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ACCII CERTIFICATE OF LIABILITY INSURANCE <br />DAT2/26/2018 ) <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(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />M3 Insurance Solutions, Inc. <br />828 John Nolen Drive <br />CONTACT <br />Alex Friedl <br />PHONE FAX <br />• 608-288-2898 A/C No): <br />E-MAIL alex.friedl@m3ins.com <br />Madison WI 53713 <br />PUDSOMER • JOHNINC-01 <br />INSURERS AFFORDING COVERAGE NAIC # <br />INSURED <br />Johnson -Davis Incorporated <br />604 Hillbrath Drive <br />INSURER A: Amerisure Mutual Insurance <br />INSURER B: <br />INSURER C : <br />Lantana FL 33462 <br />INSURER D: <br />INSURER E: <br />INSURER F <br />MED EXP (Any one person) $ <br />COVERAGES CERTIFICATE NUMBER: 1299159518 REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY <br />PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT <br />TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT <br />TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />SUBR <br />POLICY NUMBER <br />POLICY EFF <br />MM/DDIYYYY <br />POLICY EXP <br />MM/DD/YYYY <br />LIMITS <br />GENERAL LIABILITY <br />EACH OCCURRENCE $ <br />COMMERCIAL GENERAL LIABILITY <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence $ <br />MED EXP (Any one person) $ <br />CLAIMS -MADE r__1 OCCUR <br />PERSONAL & ADV INJURY $ <br />GE NERAL AGGREGATE $ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG $ <br />POLICY PRO-- LOC <br />$ <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT $ <br />(Ea accident) <br />ANY AUTO <br />BODILY INJURY (Per person) $ <br />ALL OWNED AUTOS <br />BODILY INJURY (Per accident) $ <br />SCHEDULED AUTOS <br />PROPERTY DAMAGE $ <br />(Per accident) <br />HIRED AUTOS <br />$ <br />NON -OWNED AUTOS <br />UMBRELLA LIAB <br />HCLAIMS-MADE <br />OCCUR <br />EACH OCCURRENCE $ <br />AGGREGATE $ <br />EXCESS LIAB <br />DEDUCTIBLE <br />$ <br />$ <br />RETENTION $ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y I N <br />WC210013502 <br />3/1/2018 <br />3/1/2019 <br />X I WC STATU- OTH- <br />EACH ACCIDENT $1,000,000 <br />ANY PROPRIETOR/PARTNER/EXECUTIVEE.L. <br />OFFICER/MEMBER EXCLUDED? F—] <br />N I A <br />E.L. DISEASE - EA EMPLOYE $1,000,000 <br />(Mandatory in NH) <br />If yes, describe under <br />E.L. DISEASE - POLICY LIMIT 1 $1 op0000 <br />DESCRIPTION OF OPERATIONS below <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) <br />I-t:K I II'IGA I t HULUtK CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED <br />IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />Johnson -Davis, Inc <br />863 S Kings Highway <br />AUTHOR ED REPRESENTATIVE <br />ee <br />Fort Pierce FL 34945 <br />©1988-2009 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD <br />