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From : Tani Jacobson FaxID: STUINS- FAX01 Page 2 of 2 Date: 02/10/11 12 : 40 PM Page : 2 of 2 CERTIFICATE OF LIABILITY INSURANCE OP ID TJ DATE (MM/DD/1'1'1'Y) If 02 / 10 / 11 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 po cy es must aen orsed. 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 NAME : PHONE Stuart Insurance , Inc . (A1C, No, Ext ): (A/C, No) : 3070 S W Mapp ADDRESS : Palm City FL 34990 CUSTOMERID # TIMOR- 1 Phone : 772 - 286 - 4334 Fax : 772 - 286 - 9389 INSURER(S) AFFORDING COVERAGE NAICt INSURED INSURER A : Harleysville Insurance Group 14168 Timothy Rose INSURER B Contracting , Inc , 1360 Old Dixie Hwy SW INSURER C Vero Beach FL 32962 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 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 LTR TYPE OF INSURANCE INSR WVO POLICY NUMBER (MM/DD/YYYY ) (MM/DD/YYYY LIMBS GENERAL LIABILITY EACH OCCURRENCE $ 110001000 A X COMMERCIAL GENERAL LIABILITY GL00000049465A 06 /06/10 06 /06 /11 PREMISES ( Ea occurrence ) $ 100 , 000 CLAIMS-MADE 7 OCCUR MED EXP (Any one person ) $ 5 , 000 X Contractual Liab X PERSONAL 8 ADV INJURY $ 1 , 000 , 000 X Incl XCU GENERAL AGGREGATE $ 2,., 000 , 000 GEN'LAGGREGATE LIMIT APPLIES PER . PRODUCTS - COMP/OPAGG $ 2 , 000 , 000 POLICYX jEa LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 11000 , 000 A X ANY AUTO BA00000049464A 06 /06 /10 06/06 /11 BODILY INJURY ( Per person ) $ ALL OWNED AUTOS BODILY INJURY ( Per accident) $ SCHEDULED AUTOS X HIRED AUTOS PROPERTY DAMAGE $ (Per accident) X NON-OWNED AUTOS $ A UMBRELLA LIAR X OCCUR CMB00000049462A 06 /06 /10 06 /06/11 EACH OCCURRENCE $ 31000 , 000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 31000 , 000 DEDUCTIBLE $ RETENTION $ $ AND EMPLOYERS' LIABILITY Y / N TORY LIMITS ER ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA E .L . EACH ACCIDENT $ (Mandatory In NH) If yes, describe under E. L. DISEASE - EA EMPLOYEE $ DESCRIPTION OF OPERATIONS below EL . DISEASE - POLICY LIMIT $ A Contractors Equip Cl2M1676 06 /06 /10 06/06 /11 Rented 50 , 000 Equipment $ 1000 ded DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (Attach ACORD 101 , Addftlonal Remarks Schedule, If more space Is recfulred ) Grading of Land/ Site Prep - State of Florida RE : Indian River County Sidewalk Improvements - 12th Street to 17th Street ) ^ Indian River County is additional insured * 30 days notice of cancellation 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 AUTHORIZED REPRESENTATIVE Board of County Commissioners _ 1800 27th St Vero Beach FL 32960 r) O 1988-2009 ACORD CORPORATION . All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD