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ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 01/08/2015 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 SURETY AGENCY, LLC 552-B NEW HAW CREEK ROAD ASHEVILLE, NC 28805 828-236-1000 FAX 828-236-1001 NAME KAREN KAREN BEARD PHONE 828-236-1000 (A/C No, Ext) FAX 828-236-1001 (A/C, No). E-MAIL KAREN110@BELLSOUTH.NET INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: ZURICH AMERICAN INS CO INSURED DICKERSON FLORIDA, INC. P. O. BOX 910 FT. PIERCE, FL 34954-0910 INSURER B: AMERICAN GUARANTEE & LIABILITY INS CO INSURER C. INSURER D INSURER E INSURER F. COVERAGES CERTIFICATE NUMBER: 100304 REVISION NUMBER: 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 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X GL05761374 07/01/2014 07/01/2015 EACH OCCURRENCE $ 1,000,000 PREMISESTO(Ea occurrence $ 300,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ N/A PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 GEN'L AGGREGATE POLICY X LIMIT APPLIES PRO- JECT PER: LOC $ A AUTOMOBILE X X LIABILITY ANY AUTO ALLOWNED AUTOS HIRED AUTOS — X SCHEDULED NON -OWNED AUTOS BAP5761373 07/01/2014 07/01/2015 Ea MBIaccidentSINGLE LIMIT $ 1,000,000 ,000000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident)$ PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE AUC9266387 07/01/2014 07/01/2015 EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,000 $ DED RETENTION $ RETENTION $ A WORKERS AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEN OFFICER/MEMBER EXCLUDED/ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N / A WC5731375 07/01/2014 07/01/2015 WC STATU- TH X TORY LIMITS ER E . EACH ACCIDENT $ 1 ,000,000 E L DISEASE - EA EMPLOYEE $ 1,000,000 E . DISEASE - POLICY LIMIT I $ 1 ,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, ii more space is required) PROJECT: INDIAN RIVER COUNTY BID NO. 2015010, COUNTY PROJECT NUMBER: 1314 VERO LAKE ESTATES ASPHALT MILLING PROJECT (PHASE 1) INDIAN RIVER COUNTY IS ADDITIONAL INSURED WITH A THIRTY (30) DAY NOTICE OF CANCELLATION FOR THE WORK PERFORMED BY THE INSURED CERTIFICATE HOLDER CANCELLATION INDIAN RIVER COUNTY 1801 27TH STREET VERO BEACH, FL 32960-3388 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WI L BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ‘„,„ z& -ti ACORD 25 (2010/05) © 1988-2010 ACORD CORPORAT The ACORD name and logo are registered marks of ACORD 0 N. All rights reserved.