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OP ID: TJ 'AYYY) �� o= CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/Y15 02/17/2015 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 Phone: 772-286-4334 Stuart Insurance, Inc. Fax: 772-286-9389 3070 S W Mapp Palm City, FL 34990 CONTACT Rick Halcomb PHONE 772-286-4334 FAX No): 772-286-9389 (AIC. No Ext): E-MAIL ADDRESS: rhalcomb@stuartinsurance.net Rick Halcomb, CIC, ARM PRODUCER TIMOR -1 CUSTOMER IDN: INSURERS) AFFORDING COVERAGE NAIC # INSURED Timothy Rose Contracting, Inc. 1360 Old Dixie Hwy SW, Ste 106 Vero Beach, FL 32962 INSURER A .Westfield Insurance 24112 INSURER B. CMM6079889 INSURERC 06/06/2015 INSURER D . $ 1,000,000 INSURER E . $ 500,000 INSURER F . $ 10,000 • LUVtKAUtb %,GR 11tH,? 1 L 1i V im-n-1s. - - 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 TYPE OF INSURANCE JNSR ADDLSUBR WVD POUCY NUMBER POLICY EFF (MMIDD/YYYY) POUCY EXP (MMIDD/YYYY) LIMITS LTR A GENERAL X UABIUTY COMMERCIAL GENERAL LIABILITY X OCCUR CMM6079889 06/06/2014 06/06/2015 EACH OCCURRENCE $ 1,000,000 NTED PREM AMAGE SES (Ea TO Eoccurrence) $ 500,000 MED EXP (Any one person) $ 10,000 CLAIMS -MADE PERSONAL SADV INJURY $ 1,000,000 X Contractual Liab GENERAL AGGREGATE $ 2,000,000 X Incl XCU PRODUCTS - COMP/OP AGG $ 2,000,000 GEL AGGREGATE LIMIT APPLIES PER: —1 POLICY n PRO- fl LOC E A AUTOMOBILEUABILITY X X X JFS:T ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-0WNEDAUTOS CMM6079889 06/06/2014 06/06/2015 COMBINED SINGLE UMIT (Ea accident) E 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per acddent) ( $ $ $ ACMM6079889 UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS-MADE3,000,000 06/06/2014 06/06/2015 EACH OCCURRENCE $ 3,000,000 AGGREGATE E $ DEDUCTIBLE $ $ WORKERS AND ANY (MandatoryIn OFFICER/MEMBER (Mandatory Ii yes, RETENTION COMPENSATION EMPLOYERS' UABILITY PROPRIETOR/PARTNER/EXECUTIVE Yf / N EXCLUDED? I 1 In NH) describe under OF OPERATIONS below N 1 A NC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ A DESCRIPTION Contractors Equip CMM6079889 06/06/2014 06/06/2015 Rented 50,000 Equipment $1000 ded DESCRIPTION RE: Project# general written OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Old Dixie Hwy Sidewalk Improvements 38th Lane to 45th Street (IRC 0845B) -Indian River County is additional insured witih respect to liability for ongoing and completed operations when required by contract. 30 days notice of cancellation, 10 days for non-payment CERTIFICATE HOLDER IRCOU-4 Indian River County 1801 27th Street Vero Beach, FL 32960 SHOULD 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 6cil ACORD 25 (2009/09) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD