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From:Tani Jacobson FaAD:STUINS-FAX01 Page 2 of 2 Date: 11128/2012 11 :28 AM Page:2 of 2 OP We TJ CERTIFICATE OF LIABILITY INSURANCE °"' 111261 11 /Z812 12 THIS CERTIFICATE 18 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(les) must be endorsed, If SUBROGATION 18 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 endorsements , PRODUCER 772-28&{.4NAME: Stuart Insurance, Inc. 772.286-9389 PHONE FAX 3070 S W Mapp Arc No Palm City, FL 34990 ADDRESe : Rick Halcomb, CIC, ARM cusroMER ID at: TiMORA MSU AFFORDING COVERAGE NAIC 1 INSURED Timothy Rose MSURERA : WeWeld Insurance 24112 Contracting, Inc. INSURER B : 1360 Old Dixie Hwy SW Vero Beach, FL 32962 INSURER C : INSURER 0 : INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER : IREVISION 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 POLICY NUMBER MIDD1YYYYI (MMIOOrYYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE __ $ 1 ,000, 00 A X COMMERCIAL GENERAL LIABILITY X CMM6079889 06/06M2 06/06/13 PREMISES Ea occurrence $ 10010 CLAIMS•MADE aOCCUR MED EXP Anyone person) $ 5100 X Contractual Liab PERSONAL & ADV INJURY S 11000,00 X Incl XCU GENERAL AGGREGATE $ 2,000, 00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2, 000, 00 POLICY X PR0. LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1 , 000,00 A X ANY AUTO CMM6079M 06106M2 06106/13 (Ee ecadenq BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (Per accident) S X NON-OWNEDAUTOS S $ UMBRELLA LIAR I X OCCUR EACH OCCURRENCE $ 31000900 A EXCESSLIAS rl CLAIMS-MADE MMOO798590610eri2 06106113AGGREGATE $ 30000.0 00 DEDUCTIBLE $4 — RETENTION S $ WORKERS COMPENSATION WCORYSTALIMTU- OTH- AND EMPLOYERS' LIABILITY EPL ANY PROPRIETORIPARTNERVECUTIVE Y I❑N NIA E.L. EACH ACCIDENT E OFFICERIMEMBER EXCLUDED? (Mandatory in E.L. DISEASE - EA EMPLOYEES It Yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S A rontractors Equip I MM6079m 06106M2 06/06113 Rented 50,00 Equipment $1000 ded DESCRPTION OF OPERATIONS I LOCATIONS I VE14CLES (Akach ACORD 1010 Additional Remarks Schedule, It more apace IS required) ading_ of Land/Site Prep - State of Florida RE : Old Dixie Hwy Sidewalks from 8th St to SR 60 . Indian River County is additional insured for general liability CERTIFICATE HOLDER CANCELLATION IRCOUBL SHOULD ANY OF THE ABOVE DESCRIBED POLL BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY.PROVISIONS. Indian River County 1800 27th Street F AurHCRIZEDREPRESENTATIVE Vero Beach , FL 32960 _ ® 198(8-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of"ACORD