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'nom CERTIFICATE OF LIABILITY INSURANCE DATE03M /DOD'/YYYY) 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 have ADDITIONAL INSURED provisions or 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 () C Aon Risk Services Northeast, inc. NAME:PH NE New York NY Office (AIC.No.Ext): 0866) 283-7122 FAX No.; 800-363-0105 `y 199 Water Street E-MAIL O New York NY 10038-3551 USA ADDRESS. _ INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURERA. Illinois National Insurance Co 23817 Community Asphalt Corp. INSURER B: The Insurance Co of the State of PA 19429 9675 N.W. 117th Avenue Suite 108 INSURER C: Miami FL 33178 USA INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 570065632474 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.INSR AUDL SUER P0, Limits shown are as requested LTR TYPE OF INSURANCE ICY EFF POLICY ExP INSD WVD POLICY NUMBER MMIDDIYYYY MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2,000,000 DAMAGE TO CLAIMS-MADE X❑OCCUR PREMISES Ea occurrence $300,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $2,000,000 t GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $4,000,000 N POLICY �JET ❑X LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: p 0 AI` AUTOMOBILE LIABILITY 3194530 12/31/2016 12/31/2017 COMBINED SINGLE LIMIT $1,750,000 U1SIR applies per policy tors & condi ions Ea accident X ANYAUTO BODILY INJURY(Per person) O OWNED SCHEDAUTOS ONLY AUTOS BODILY BODILY INJURY(Per accident) y HIRED AUTOS NON-OWNEDPROPERTY DAMAGE V ONLY AUTOS ONLY Per accident t d UMBRELLALIAB HOCCUR EACH OCCURRENCE U EXCESS LIAB CLAIMS-MADE AGGREGATE DED RETENTION B WORKERS COMPENSATION AND 14629414 —1273 1-72 0-16 12 3-172 0-17 X I PER STATUTE I OTH- EMPLOYERS'LIABILITY YIN ER ANY PROPRIETOR/PARTNER/EXECUTIVE N E.L.EACH ACCIDENT $1,000,000' OFFICER/MEMBER EXCLUDED? ❑ N I A (Mandatory in NH) E.L DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000— DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) RE. CAC#7085; Round Island Riverside Park Pavement Resurfacing, County Project. 1619, Bid No. 2017017, Project Address. 2200 South AlA, Vero Beach, FL 32963. Indian River County is included as Additional Insured in accordance with the policy rJ provisions of the General Liability policy. �i CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1 - 800 27tt h Street Ver county AUTHORIZED REPRESENTATIVE 1800 2 Vero Beach FL 32960 USA CXl4yd i%��6fiLfCQeD��✓fdQ ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD