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JOHNINC-02 SMAJESK
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<br />ACOR®� CERTIFICATE OF LIABILITY INSURANCE
<br />COVERAGES. CERTIFICATE NUMBER: 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 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 />DATE 1/14/201 8 )
<br />11114/201$
<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 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 Sharon Majeski, ARM
<br />Johnson Insurance Racine
<br />1103 Hunter Dr Ste 100(kc,
<br />Mount Pleasant, WI 53406
<br />PHONE FAX
<br />No, EXs : 920. 433-7107 1Arc,:No : $77: 254-8586
<br />E-MAs _. smajeski, johnsohfirianciai Pou .com
<br />INSURERS AFFORDING COVERAGE NAIC #
<br />07/01/2018;
<br />INSURERA.Zurich North America 16535
<br />EACH OCCURRENCE
<br />INSURED
<br />INSURER B: American Guarantee & Liability Insurance Co 26247
<br />INSU ERC:
<br />Johnson -Davis, Inc.
<br />INSURER D:
<br />604 Hilibrath Drive
<br />Lantana, FL 33462
<br />INSURER E
<br />INSURER F:
<br />PERSONAL & AOV INJURY
<br />COVERAGES. CERTIFICATE NUMBER: REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />?NSR.
<br />TYPE OF INSURANCE
<br />ADDL
<br />SUBR
<br />POLICY NUMBER
<br />POLICY EFF,
<br />. POLICY EXP_-.
<br />LIMITS
<br />A .'
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />�j
<br />CLAIMS-MADE.[XOCCUR
<br />J .
<br />X
<br />GLO 9813382-00
<br />07/01/2018;
<br />07/01/2019
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGE TO RENTED
<br />MtSES (E�ostrre4c
<br />300,000
<br />MEDEXP.(Any oneperson)
<br />$ 10,000
<br />PERSONAL & AOV INJURY
<br />$ 1,000,000
<br />GEN 'LAGGREGATELIMIT APPLIESPER:
<br />POLICY L -- i j T E LOC
<br />OTHER:
<br />GENERALAGGREGATE
<br />$ 2,000'000
<br />PRODUCTS:- COMPIOP AGG
<br />$ 2'000,000
<br />A.:
<br />AUTOMOBILE
<br />X
<br />X
<br />LIABILITY
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY AUUT.}O.SS1 p
<br />AUMOS ONLY X AUTOS ONLY
<br />X
<br />BAP 9813380-00
<br />07/01/2018
<br />07/0112019!
<br />COMBINED SINGLE LIMIT
<br />$ 1,000,000
<br />BODILY INJURY Per, erson
<br />BODILY INJURY (Par accident1
<br />$
<br />pPeacetlant?AMAGE
<br />B
<br />�DEDEXCESSLIAB
<br />UMBRELLA LIAB
<br />N
<br />OCCUR5,000,000
<br />CLAIMS -MADE
<br />AUC 5676415-00
<br />07/01/2018
<br />07/01/2019
<br />EACH OCCURRENCE.
<br />AGGREGATE
<br />$ 5'000,000
<br />1.X I RETENTION $ 0
<br />$
<br />.
<br />WORKERS COMPENSATIONPER
<br />AND EMPLOYERS' LIABILITY Y1N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />�FtCERIMggMg�� EXCLUDED?
<br />ehdatary,in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />N / A
<br />0TH -
<br />E L. EACH ACCIDENT
<br />$
<br />E. L, DISEASE - EA EMPLOYEE
<br />$
<br />E.L. DISEASE - POLICY LIMIT
<br />A
<br />Equipment Floater
<br />CPP 4289118-00
<br />07/01/2018
<br />07101/2019
<br />Leased Rented
<br />300,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additlonal Remarks Schedule,may bo aftached It more -space Is required)
<br />Contractor's Pollution Liability - Policy # 7930030920003- Limit - $1,000,000 - 3/112018=31112019 - Homeland Insurance Company of NY
<br />Project: 45" Street Beautification Project Phase II, County Project #IRC -1748, Bid Number: 2018048, Project Address: 45th Street from 43rd Avenue to 28th
<br />Court Vero Beach, Florida 32967. Indian River County is additional Insured on the general liability and automobile policies. A 30 day written notice of
<br />cancellation applies.
<br />Indian River County
<br />1800 27th Street
<br />Vero Beach, FL 32960
<br />ACORD 25 (2016103)
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />.3, 'mL
<br />© 1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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