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ACS CERTIFICATE OF LIABILITY INSURANCE TA DATE 09/14/2016 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 CONTACT NAME: Bouchard Insurance for WBSPHONE FAX P O.Box 6090 a o Ext: 866 293 3600 ext.623 AIC No: E-MAIL Clearwater,FL 33758-6090 ADDRESS. INSURERS AFFORDING COVERAGE NAIC k INSURER A: American Zurich Insurance Company 40142 INSURED INSURER B. Workforce Business Services,Inc.Alt.Emp:Guettler Brothers Construction LLC 1401 Manatee Ave.West Ste 600 INSURER C Bradenton,FL 34205-6708 INSURER D INSURER E. INSURER F. COVERAGES CERTIFICATE NUMBER:15FLO79902691 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS. IEXP LTR TYPE OF INSURANCE AND BR POLICY NUMBER MM/DDPOLICYIYYYY MM/DDEFF Y/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s CLAIMS-MADE r OCCUR AM PREMISE $ S Ea occurrence MED EXP(Any one person) S PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- POLICY JECT LOC PRODUCTS-COMPIOP AGG S OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ g WORKERS COMPENSATIONPER OTH- AND EMPLOYERS'LIABILITY YIN X STATUTE ER A ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICERIM EMBER EXCLUDED? N/A WC 90-00-818 OS 12/31/2015 12/31/2016 (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 Location Coverage Period: 12/31/2015 12/31/2016 Client# 050682 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Coverage Is provided for Guettler Brothers Construction LLC only those co-employees 4401 White Way Dairy Road of,but not subcontractors Fort Pierce,FL 34947 to: CERTIFICATE HOLDER CANCELLATION Indian River County Building Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1800 27th Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Vero Beach,FL 32960 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD