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TIMOR -1 OP In- T.I v CERTIFICATE OF LIABILITY INSURANCE DATE (M2 06/12120 YYY) /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 772-286-4334 Stuart Insurance, Inc. 3070 S W Ma pp Palm City, FL 34990 Rick Halcomb, CIC, ARM CoMNT CT Rick Halcomb, CIC, ARM PHONE 772_286-4334 FAX ( ) 772-286-9389 (A/C, No, Ext): AIC, No AD KESS: rhalcomb stuartinsurance.net INSURERS AFFORDING COVERAGE NAIC # A INSURERA:Westfield Insurance CO. 24112 INSURED Timothy Rose Contracting Inc 1360 Old Dixie Hwy SW, Ste 106 INSURERS: CMM6079889 Vero Beach, FL 32962 INSURER C: INSURER D: PREMGES(Eaoiccurf0ence $ 500,000 INSURER E, X Inc[XCU INSURER F: GEN'LAGGREGATE LIMIT APPLIES PER : POLICY ❑X JECT LOC COVERAGES CERTIFICATE NUMBER: REVISION NUMBS R. 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 TR TYPE OF INSURANCE NIDDL INSD SUBIR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX OCCUR X Contractual Liab CMM6079889 06/06/2017 06/06/2018 EACH OCCURRENCE $ 1,000,000 PREMGES(Eaoiccurf0ence $ 500,000 MED EXP An one person)$ 5,000 X Inc[XCU PERSONAL BADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER : POLICY ❑X JECT LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 Emp Ben. $ 1,000,000 COMBINED SINGLE LIMIT 1,000,000 Ea accident $ A OTHER: AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY X PIP $10000 CMM6079889 06/06/2017 06/06/2018 BODILY INJURY Per erson $ BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident $ A XUMBRELLALIAB X OCCUR EXCESS LIAB CLAIMS -MADE CMM6079889 06/06/2017 06/06/2018 EACH OCCURRENCE $ 3,000,000 AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITYYIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? F-1NIA (Mandatory Ifunder yes, describe under PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ Rented 50,000 A DESCRIPTION OF OPERATIONS below Contractors Equip CMM6079889 06/06/2017 06/06/2018 Equipment $1000 ded �q7 �p (( CC pp.� dd 4 U°racCriingoPLOnM1'Ie repT�ia4eO OtIAC1aRClieSl10111Q11rCgOVkCOrTldule,maybeattacheditmorespaceisrequired) IRCBD-1 Indian River County 1801 27th St Vero Beach, FL 32960 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN' ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Mi ,,Jmu GD (LU -I twvo) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD