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TIMOR -1 OP ID: TJ A ®� 14.�CERTIFICATE OF LIABILITY' INSURANCE FDA�(MM/DD/YYYY) /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). PRODUCER 772-286-4334 Stuart Insurance, Inc. 3070 S W Mapp Palm City, FL 34990 Rick Halcomb, CIC, ARM NONEACT Tani Jacobson PHONE772-286-4334 FAX 772-286-9389 (A/C, No, Ext): A/c, No): Epp IEs , tjacobson@stuartinsurance.net INSURERS AFFORDING COVERAGE NAIC # INSURER A: Westfield Insurance Co. 24112 INSURED Timothy Rose Contracting Inc 1360 Old Dixie Hwy SW, Ste 106 Vero Beach, FL 32962 INSURER B: Travelers INSURER C : INSURER D : INSURER E: DAMAGE TO RENTED 500,000 PREES Ea ccurrence $ INSURER F: CLAIMS -MADE � OCCUR VERAGES CERTIFICATE NUMBER: REVISION NUMBER: CO 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 I TYPE OF INSURANCE D D L UBp POLICY NUMBER POLICYEFF MMIDDrYYYYI POLII pY EXPLTR ffYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Vero Beach, FL 32960 AUTHORIZEREPRESENTATIVE �-ter_----- EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 500,000 PREES Ea ccurrence $ CLAIMS -MADE � OCCUR CMM6079889 06106/2018 06/06/2019 MED EXP (Any oneperson) $ 5,000 X Contractual Liab X Incl XCU PERSONAL BADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ® PEO LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS $ 2,000,000 Emp Ben. $ 1,000,000 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 a acc' e1 $ BODILY INJURY Perperson) $ X ANY AUTO CMM6079889 06/06/2018 06/06/2019 BODILY INJURY Per accident $ OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PerraccidenDAMAGE $ $ X PIP $10000 B X UMBRELLA LIAR X OCCUR 3,000,000 EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE ZUP-6lM977995-18-NF 06/0612018 06/0612019 DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVEF—]E.L. PER OTH- T E EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below A Contractors Equip CMM6079889 06106/2018 06/0612019 Rented 50,000 Equipment $1000 ded DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Grading of Land/Site Prep - State of Florida dfeshoh@ircgov.com rr:Drinr'Arc un! nGD CANCFI 1 ATInN IRCBD-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Indian River County 1801 27th St Vero Beach, FL 32960 AUTHORIZEREPRESENTATIVE �-ter_----- ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD