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TIMOR -1 <br />OP ID: TJ <br />ACORif,'CERTIFICATE F L A, L TY INSURANCE <br />4.----05/31/2018 <br />DATEIMMIDDrYYY) <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 772-286-4334 <br />Stuart Insurance, Inc. <br />3070 S W Ma pp <br />Palm City, FL 34990 <br />Rick Halcomb, CIC, ARM <br />CONTACT Tani Jacobson <br />NAME: <br />PHONE 772.286 4334 I FAx 772-286-9389 <br />(A/C, No, Ext): (A1C, No): <br />E-MAIL tjacobson@stuartinsurance.net <br />ADDRESS: @ <br />INSURER(S) AFFORDING COVERAGE <br />NAIC N <br />INSURER A :Westfield Insurance Co. <br />24112 <br />INSURED Timothy Rose Contracting Inc <br />1360 Old Dixie Hwy SW, Ste 106 <br />Vero Beach, FL 32962 <br />INSURER B:Travelers <br />_INSURER C: <br />INSURER D : <br />$ 1,000,000 <br />INSURER E : <br />INSURER F : <br />CLAIMS -MADE I X OCCUR <br />I_ <br />COVERAGES <br />CERTIFICATE 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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />AUDL <br />INSD <br />SUER <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />IMMIDD/YYYY) <br />POLICY EXP <br />(MM/DD/YYYY) <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 1,000,000 <br />CLAIMS -MADE I X OCCUR <br />I_ <br />CMM6079889 <br />06/06/2018 <br />06/06/2019 <br />DAMAGE TO RENTED <br />PREMISES <br />$ 500,000 <br />X <br />Contractual Liab <br />(Ea occurrence) <br />MED EXP (Any one person) <br />$ 5,000 <br />X <br />— <br />Incl XCU <br />— <br />PERSONAL 8 ADV INJURY <br />1,000,000 <br />$ <br />GE <br />'L AGGREGATE LIMIT APPLIES PER. <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />POLICY ( X JECT LOC <br />PRODUCTS -COMP/OP AGG <br />$ 2,000,000 <br />OTHER: <br />Emp Ben. <br />$ 1,000,000 <br />A <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />1,000,000 <br />$ <br />X- <br />ANY AUTO <br />CMM6079889 <br />06/06/2018 <br />06/06/2019 <br />BODILY INJURY (Per person) <br />$ <br />OWNED <br />AUTOS ONLY <br />SCHEDULED <br />AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />X <br />HIREDTONLY <br />_ x <br />NON-OWNED <br />ONEYY <br />(Peri accidentDAMAGE <br />$ <br />X <br />PIP $10000 <br />$ <br />B <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />EACH OCCURRENCE <br />$ 3,000,000 <br />EXCESSLIAB <br />CLAIMS -MADE <br />ZUP-61M977995-18-NF <br />06/06/2018 <br />06/06/2019 <br />AGGREGATE <br />$ <br />DED <br />RETENTION$ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITYY <br />PER OTH- <br />STATUTE ER <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFiCER/MEMUER EXCLUDED? <br />/ N <br />N / A <br />E L. EACH ACCIDENT <br />$ <br />(Mandatory in NH) <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />A <br />Contractors Equip <br />CMM6079889 <br />06/06/2018 <br />06/06/2019 <br />Rented <br />Equipment <br />50,000 <br />$1000 ded <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is requi ed) <br />Grading of Land/Site Prep - State of Florida dfeshoh@ircgov.com <br />CERTIFICATE HOLDER <br />CANCELLATION <br />IRCBD-1 <br />Indian River County <br />1801 27th St <br />Vero Beach, FL 32960 <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 />ACORD 25 (2016/03) <br />© 1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />