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OP ID: MK <br /> ACORO` DATE(MM/DD/YYYY) <br /> CERTIFICATE OF LIABILITY INSURANCE 09/13/2016 <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 /> PRODUCER CONTACT <br /> Stuart Insurance,Inc. NAME: Joseph E Coons <br /> 3070 S W Mapp a°NN E,,:772-286-4334 F Ne 772-286-9389 <br /> Palm City,FL 34990 E-MAIL coons stuartinsurance.net <br /> Joseph .Coons,CPCU.CIC. ADDRESS:1 <br /> PRODUCER GUETB-1 <br /> CUSTOMER ID#: <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURED Guettler Brothers INSURER Westfield Insurance 24112 <br /> Construction LLC <br /> Ben G.Guettler INSURER B. <br /> P.O.Box 12271 jNSURERC. <br /> Fort Pierce,FL 34979-2271 INSURER D. <br /> INSURER E. <br /> INSURER F. <br /> COVERAGES CERTIFICATE NUMBER: 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 /> INSR TYPE OF INSURANCE POLICY EFF POLICY EXP <br /> LTR POLICY NUMBER MM/DD/YYYY (MM/DD/YYYY LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 <br /> A X COMMERCIAL GENERAL LIABILITY X X TRA7630158 06/30/2016 06/30/2017 PREMISES R occurrence $ 500,00 <br /> CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 10,00 <br /> X Contractual PERSONAL&ADV INJURY S 1,000,00 <br /> X INCLUDES XCU GENERAL AGGREGATE S 2,000,00 <br /> GEN L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 <br /> POLICY X PRO LOC $ <br /> AUTOMOBILE LIABILITY X X COMBINED SINGLE LIMIT $ 1,000,00 <br /> A X ANY AUTO TRA7630158 06/30/2016 06/30/2017 (Ea accident) <br /> BODILY INJURY(Per person) $ <br /> ALL OWNED AUTOS BODILY INJURY(Per accident) $ <br /> X SCHEDULEDAUTOS <br /> PROPERTY DAMAGE $ <br /> X HIRED AUTOS (PER ACCIDENT) <br /> X NON-OWNED AUTOS PIP $ 10,00 <br /> $ <br /> X UMBRELLA LIAB X OCCUR <br /> EACH OCCURRENCE $ 5,000,00 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,00 <br /> A TRA7630158 06/30/2016 06/30/2017 <br /> DEDUCTIBLE <br /> $ <br /> RETENTION S $ <br /> WORKERS COMPENSATION WC STATU- OTH- <br /> AND EMPLOYERS'LIABILITY Y/N T RY LIMITS I I ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED9 r N/A <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEd S <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) <br /> GRADING OF LAND" glarlket Additio al Insured in regards tg General <br /> LLla Ili% pd Automobile Liability. Blanket Waiver of Smrogatlon <br /> Genera .lability. <br /> CERTIFICATE HOLDER CANCELLATION <br /> IRCBD-1 <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Indian River County ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 1800 27th Street <br /> Vero Beach, FL 32960 AUTHORIZED REPRESENTATIVE <br /> ©1988-2009 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD <br />