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rl Um. I dill Jecvuwn rayc z of 4 AC�!Rb' CERTIFICATE OF LIABILITY INSURANCE OP ID TJ DATE(MMIDD/YYYY) CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 05/12/10 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 cert rate holder Is an ADDITIONAL INSURED, the po cy es must be endorsed. , 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 NAME: (AJC, No, EM): (A C, No): Stuart Insurance, Inc. ADDRESS: 3070 S W Mapp Palm City FL 34990 Phone:772-286-4334 Fax:772-286-9389 CUSTOMERos, TIMOR -1 INSURER(S) AFFORDING COVERAGE NAICt INSURED - Timothy Rose Contracting, Inc. INSURER A :1416 8 Hacl�ysvill• ZnauLanc• Croup INSURER B INSURER C: 1360 Old Dixie Hwy SW Vero Beach FL 32962 INSURER D: GL00000049465A INSURER E: 06/06/10 INSURER F �an i Irn_i I m numomn: rz FVICInN NIIMRFP- 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, LTR TYPE OF INSURANCE INSR POLICY NUMBER MMMD(1'YYY ( ) (MM/LK.Y EA) LIMBS GENERAL LIABILITY - EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR GL00000049465A 06/06/09 06/06/10 PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 X GENERAL AGGREGATE $ 2,000,000 '10 DAYS NOTICE NON -PAY GEN'L AGGREGATE LIMIT APPLIES PERS PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY JPE4 LOC $ A AUTOMOBILE X LIABILITY ANYAITO " BA00000049464A 06/06/09 06/06/10 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED ALTOS PROPERTY DAMAGE $ (Per accident) X HIRED AUTOS X NON -OWNED AUTOS •10 DAYS NOTICE 0ON-PAY $ $ A UMBRELLA LIAR}{ OCCUR CMB00000049 462A 06/06/09 06/06/10 EACH OCCURRENCE s3,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $3,000,000 DEDUCTIBLE *10 DAYS $ NOTICE $ _VM RETENTION $ RKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE ❑ OFFICERIMEMSER EXCLUDED? / A - VVC6AIU TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) II yes, describe under - E DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS belo. A Contractors Equip Cl2M1676 06/06/09 06/06/10 I Rented 50,000 •10 DAYS NOTICE NON -PAY Equipment $1000 ded DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more apace Is required) Grading of Land/Site Prep - State of Florida RE: BID #2010024, North WTP Raw Water Transmission System, Vero Beach, FL. UL:K TIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE INDRC-4 I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Indian River County Purchasing Division 772-770-5333 1800 27th Street Vero Beach FL 32960 ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD MAY -12-2010 09:26 From:STUINS-FAX01 ID:TIM ROSE TION. II rlahfs reserved Pa9e:002 R=90%