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MANCTRA-02 RMFRRITT <br />CERTIFICATE OF LIABILITY INSURANCE <br />°ATE 1 02/05/20`05120Y8 <br />0218 <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(les) 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 />CONTACT Suzanne Nelson <br />Collinsworth, Alter, Lambert, LLCFAX <br />23 Eganfuskee Street <br />Suite 102 <br />Jupiter, FL 33477 <br />PHONE <br />Arc, No, Ext : 561 868-6291 AIC, No :(561) 427-6730 <br />Eo A'E • Snelson@calllc.com <br />POLICY EFF <br />WMID D <br />- <br />INSURERS AFFORDING COVERAGE NAIC A <br />INSURERA:Amerisure Mutual Ins Co 23396 <br />X COMMERCIAL GENERAL LIABILITY <br />INSURED <br />INSURER B:Brld efleld Employers Ins Co 10701 <br />INSURERC :AS en American Insurance Company 43460 <br />Mancil's Tractor Service, Inc. <br />8530 SW Jayme Way <br />Palm City, FL 34990 <br />INSURER D: <br />CLAIMS -MADE QX OCCUR <br />INSURER E <br />INSURER F: <br />GL21078120002 <br />COVFRAr,FS RFDTIFIRATC Kit IMRCD• - or�n�rn�r ur nanrn. <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 />L <br />TYPE OF INSURANCE <br />ADDL <br />S <br />SUER <br />POLICY NUMBER <br />POLICY EFF <br />WMID D <br />POLICY EXP <br />D-yn <br />LIMITS <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE S 1+000+000 <br />CLAIMS -MADE QX OCCUR <br />GL21078120002 <br />02/04/2018 <br />02/04/2019 <br />DAMAGE TO RENTED $ 100,000 <br />MED EXP (Any oneperson) $ 5,000 <br />PERSONAL & ADV INJURY $ 1,000,6-00 <br />GENERAL AGGREGATE S 2,000,000 <br />GEN'LAGGREGATE LIMIT APPLIES PER: <br />❑X F <br />PRODUCTS - COMP/OP AGG S 2,000+000 <br />POLICY JEa LOC <br />$ <br />OTHER: <br />A <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE OMIT $ 1,000,000 <br />X <br />ANY AUTO <br />CA21078110002 <br />02/04/2018 <br />02/04/2019 <br />BODILY INJURY Per person)$ <br />OWNED SCHEDULED <br />BODILY INJURY Per accident $ <br />AUTOS ONLY AUTOS <br />X <br />D <br />AURT0.S ONLY X AUTO ONLY <br />�� <br />Parr eEwR'�t AMAGE $ <br />PIP $ 10,000 <br />A <br />X <br />UMBRELLA LIABX <br />OCCUR <br />EACH OCCURRENCE $ 2'000'000 <br />EXCESS LIAR <br />CLAIMS -MADE <br />CU21078130002 <br />02/04/2018 <br />02/04/2019 <br />AGGREGATE S 2,000,000 <br />DED I I RETENTION $ <br />$ <br />B <br />WORKERS COMPENSATION <br />- <br />X PER OTH- <br />TUTF <br />AND EMPLOYERS' LIABILITY <br />YIN <br />E.L.EACH ACCIDENT S 1'000,000 <br />ANY PROPRIETORIPARTNERIEXECLmVE <br />83056494 - <br />09/01/2017 <br />09/01/2018 <br />OFF %E�IMlg% EXCLUDED? <br />ttJJ <br />NIA <br />1,000 000 <br />E.L. DISEASE - EA EMPLOYE $ + <br />Ifiesh <br />If yes, describe under <br />E.L. DISEASE - POLICY LIMIT $ 1,000,000 <br />DESCRIPTION OF OPERATIONS below <br />C <br />Equipment Floater <br />IMZ364718 <br />02/04/2018 <br />02/04/2019 <br />11-eased/Rented Equip 250,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additlonal Remarks Schedule,may be attached If more space is required). <br />Certificate holder is included as an additional insured for ongoing and completeoperations regarding general liability form CG7048 and auto Liability <br />per <br />when required by written contract General Liability is primary and non-contributory when required by written contract Waiver of subrogation applies to <br />general liability, auto, and workers compensation when required by written contract Umbrella extends over general liability, auto liability and employer's <br />liability. Cancellation per policy terms and conditions. <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />Indian River County Board of County Commissioners THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />1840 25th Street <br />Vero Beach, FL 32960 <br />AUTHORIZED REPRESENTATIVE <br />na.vrcv co tcu ICIUJ) @ 1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />