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ACORO® CERTIFICATE OF LIABILITY INSURANCE �..------- DAT) 12/15/2015 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 policy(ies) must be endorsed. 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 SUNZ Insurance Solutions, LLC ID (Essential) c/o Essential HR, Inc dba First Star HR 4455 LBJ Freeway, Suite 1080 Dallas, TX 75244 CONTACT Jennifer Hauger PHONE FAX IA/C, No.Extl: 972-404-0295 (A/C, No): IL ADDRESS. Ienniferhauger@firststarhr.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A . SUNZ Insurance Company INSURER a : Aspen Re - London - Best Rating "A" 34762 INSURED Essential HR Inc FirstStar HR 4455 LBJ Freeway Suite 1 080 Dallas TX 75244 INSURER c : Catlin Syndicate - Lloyds - Best Rating "A" INSURER D . Brit Syndicate - Lloyds - Best Rating "A" 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. INSR LTRINSD TYPE OF INSURANCE ADDL SUBR WVD POLICY NUMBER POLICY EFF IMM/DD/YYYY) POLICY EXP (MMIDD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) S MED EXP (Any one person) S PERSONAL & ADV INJURY $ GE 'L AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT PER: LOC GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) S BODILY INJURY (Per accident) $ PROrPERfl'tDAMAGE $ S UMBRELLA LIAB_ EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE S DED RETENTIONS S A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y 1 N N 1 A WCPE00000184 03 10/1/2015 10/1/2016 ,/ STATUTE 1 1 OH OT E.L. EACH ACCIDENT S 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT S 1,000,000 B C D Workers Compensation Excess Coverage This is for informational purposes and nothing shall create any right under such reinsurance. DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is requi ed) Coverage provided for all leased employees but not subcontractors of Timothy Rose Contracting, Inc. Effective date: 10/1/2013 Project: Old Dixie Hwy Resurfacing, from 71st Street to CR 510 CERTIFICATE HOLDER CANCELLATION 62200099 Indian River CountySHOULD 1800 27th Street Vero Beach FL 32960 ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ,/�� Y eI Glen J Distefano G © 1988-2014 ACORD CORPORATION All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 27627003 1 1 Master Essential 140 dba Employee Professionals 1 Natalie Matthews 1 12/15/2015 1 56 36 PM (CST) 1 Page 1 of 1