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ACRD® 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). CONTACT NAME: Jennifer Hauger PHONEFAX WC. No,_Ext,): 972-404-0295 (AJC, No): E-MAIL ADDRESS: lennlfe,LhaugerPtlratstarhccom CERTIFICATE F LIABILITY INSURANCE DATE (MMIDDIYYYY) 9/26/2017 RODUCER SUNZ Insurance Solutions, LLC ID: (Essential) c/o Essential HR, Inc. dba First Star HR 4455 LBJ Freeway, Suite 1080 Dallas, TX 75244 INSURED Essential HR Inc., Essential HR II, Inc. dba FirstStar HR 4455 LBJ Freeway Suite 1080 Dallas TX 75244 INSURER(S) AFFORDING COVERAGE NSURER A : SUN7. Insurance Company NSURER B: INSURER C : NAIC # 34762 INSURER D: INSURER E : INSURER F • REVISION NUMBER: 4lJVCtCKk.., va_rs .. vvvvvvt, 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 TYPE OF INSURANCE ADDL IVSD SUER WVD POLICY NUMBER POLICY EFF (MMIDD/YYYYI POLICY EXP ' rMMIDD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED - - OCCUR PREMISES Ee occurrence CLAIMS -MADE MED EXP (Any one person) .� PERSONAL & ADV INJURY APPLIES PER: GENERA(_ AGGREGATE $ GEN'L AGGREGATE LIMIT PRO LOC PRODUCTS - COMP/OP AGG POLICY OTHER: JECT AUTOMOBILE LIABILITY CEO aBINEDDtj INGLE LIMIT $ ANY AUTO BODILY INJURY (Per person) $ J 4 $ OWNED SCHEDULED BODILY INJURY (Per accident} AU1OS ONLY HIRED AUTOS NON -OWNED PROPERTY DAMAGE Per accident) $ AUTOS ONLY AUTOS ONLY UMBRELLA LIAR EACH OCCURRENCE $ EXCESS LIAB OCCUR CLAIMS -MADE AGGREGATE DED RETENTION 5 $ A WORKERS COMPENSATION WCPE0000018405 10/1/2017 10/1/2018 �j PERTUTE R O0RIi _ AND EMPLOYERS' LIABILITY Y / N WCPE0000018404 10/1/_ 10/1/2017 E.L EACH ACCIDENT $ 1,000,000 $ 1 ,000,000 ANYPROPRIETOR/PARTNER/EXECUTIVF OFFICER(MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below -- N/A _E.L. DISEASE - EA EMPLOYEE E.L. DISEASE -POLICY LIMIT _ $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Coverage provided for all leased employees but not subcontractors of: Timothy Rose Contracting, Inc. 1360 SW OLID DIXIE HWY SUITE 106 Effective date: 10/1/2013 Ct[1Irl4.n 11- rrvL.uLrl 52200099 Indian River County Purchasing 1800 27th St Bldg B Vero FL 32960 _. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TILE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ✓ i� Glen J Distefano © 1988-2015 ACORDUKATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 38008923 ' Esnential HR Inc PEO 184 MASTER CERT I Natalie Matthew:; 19/26/2017 5:16:00 PM (CDT) i Page L of 1