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1 ® A� o CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYY1� 2/17/2015 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 SUNZ Insurance Solutions, LLC ID(Essential) c/o Essential HR, Inc. dba First Star HR 251 O'Connor Ridge Blvd Suite 370 Irving, TX 75038 CONTACT NAME: Jennifer Hauger PHONE EMI 214 92-1986 FAX -4 E-MAIL(o ADDRESS: lennifer.hauger@firststarhr.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A. SUNZ Insurance Company 34762 INSURED Essential HR Inc dba Employee Professionals 251 O'Connor Ridge Blvd Suite 370 Irving TX 75038 INSURER B . Aspen Re - London - Best Rating "A" INSURER c. Catlin Syndicate - Lloyds - Best Rating "A" INSURER D . Brit Syndicate - Lloyds - Best Rating "A" $ INSURERE: INSURER F : • I.UVtRAUtJ l,GR 11r-1t,h , L INV1111... 1 s. LUYUJUUT ---" -- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVVITHSTANDING 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 ADDL INSD SUBR WVD POUCY NUMBER POUCY EFF (MM/DD/YYYY) POUCY EXP (MMIDDIYYYY) LIMITS LTR COMMERCIAL GENERAL LABILnY EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) S CLAIMS -MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE UMIT APPLIES PR PER PRODUCTS - COMP/OP AGG $ POUCY OTHER: JECOT LOC $ UABILITY COMBINED SINGLE LIMIT (Ea accident) S AUTOMOBILE BODILY INJURY (Per person) S ANY AUTO ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS JAUTOS NON -OWNED PROPERTY DAMAGE (Per accident) $ HIRED AUTOS _ AUTOS $ LIAB_ EACH OCCURRENCE $ UMBRELLA OCCUR AGGREGATE $ EXCESS UAB CLAIMS -MADE RETENTION $ $ WORKERS DED COMPENSATION WCPE00000184 02 10/1/2014 10/1/2015 iSTA TUTE OER A AND EMPLOYERS' LABILITY Y / N WCPE00000184 01 10/1/2013 10/1/2014 EL EACH ACCIDENT $ 1,000,000 ANY PROPRIETOR/PARTNER/EXECUl1VE OFFICER/MEMBER EXCLUDED? N / A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under OF OPERATIONS below EL DISEASE - POUCY UMIT $ 1,000,000 B C ID DESCRIPTION Workers Compensation Excess Coverage This is for informational purposes and nothing shall create any right under such reinsurance. DESCRIPTION Coverage Effective OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) provided for all leased employees but not subcontractors of: Timothy Rose Contracting, Inc. date: 10/1/2013 CERTIFICATE HOLDER 62200099 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 Glen J Distefano ACORD 25 (2014/01) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CERT ND 23463564 Natalie Matthews 2/17/2015 11:58 05 AM (CST) Page 1 of 1