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PROCT-2 OP ID: QJ
<br /> DATE / Y)CERTIFICATE OF LIABILITY INSURANCE 02/24/2017
<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 /> Brown&Brown of Florida,Inc. PHONE FAX
<br /> 1201 W Cypress Creek Rd#130 ac No Ell:954-776-2222 A/c No): 954-776-4446
<br /> P.O.Box 5727 E-MAIL
<br /> Ft.Lauderdale,FL 33310-5727 ADDRESS:
<br /> Ken E Willits,CPCU,CFP,CRIS INSURERS AFFORDING COVERAGE NAIC#
<br /> INSURER A:Amerisure Mutual Ins.Co. 23396
<br /> INSURED Proctor Construction Co, LLC INSURER B Amerisure Insurance Company 19488
<br /> Attn:Valerie Brown
<br /> 2050 Highway US 1; Suite 200 INSURER C:North River Insurance Company 21105
<br /> 2050
<br /> Vero Beach,FL 32960 INSURER D:AIG Specialty Insurance Co 26883
<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 I ADDL SUBR POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE INSD VWVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00
<br /> CLAIMS-MADE OCCUR X GL203461110 05/25/2016 05/25/2017 DAMAGE TO RENTED
<br /> PREMISES Ea occurrence $ 100,00
<br /> MED EXP(Any one person) $ 10,00
<br /> PERSONAL&ADV INJURY $ 1,000,00
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00
<br /> POLICY a PR -
<br /> JECOT F__]LOC
<br /> PRODUCTS-COMP/OP AGG $ 2,000,00
<br /> OTHER: Emp Ben. $ 1,000,00
<br /> AUTOMOBILE LIABILITY Ea BINEDtSINGLE LIMIT $ 1,000,000
<br /> B X ANY AUTO CA203460910 05/25/2016 05/25/2017 BODILY INJURY(Per person) $
<br /> ALL OWNED SCHEDULED
<br /> AUTOS AUTOS BODILY INJURY(Per accident) $
<br /> NON-OWNED PROPERTY DAMAGE
<br /> HIRED AUTOS AUTOS Per accident $
<br /> $
<br /> X UMBRELLA LIABX OCCUR EACH OCCURRENCE $ 10,000,00
<br /> C EXCESS LIAB CLAIMS-MADE 581106922 05/25/2016 05/25/2017 AGGREGATE $ 10,000,00
<br /> DED X RETENTION$ 0 $
<br /> WORKERS COMPENSATION _
<br /> AND EMPLOYERS'LIABILITY X STATUTE ER H
<br /> B ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WC203730510 05/25/2016 05/25/2017 E.L.EACH ACCIDENT $ 1,000,00
<br /> OFFICER/MEMBER EXCLUDED? ❑ N/A
<br /> (Mandatory in E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under nd
<br /> DESCRIPTION OF OPERATIONS below
<br /> D Contractor's CPL1067283 01/28/2015 05/25/2017 Each Occ POLICY LIMIT $ 1,000,00
<br /> 2,000,00
<br /> Pollution Liab Aggregate 2,000,00
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required)
<br /> Project: IRC Shooting Range Hunter Education Classroom
<br /> Indian River County and Florida Department of Environmental Protection is an
<br /> additional insured with respect to General Liability if required by written
<br /> contract.30 Day Notice of Cancellation applies except 10 days for non-
<br /> payment of premium.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> INDIANR
<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 /> and Florida Department ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> of Environmental Protection
<br /> 1801 27th Street AUTHORIZED REPRESENTATIVE
<br /> Vero Beach,FL 32960-3388
<br /> ©1988-2014 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
<br />
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