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W&JCONS-01
<br />DSMITH2
<br />ACORU` CERTIFICATE OF LIABILITY INSURANCE
<br />`--�
<br />DATE(MM/
<br />01/31/2019
<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 />Hub International Florida
<br />1560 Orange Ave, Ste 750
<br />Winter Park, FL 32789
<br />CONTACT
<br />NAME:
<br />PHONE
<br />(NC, No, Ext): (321) 255-2220 1 FAX
<br />(NC, No):(321) 255-7770
<br />AIL
<br />ADDRESS: Certificates.FLA@Hubinternational.com
<br />INSURER(S) AFFORDING COVERAGE j NAIC #
<br />INSURER A: Liberty Insurance Corporation 142404
<br />INSURED
<br />W&J Construction Corporation
<br />1038 Harvin Way #120
<br />Rockledge, FL 32955
<br />I INSURER B: Liberty Mutual Fire Insurance Company 123035
<br />INSURER C: XL Specialty Insurance Company 137885
<br />INSURER D :Ironshore Specialty Company 25445
<br />INSURER E :
<br />INSURER F :
<br />COVERAGES
<br />CERTIFICATE NUMBER:
<br />•
<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 POLIC ES 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' TYPE OF INSURANCE ADDLISUBR
<br />LTR INSD ! WYD
<br />POLICY NUMBER ' POLICY EFF
<br />(MMIDD YYYYI
<br />POLICY EXP
<br />IMMIDD/YYYY)
<br />LIMITS
<br />A
<br />I X 1 COMMERCIAL GENERAL
<br />LIABILITY
<br />I X OCCUR
<br />.'
<br />i X
<br />I
<br />I '
<br />I i
<br />t
<br />TB7-Z51-292383-029 101/31/2019
<br />01/31/2020
<br />1 1,000,000
<br />EACH OCCURRENCE $
<br />f
<br />1 j CLAIMS -MADE
<br />DAMAGE TO RENTED
<br />PREMISES ( a occurrence)
<br />100,000
<br />$
<br />$ 15,000
<br />1 X 1 Standard Contractual
<br />MED EXP (Any one person)
<br />I
<br />PERSONAL & ADV INJURY ` $ 1,000,000
<br />1 GEN'LAGGREGATE LIMIT APPLIES PER:
<br />' I POLICY 1 X PES � I LOC
<br />I X I OTHER:$15M Total Agg Limit
<br />GENERAL AGGREGATE $ 2,000,000
<br />2,000,000
<br />PRODUCTS -COMP/OP AGG
<br />I$
<br />$
<br />B AUTOMOBILE UABIUTY
<br />X ;ANY AUTO I X I
<br />j
<br />AS2-Z51-292383-019 1 01/31/201911 01/31/2020
<br />COMBINED SINGLE LIMIT I 1,000,000
<br />(Ea accident) $
<br />LY
<br />BODIINJURY(Perperson) 1 $
<br />OWNED
<br />AUTOS ONLY
<br />j ATOS ONLY
<br />AU
<br />1 PIP
<br />1 SCHEDULED
<br />AUTOS pSyyNEp i
<br />1 OS ONLY I
<br />i(Per
<br />1
<br />I
<br />BODILY INJURY (Per accident)! $
<br />PROPERTY DAMAGE I
<br />accident) 1 $
<br />1 $ 10,000
<br />A
<br />�X ' UMBRELLA UAB
<br />EXCESS LIAR
<br />i
<br />X OCCUR
<br />I CLAIMS -MADE;
<br />!
<br />i
<br />TH7-Z51-292383-049 01/31/2019 ; 01/31/2020
<br />I
<br />EACH OCCURRENCE i $ 10,000,000
<br />AGGREGATE 10,000,000
<br />$
<br />1 DED 1 X 1 RETENTION $ 10,0001
<br />1
<br />Follow form Is
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />Y/N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE •
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory In NH) --'
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />1
<br />!
<br />'
<br />N /A•
<br />WC2-Z51-292383-039
<br />! I
<br />01/31/20191 01/31/2020
<br />I
<br />1
<br />X I STATUTE I I ERH i
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />1,000,000
<br />E.L. DISEASE - EA EMPLOYEE! $
<br />E.L. DISEASE - POLICY LIMIT $ 1,000,000
<br />C
<br />D
<br />Equipment Floater
<br />Pollution/Each claim
<br />i
<br />UM00028344MA19A
<br />003964700
<br />01/31/2019 1 01/31/2020
<br />01/31/20191 01/31/2020
<br />I
<br />Lease/Renti 50,000
<br />Ded. $20K / Limit -> 1 1,000,000
<br />,
<br />I
<br />DESCRIPTION OF OPERATIONS 1 LOCATIONS l VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
<br />Indian River County Florida is included as Additional Insured for General Liability & Auto Liability, when required in a written contract or agreement with the
<br />Insured. Should a policy be cancelled before the expiration date, a 30 days' notice is to be provided by the Insurer to the certificate holder.
<br />ATE HOLDER
<br />CANCELLATION
<br />Indian River County Florida
<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 />
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