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• CROSS-1 OP ID:SC ACCORD," CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDrrrrr) 09/18/2017 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 772-231-2022 NCiAM ACT Mary Campbell Vero Insurance,Inc. PHONE 772-231-2022 FAX )772-231-7444 3339 Cardinal Drive (A/c,No,Ext): (A/C.No): Vero Beach,FL 32963 ADDRESS: Mary Campbell INSURER(S)AFFORDING COVERAGE NAIC S INSURER A:New Hampshire Insurance Co. 23841 INSURED Crossover Mission,Inc. Associated Industries 23140 1965 42nd Ave,Ste 3 INSURER 8 Vero Beach,FL 32960 INSURER C:Nationwide Life Insurance 66869 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED 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. iLTR TYPE OF INSURANCE IINNSD INVD POLICY NUMBER I M/DINTYYPY1 (MP01�LI p/yEYX�Fn LIMITS A X COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 01LX0921782900 08/25/2017 08/25/2018 iiiremMISES(EirrrExr°encel $ 100,000 MED EXP(My one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN?.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY n JEC LOC 000000, 2 PRODUCTS-COMP/OP AGG $ ' OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) S -ANY AUTO BODILY INJURY(Per person) $ OWNED ONLY SCHEDULED BODILYRINJURY(Per accident) $ AUTOS ONLY AUTO ONLY (Per deT DAMAGE $ , $ UMBRELLA LAB _ OCCUR EACH OCCURRENCE _ $ _ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ - •$ B AND EMPLOYERS'LIABILITY Y!N• STATUTE ERTH- ANY PROPRIETOR/PARTNERIEXECUTIVE AWC1070048 08/25/2017 08/25/2018 EL.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEER EXCLUDED? N/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 C Accident 50207081116117001 04/14/2017 04/14/2018 Med Pay 25,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE Indian River CountyTHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1800 27th Street Vero Beach,FL 32960 AUTHORIZED REPRESENTATIVE Mary Campbell ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. • The ACORD name and logo are registered marks of ACORD