAL 6 ADV INJURY $ 11000 , 000 X Incl XCU GENERAL AGGREGATE s2 , 000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER . PRODUCTS - COMP/OP AGG $ 21000 , 000 POLICYFX JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1 000 A X ANY AUTO BA00000049464A 06 /06 /10 06 /06 /11 ( Ea accident) r — r 000 BODILY INJURY ( Per person ) $ ALL OWNED ALTOS BODILY INJURY (Per accident ) $ SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS ( Per accident ) $ X NON- OWNED AUTOS $ $ A UMBRELLA UAB X OCCUR CM800000049462A 06 /06 / 10 06 /06 /11 EACH OCCURRENCE $ 31000 , 000 EXCESS LIAR CLAIMS-MADE AGGREGATE $ 31000 , 000 DEDUCTIBLE RETENTION $ $ RKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN TORY UMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH ) E L DISEASE - EA EMPLOYEE $ if yes . describe under DESCRIPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT $ A Contractors Equip Cl2MI676 06 /06 / 10 06 /06 /11 Rented 50 , 000 Equipment $ 1000 ded DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101 , Additional Remarks Schedule, N more apace is required ) Grading of Land/ Site Prep - State of Florida RE : Barrier Island Reuse Water System Improvements & SK510 Reuse Water SytemImprovements " Indian River Souncy Dept of Utility Services is additional insured with respect to general liability CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE IRCBD - 1 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Indian River County Dept of Utility Svcs AUTHORaZGDREPRESENTATTVE Purchasing Div 1801 27th St % Vero Beach FL 32960 @"088-2009ACdftTO_R17MATION . All rights reserved. ACORD 25 ( 2009109 ) The ACORD name and logo are registered marks of ACORD