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At ® DATE / Y) <br /> v CERTIFICATE OF LIABILITY INSURANCE 2/17/17/20152015 <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 /> BELOW. 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 /> CONTACT <br /> PRODUCER <br /> SUNZ Insurance Solutions, LLC ID(Essential) NAME: Jennifer Hau er <br /> c/o Essential HR, Inc. dba First Star HR P IC, o 214-492-1986 AAIC No: <br /> 251 O'Connor Ridge Blvd Suite 370 E-MAIL <br /> Irving,TX 75038 s: ennifer.hau er firststarhr.com <br /> INSURER(S) AFFORDING COVERAGE NAIC# <br /> INSURERA: SUNZ Insurance Company 34762 <br /> INSURED INSURER B: Aspen Re-London-Best Rating"A" <br /> Essential HR Inc dba Employee Professionals INSURERC: Catlin Syndicate-Lloyds-Best Rating"A" <br /> 251 O'Connor Ridge Blvd <br /> Suite 370 INSURER D: Brit Syndicate-Lloyds-Best Rating"A" <br /> Irving TX 75038 INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 23463564 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 /> .ADDL SUER POLICY EFF POLICY EXP LIMITS <br /> M <br /> E OF INSURANCE POLICY NUMBER MMIDD/YYYY MM/DD <br /> AL GENERAL LIABILITY EACH OCCURRENCE $ <br /> DAMA ET RENTED $ <br /> S-MADE �OCCUR RE I E Ea occurrenMED EXP An one rson $ <br /> PERSONAL&ADV INJURY $ <br /> TE LIMIT APPLIES PER: GENERAL AGGREGATE $ <br /> PRO-JECT FI LOC PRODUCTS-COMP/OPAGG $ <br /> COMBINED SINGLE LIMIT $ <br /> ABILITY Ea accident <br /> BODILY INJURY(Per person) $ <br /> ANY AUTO <br /> ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS PROPERTY DAMAGE <br /> NON-OWNED eraccident) <br /> $ <br /> HIRED AUTOS AUTOS <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> $ <br /> DED RETENTION$ <br /> A WORKERS COMPENSATION WCPE0000018402 10/1/2014 10/1/2015 V STATUTE ER ' <br /> AND EMPLOYERS'LIABILITY YIN WCPE0000018401 10/1/2013 10/1/2014 1,000,000 <br /> ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> OFFICERIMEMBER EXCLUDED? N/A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 <br /> If es,describe under EL.DISEASE-POLICY LIMIT $ 1,000,000 <br /> DESCRIPTION OF OPERATIONS below <br /> B Workers Compensation This is for informational purposes <br /> C Excess Coverage and nothing shall create any right <br /> under such reinsurance. <br /> D <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> Coverage provided for all leased employees but not subcontractors of.Timothy Rose Contracting,Inc. <br /> Effective date:10/1/2013 <br /> CERTIFICATE HOLDER CANCELLATION <br /> 62200099 <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Indian River County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> 1801 27th Street ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Vero Beach FL 32960 <br /> AUTHORIZED REPRESENTATIVE <br /> Glen J Distefano <br /> ©1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br /> CERT NO.: 23463564 Natalie Matthews 2/17/2015 11:58:05 AM (CST) Page 1 of 1 <br />