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ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE 12/114/20174/21017 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 Frank H. Furman, Inc. 1314 East Atlantic Blvd. P. 0. BOX 1927 Pompano Beach FL 33061 CONTACT NAME: PHDNE (954) 943-5050 FAX (954)942-6310 A C x : A/C No E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC9 INSURERA:National Fire Ins Of Hartford 20478 INSURED Advanced Roofing Inc Advanced Leasing Inc 200 Northstar Court Sanford FL 32771 INSURERB:Valley Forge Ins 20508 INSURER C:Ameri can Guarantee & Liability Ins 26247 INSURER D:Brid efield Employers Ins Cc 10701 INSURERE:Continental Casualty Cc 20443 INSURER F: rnvcaeaGc CERTIFICATE NUMBFR-Jan 18 Sanford REVISION NUMBER: v THIS ISTOCERTIFY 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 LTR TYPE OF INSURANCE ADDL 5 BR POLICY NUMBER EFF MM1DDNYYY MPOLICY M ODNYYY Y EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE ❑X OCCUR DAMAGE TO RENTEU PREMISES (Ea occurrence $ 100,000 MED EXP (Any one person) $ 15,000 X Contractual & XCU Incl X 6017071866 1/1/2018 1/1/2019 X Broad form PD PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 POLICY [K] JELOC $ OTHER: AUTOMOBILE LIABILITY COEaMcodan accident SINGLE LIMIT $ 3_000,000 BODILY INJURY (Per person) $ B X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X 6017071849 1/1/2018 1/1/2019 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED X HIRED AUTOS X AUTOS PIP $ 10,000 X nonownphysdam X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 25,000,000 AGGREGATE $ 25, 000, 000 C EXCESS LIAB CLAIMS -MADE DED I X J RETENTION$ 0 $ 1 IAUC930367416 1/1/2018 1/1/2019 D WORKERS COMPENSATIONPER AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? r (Mandatory In NH) If es, describe under DESCRIPTION OF OPERATIONS below A NIA 830-56020 1/1/2018 1/1/2019 OTH- X STATUTE ER E.L-EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000. E Installation Floater 4016260407 1/1/2018 1/1/2019 Any One Jobsile 2,000,000 5% W/H; $1000 AOP Any One Occurrence 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Project: Indian River County Health Department Indian River County and the Florida Department of Health are included as Additional Insured as regards General Liability and Automobile Liability where required by written contract in accordance with policy terms and conditions. CERTIFICATE HOLDER CANCELLATION jhyde@ircgov.com Indian River County ATTN: Jennifer Hyde SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1801 27th Street Vero Beach, FL 32960 AUTHORIZED REPRESENTATIVE Dirk DeJong/MR U 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)