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JOHNINC-02 MMCQUILI
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />DATE/02120Y
<br />18
<br />03102/208
<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 have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder In lieu of such endorsement(s).
<br />PRODUCER
<br />Johnson Insurance Racine
<br />555 Main Street, Suite 291
<br />Racine, Wl 53403
<br />NONEACT Sharon Majeski, ARM
<br />PHONE FAX
<br />AIC, No, Extl: (920) 433-7107 Alc, No : 877 254-8586
<br />E-MAIL j �j
<br />ADDRESS: sma eski ohnsonins.com
<br />INSURERS AFFORDING COVERAGE NAIC #
<br />A
<br />INSURERA:HDI Global Insurance Company 41343
<br />X
<br />INSURED
<br />INSURER B: Certain Underwriters at Lloyd's
<br />INSURER c: Travelers Insurance
<br />Johnson -Davis, Inc.
<br />604 Hillbrath Drive
<br />Lantana, FL 33462
<br />INSURERD:
<br />MED EXP (Any oneperson) $ 10,000
<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
<br />LTRIN
<br />TYPE OF INSURANCE
<br />ADDL
<br />SD
<br />SUER
<br />WVD
<br />-
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM/DDNYYYI
<br />POLICY EXP
<br />IMMIDDIYYYYI
<br />LIMITS
<br />A
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE ❑X OCCUR
<br />X
<br />EGGCC000173517
<br />0310112017
<br />05/01/2018
<br />EACH OCCURRENCE $ 2'000,000
<br />ORMAGE TO RECTEDn $ 300,000
<br />MED EXP (Any oneperson) $ 10,000
<br />PERSONAL & ADV INJURY $ 2,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY ❑X je, E LOC
<br />GENERAL AGGREGATE $ 2,000,000
<br />PRODUCTS •COMP/OP AGG $ 2,000,000
<br />OTHER:
<br />A
<br />A
<br />AUTOMOBILE
<br />X
<br />X
<br />X
<br />LIABILITY
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AURRTEEOS ONLY AUTO
<br />OppS p
<br />AU703 ONLY X AUUTOS ONLY
<br />UMBRELLA LIAB X OCCUR
<br />EXCESS LIAR CLAIMS -MADE
<br />X
<br />EAGCC000173517
<br />EXAGC000173517
<br />03101/2017
<br />03/01/2017
<br />05/01/2018
<br />05/01/2018
<br />COMBINED SINGLE LIMIT 2,000,000
<br />� S
<br />BODILY INJURY Per person)$
<br />BODILY INJURY Per accident $
<br />PI(iOPERTY AMAGE
<br />er accident S
<br />PIP Basic 101000
<br />EACH OCCURRENCE S 3'000,000
<br />AGGREGATE $ 3,000,000
<br />DED I X I RETENTIONS O
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY �, / N
<br />ANY PROPRIIETgOER/PARTNERIEXECUTIVE
<br />W.F.1C ER/Malory9In NH) EXCLUDED? ❑
<br />N / A
<br />PER OTH-
<br />T
<br />E.L. EACH ACCIDENT $
<br />E.L. DISEASE - EA EMPLOYEE $
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />B
<br />C
<br />Excess LiabilityE.L.ess
<br />Equipment Floater
<br />ELD10006501302
<br />660 -4H592540 -TIL -18
<br />03/01/2017
<br />03/01/2018
<br />08/0112018
<br />03/01/2019
<br />LE-POLICY LIMIT $
<br />Excess iab over 3 M 1,000,000
<br />Leased Rented 300,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES `ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
<br />Contractor's Pollution Liability - Policy # 7930030920003- Limit - $1,000,000 - 3111201$-19 - Homeland Insurance Company of NY
<br />Project: 74th Ave and 1st St SW Culvert Replacement, project number 1737, bid number 2018024, 74th Ave and 1st St SW, Vero Beach, FL 32968.
<br />Ind an River County Is additional Insured with respect to General Liability and Automobile Liability.
<br />30 days notice of cancellation to Indian River County applies.
<br />CERTIFICATE HOLDER CANCELLATION
<br />Indian River County
<br />1801 27th Street
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Vero Beach, FL 32960
<br />AUTHORIZED REPRESENTATIVE
<br />GCflA tl oc ron.,. r,..,,
<br />f ' ,l•Il Z%`//
<br />t�v �r�Jl ©1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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