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ACcJR17® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/ODIYYYY) 08/18/15 THIS CERTIFICATE IS ISSUED ASA 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 certiflcate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certaln 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 Great Florida Insurance 4213 Bee Ridge Rd Sarasota, FL 34233 Phone (941) 378-1900 INSURED West Florida Maintenance Inc 253 Aloha Dr Palmetto. FL 34221 Fax (941)378-1922 (813) 843-0041 CONTACT NAME: PHONE (NC, No, Ext): E-MAIL ADDRESS. INSURER A _INSURER B : INSURER C 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 O_ F S_UCH_P_OLICIES. LIMITS SHOWN... MAY HAVE BEEN E_N R_ _EDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADOLSUBR' • POUCY EFF —POLICY EXP ' LIMITS LTR LINSR !MD, POLICY NUMBER_„LM _ ;_(MM/DPIYYYY)MIDPIYYYY).- : _ ___.__ ... _ .. GENERAL LIABILITY t EACH OCCURRENCE 3 1.000.000 00 IDAMAGE TO RENTED S 100,000.00 d COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) A CLAIMS -MADE d• OCCUR Y CIBFL0005632 MED EXP (Any one person) S 5.000.00 04/22/2015 04/22/2016 PERSONAL a ADV INJURY s 1,000,000 00 GENERAL AGGREGATE_ S 2,000,000.00 GEN?. AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S 2,000,000.00 S !(:- POLICY __JECT. _ '- lOC _, Victor Hernandez (941) 378-1900 g fivictor©comca st. n e t INSURERS) AFFORDING COVERAGE Lloyds of London FAX (NC, No): (941) 378-1922 NAIC 0 _ .7 COMBINED SINGLE LIMIT AUTOMOBILE LIABIUTY Aga accident) _ _ - 5 BODILY INJURY (Per person) S ANY AUTO -' - ALL OWNED SCHEDULED BODILY INJURY (Per accident) 5 AUTOS AUTOS PROPERTY OHMAGE 5 NO(Par accident) HIRED AUTOS AUTOS -OWNED 5 UMBRELLA LIAB OCCUR EACH OCCURRENCE 5 EXCESS LIAB CLAIMS -MADE AGGREGATE S UEU RETENTIONS • WORKERS COMPENSATION. AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes. describe under DESCRIPTION OF OPERATIONS below NIA DESCRIPTION OF OPERATIONS / LOCATIONS/VEHICLES (Attach ACORD 101. Additional Remarks Schedule, if more space is required) Painting - Interior & Exterior Blanket Additional Insured Endorsement Applies CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Indian River County Building Department 1807 27th Street Vero Beach, FL 32960 5 WC STATU- 01H• TORY LIMITS ER E.L. EACH ACCIDENT 3 E.L. DISEASE - EA EMPLOYEE S E L DISEASE • POLICY LIMIT S AUTHORIZED REPRESENTATIVE © 1988-2010 ACORD CORPORATION. All rights reserved ACORD 25 (2010/05) QF The ACORD name and logo are registered marks of ACORD