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ROOFE-3
<br />OP ID: LW
<br />M R' Cs CERTIFICATE OF LIABILITY INSURANCE
<br />ll`,-------
<br />DATE(MMIDDIYYYY)
<br />03/03/2014
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />3ELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER Phone: 919-556-3698
<br />Hartsfield & Nash Fax: 919-556-8758
<br />P.O. Box 1109
<br />Wake Forest, NC 27588
<br />Lorie Borrelli, CIC, AAI
<br />CONTACT Lorie Borrelli CIC, AAI
<br />NAME:
<br />PHONE 919-556-3698 FAX
<br />(AIC, No. Ext): (AIC, No):
<br />E-MAIL Lorie@Hartsfield-Nash.com
<br />ADDRESS:
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />INSURER A : Cincinnati Insurance Companies
<br />10677
<br />INSURED REI Engineers
<br />REI Consulting Inc
<br />8001 Creedmoor Rd Ste 107
<br />Raleigh, NC 27613-4396
<br />INSURER B:The Travelers Insurance Co.
<br />36170
<br />INSURER C : Endurance American Specialty
<br />41718
<br />INSURER D :
<br />$ 1,000,000
<br />INSURER E :
<br />$ 100,000
<br />INSURER F :
<br />$ 10,000
<br />•
<br />REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />ILTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSR
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />(MMIDDIYYYY)
<br />POLICY EXP
<br />(MMIDDIYYYY)
<br />LIMITS
<br />A
<br />GENERAL
<br />X
<br />LIABILITY
<br />COMMERCIAL GENERAL LIABILITY
<br />X
<br />ENP0196990
<br />06/01/2013
<br />06/01/2014
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGE TO RENTED
<br />PREMISES (Ea occurrence)
<br />$ 100,000
<br />MED EXP (Any one person)
<br />$ 10,000
<br />CLAIMS -MADE
<br />X
<br />OCCUR
<br />PERSONAL &ADV INJURY
<br />$ 1,000,000
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />PRODUCTS - COMP/OP AGG
<br />$ 2,000,000
<br />GENII AGGREGATE
<br />—1 POLICY
<br />X
<br />LIMIT APPLIES
<br />TB,
<br />PER:
<br />LOC
<br />$
<br />A
<br />AUTOMOBILE
<br />X
<br />X
<br />LIABILITY
<br />ANY AUTO
<br />ALL OWNED
<br />AUTOS
<br />HIRED AUTOS
<br />_
<br />X
<br />SCHEDULED
<br />AUTOS
<br />NONr/NED
<br />AUTOS
<br />X
<br />EBA0196990
<br />06/01/2013
<br />0610112014
<br />COMBINED SINGLE LIMIT
<br />(Ea accident)
<br />_$ 1,000,000
<br />$
<br />BODILY INJURY (Per person)
<br />BODILY INJURY (Per accident)
<br />$
<br />dentDAMAGE
<br />(Per PROPERTY
<br />$
<br />$
<br />A
<br />X
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />X
<br />ENP0196990
<br />06/01/2013
<br />06/01/2014
<br />EACH OCCURRENCE
<br />$ 5,000,000
<br />AGGREGATE
<br />$ 5,000,000
<br />$
<br />DED
<br />X RETENTION $ 0
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE Y I N
<br />OFFICER/MEMBER EXCLUDED? N
<br />(Mandatory in NH)
<br />H yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />N / A
<br />XFUB-9886Y794
<br />06/01/2013
<br />06/01/2014
<br />X
<br />WC STATU-
<br />TORY LIMITS
<br />OTI-t-
<br />ER
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000, 000
<br />C
<br />Professional Liab
<br />PPL10002229400
<br />06/01/2013
<br />06/01/2014
<br />Per Occ 3,000,000
<br />Agg 3,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />Certificate Holder is added as Additional Insured with regard
<br />to contract with the insured. 30 day notice of cancellation
<br />except for non-payment which is 10 days notice.
<br />CERTIFICATE HOLDER
<br />CANCELLATION
<br />INDIANI
<br />Indian River County Florida
<br />County Risk Manager
<br />1801 27th St
<br />Vero Beach, FL 32960
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />ACORD 25 (2010/05)
<br />© 1988-2010 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />239
<br />
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