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. CORD CERTIFICATE OF LIABILITY INSURANCE Tt Tt (,DD YYYYt
<br />863.688.S495 FAX $63 .688.4344 THIS OERTIFiCATE IS ISSUED AS A MATTER OF INFORiAATIC)I1 -
<br />Herndon & Associates Insurance, LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOCS NOT AMEND, EXTEND OR
<br />P 0 Box 3608 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />Lakeland, IL 33802
<br />INSURERS AFFORDING COVE -,RAGE NAIC III
<br />INSURED Tri -Sure Corporation NSu:rrtn FCCI
<br />P 0 Box 6S3 ;NxF;_lt:, Bridgefieid Employers Ins Co
<br />Auburndale, FL 33823 r,cL,REH
<br />' MlSUIilTt ?
<br />INSURLIi L
<br />COVERAM
<br />Eit- P.-)LI61cs OE INSURANCE LISTED ETELOVv HAVE BEEN IS',ULD TO THE INSURED NAMED A(10vC FOR THE POLICY 1`I7RI00 !NDICAY('D Vl�T:�.'ITHSTAi.DIA1G
<br />ANY REQUIREMENT. TERM OR CONDITIOI•. or ANY CO`ITRAC r OR OTHEP DOCUMENT'ViT,+ 17,7SPECT Tp M41i'FI'Tl+iS CCRTIFIC-1�TL I`JA RE CRUEL? OR
<br />MAY PCRI'AIN, THE INSURANCE At POW)ED m TILE PO (CIES DESCRIBED HEREIN i5 (ILi_rCT 10 41-L IEEE_ fl ;{115, t.AG1 l!SiC I`. AND (MNI)!I I(iN`- 0; SI H;-
<br />POLICIES AGGREGATE L ,TITS SHOWN AMY NAVE BEEN RELI(,CED BY PAID CLAIMS
<br />IriSR/�UD'4 POLICY EFF EC TIVU POLICY EXPIRATION
<br />LAR ENSRD _ TYPE OK INSURANCE POLICY NUMBER_-O-ArE,jMhLOD_YY YY' UAIE m 'P()1YYYYI.._.___,.
<br />i GENERAL. UA61LnY `----- PP
<br />C0004 89- 10/01/'QO$ 10/OI/LOOJ --1,000, 0010
<br />I - 'M1A.,L IC tit- N`L 100 (IOU
<br />S. -:LAqr,75 MA C)= X :;(,cur '.,LCL �r�A-,-:r„{..� ,..: S.00t0
<br />A
<br />GEN L AGGP!.GA I I I Mall APPI M S I'( R
<br />- PHO-
<br />-X — P�`L1CY .IECT (Ul
<br />= ;,,L.,. ; .c. Iv).,,:.
<br />Dl,tTii . COMP0- 0- A.!;G
<br />1,000,000
<br />2,000,000
<br />2,000,000
<br />_--__.-' _
<br />AUTOMOBILE LIABILITY CA00049S9 10/01/2008 10/01/2009
<br />rl11,C! r.ED SI'tGLE tl'JIT
<br />X ANY At TO
<br />r
<br />1,) ;; ;.rur!'
<br />1,000,000
<br />- - AL I OVdNr) AL -OS
<br />UcA:ll Y V j,'F',
<br />A 1 SCHERULTDA(:'US
<br />',;,,_r':..`";.
<br />IX IIIRED AU1p5
<br />IR1F:;1,
<br />' X NON-OANED AJ105
<br />rvr :r-;,•••'., .
<br />X'Hired & Phvsical
<br />I Damage
<br />4
<br />GARAGE LIABILITY
<br />AUT:, i'M Y rA ACC ff!:" S
<br />ANv .CJTO
<br />,rHEr, nwL,
<br />Or,t� ,MVV
<br />-
<br />EXCESS l UMBRELLA UABILIT% UMB00(12 S S 1 10/Q 1/2008 110/01/2009
<br />-At:l- r('c;.Rkt:,.rF s
<br />2,000,000
<br />! OL:CLH CLAMS MADG
<br />:.+--(t•t-".alh S
<br />2,000,00
<br />A I
<br />s
<br />! CL DLIC7ia LE
<br />j X +ttkltN:ioN g 1.0,000}
<br />- `---------
<br />------83039949 10/25/ 2008 10/2 5/Z009
<br />WORKERSCOMPENSATION
<br />X ,. -, i, 1.
<br />AND EMPLOYERS' LIA8i0TY YIN I
<br />ANS PRCI RIETORPARTNER'E*.ECUT1,'E' � � _'t
<br />B i—
<br />-r; tl
<br />S00, 00
<br />'4 111Ci i<,M! MRL 0 i AQ.UUiL'"�
<br />(Mandalory in Nhi
<br />r_ t u� LA,L
<br />500,000
<br />❑.as, ±ecce ue..:ce
<br />?;14 IAMI'Itt. ilC,�C'.te5 E„4.r.4 ��..._-----1---:.
<br />I" t lrs! A:,I ,`_ q n • , IIV ,
<br />----.--.�-__...------T---
<br />5Q0 (}Q0
<br />_
<br />OTHER --`-�--- —-CPP0004089 101011ZOOB 10/O1/ZO09I
<br />SZ50,000
<br />}tented/Leased
<br />I
<br />A Equipment
<br />OESCRjPTION OF OPERATIONS; LO:ATIONS I VEHICLES t EXCLUSIONS ADDED 13Y +.NUORSE VENT I SPECIAL PROViSfONS
<br />REF. Ifs" Reuse Water Hain Extension along Lateral G Canal & 16” Reuse Water
<br />Main - 57th
<br />Street, Did No# 2009046 -UCP #2.830 Indian River County Board of
<br />County Commissioners
<br />3 Masteller & Moler, Inc (Engineers) are fisted as additional insureds with
<br />respects to the General &
<br />kuto liability pol i0es. Waiver of subrogation applies in oil the Workers Compensation.
<br />`10 day notice of c.ancellat94_TL, WjL gr np�pALq n�9t
<br />CERTIFICATE HOLDER ----- _ L:ANL;LLLAIIVN
<br />51`+til)IUASI-(1FIN L A BOA :L'I L SCR14-tt, PVtlf,FS At CAI.;:f l LLE) Bit OR 11iE-LXP,rt A7 -JS
<br />qRl( TN9RFOF, THE i551hE,i_ iNSURER',VtI t40EA`,0R I ) VAIt SiI L,Av'7 s1R
<br />Indian River County NOT 10EIC) Ttit stRTiF,QATEItQLCfflNAMEDtOIiiELEtt HLITFAjLNt IOVO-?IstiA.tk
<br />i141%'USE SU GBt t;AT!QN UN L!AR'L 11Y OF AN', X.ND UPON Tti� •SSL'tTE H..T5 Ac.i N:7 OR
<br />Board of County Corrrrlissioners �
<br />1800 27th Street REt xL .LNT i!vF5
<br />Vero Reach, FL 32950 A1T„OR1"CtRIPRF�tn, AlttiE
<br />Marc Wilder i'R,ICIICt__
<br />_.._ 190.2009 A( ORL) Cf.)ERPORAt I04 All r ;111ts mse acct
<br />Tho ACORO n rup and logo ate m9i,s.twed inaii % OI ACORD
<br />
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