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/ ® A " O CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 5/17/2018 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). SUNZ Insurance Solutions, LLC ID: (Essential) c/o Essential HR, Inc. dba First Star HR 4455 LBJ Freeway, Suite 1080 Dallas, TX 75244 CONTAPRODUCER NAME: Jennifer Hau er PHONE 872.404-0295 NC No: E-MAIL ADDRESS: 'ennifer.hau er firststarhr.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: SUNZ Insurance Company 34762 INSURED Essential HR Inc. INSURER B: EACH OCCURRENCEDAMAGE $ dba FirstStar HR INSURER C: INSURER D: 4455 LBJ Freeway INSURER E Suite 1080 Dallas TX 75244 • INSURER F COVERAGES CERTIFICATE NUMBER: 41962996 REVISION NUMBER: 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 LTR OF INSURANCE ADDTYPE INSD WVDSUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEDAMAGE $ CLAIMS -MADE � OCCUR PREM SESOEa occurrent$ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑PRO LOC JECT PRODUCTS - COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ UMBRELLALIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB DED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN WCPE0000018405 10/1/2017 10/1/2018,/ STATUTE EORH EACH ACCIDENT $1,000,000 ANYPROPRIETORIPARTNER/EXECUTIVEE.L. OFFICER/MEMBER EXCLUDED? F—] NIA E.L. DISEASE - EA EMPLOYEE $ 1 000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below I I I E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Coverage provided for all leased employees but not subcontractors of: Timothy Rose Contracting, Inc. 1360 SW OLD DIXIE HWY SUITE 106 Effective date: 10/1/2013 Work performed at 43rd Ave Bridge IRC #1523 CERTIFICATE HOLDER CANCELLATION 62200099 Indian River Count SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1801 27th Street y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Vero Beach FL 32960 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE N `7 Glen J Distefano ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 41962996 1 Essential HR Inc PEO 184 MASTER CERT I Natalie Matthews 1 5/17/2018 9:43:02 AM (CDT) I Page 1 of 1