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O ACR CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 12/08/2016 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(les) 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 Ileu of such endorsement(s). PRODUCER Bouchard insurance for WBS P,O.Box 6090 Clearwater, FL 33758-6090 COATACT NAME: PHONE INC No Extl, (866 ) 283-3600 ext. 623 E-MAIL ADDRESS: FAX (A/C, Nof: INSURER(S) AFFORDING COVERAGE NAIC p INSURER A : American Zurich Insurance Company INSURED Workforce Business Services, Inc. Alt. Emp: Guettler Brothers Construction LLC 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708 INSURER B: INSURER C INSURER D : 40142 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 15FL079902691 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 CF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LIR TYPE OF INSURANCE AODL INSR SUBR WVD POLICY NUMBER POLICY EFF (MMIDD/YYYY) POLICY EXP DfY (MM/DYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MAGE [ J OCCUR -"PRM�ET"O RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ POLICY } PRO- -- _) JECT )LOC PRODUCTS - COMP/OP AGG $ i OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO - BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS) INJURY BODILY (Per acatlent $ HIRED AUTOS NON -OWNED AUTOS (PPROPERTY E accident)MAGE $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS -MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATIONPER AND EMPLOYERS' LIABILITY OTH- X STATUTE ER A OFFICERfM£MBER EXCLUDE07 ECUTIVE YIN N / A WC 90-00-818-05 12/31/201 12/31/2016 E.L. EACH ACCIDENT $ 1,000 000 (Mandatory In NH) If describe E L. DISEASE - EA EMPLOYEE $ 1,000,000 yes, DESCRIPRIPTIONION OFOF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 Location Coverage Period: 12/31/2015 12/31/2016 Client# 050682 DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is requi ed) Coverage is provided for Guettler Brothers Construction LLC only those co -employees 4401 While Way Dairy Road of, but not subcontractors Fon Pierce, FL 34947 to: Indian River County 1800 27th Street Vero Beach, FL 32960 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE (.` ACORD 25 (20141011 CO 1988-2014 ACORD CORPORATION. Ali rights reserved, The ACORD name and logo are registered marks of ACORD