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AC40 V CERTIFICATE OF LIABILITY INSURANCE 4/DATE(M 8 D/YYYY) 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 Arthur J. Gallagher Risk Management Services, Inc. 200 S. Orange Avenue Orlando FL 32801 CONTACT NAME: Kim Zastrow PHONE 407-563-3537 FAX o .4O7-370-3057 E-MAIL .Kim Zastrow@ajg.com @ jg.com INSURERS AFFORDING COVERAGE NAIC # 5/1/2017 INSURER A:Lloyd 'S S nd 2987 EACH OCCURRENCE $2,000,000 INSURED INDIRIV-04 INSURER B: SafetyNational Casualty Corporation 15105 Indian River County Board of County Commissioners Attention: Beth Martin INSURERC:Markel American Insurance Company 28932 GEN'LAGGREGATE LIMIT APPLIES PER: %( POLICY 1:1 PRO-JECT ❑ LOC OTHER: 1800 27th St. INSURER D : INSURER E: Vero Beach FL 32960 INSURER F: LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY X SIR $200,000 COVERAGES CFRTIFICATF NI IMRFR• 1222349823 01=%1ICIt,11U MI 11111R1=0• 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. ILTR TYPE OF INSURANCE 'INSD WVD POLICY NUMBER MM/DDY� MM/DDr� LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE XX OCCUR PK1017417 5/1/2017 5/1/2018 EACH OCCURRENCE $2,000,000 DAMAGE( RENTED PREMISESSEa occurrence) $ MED EXP (Any one person) $ X SIR $200.000 PERSONAL & ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: %( POLICY 1:1 PRO-JECT ❑ LOC OTHER: GENERAL AGGREGATE $4,000,000 PRODUCTS - COMP/OP AGG $ $ A AUTOMOBILE X LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY X SIR $200,000 PK1017417 5/1/2017 5/1/2018 C MBINED SINGLE LIMIT$ Ea accident 2,000,000 BODILY INJURY (Per person) $ Pe id BODILY INJURY r accent ( ) $ PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTI VE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA SP4054789 5/1/2017 5/1/2018 PER OERT X STATUTE ER E.L. EACH ACCIDENT $2,000,000 E.L. DISEASE - EA EMPLOYEE $2,000,000 E.L. DISEASE - POLICY LIMIT $2,000,000 C Auto Physical Damage MKLM31M0049722 5/1/2017 5/1/2018 Per Occurrence 15,712,189 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Workers Compensation & Employer's Liability Policy # SP4054789 SIR: $650,000 RE: Statewide Mutual Aid Agreement. i CERTIFICATE HOLDER CANCELLATION ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 26 (2016/03) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Florida Department of Emergency Management THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Alonna Vinson ACCORDANCE WITH THE POLICY PROVISIONS. Bureau of Response, Logistics Section 2555 Shumard Oak Blvd. ED AUTHORZEREPRESENTATIVE UD, I y AUTHORIZED, Tallahassee FL 32399 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 26 (2016/03) The ACORD name and logo are registered marks of ACORD