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AC©RL7 <br />CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MMIDD/YYYY) <br />7/17/2018 <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 />9RESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />)ORTANT: 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 />Frank H. Furman, Inc. <br />1314 East Atlantic Blvd. <br />P. 0. Box 1927 <br />Pompano Beach <br />FL 33061 <br />CONTACT <br />NAME; Griselidys Acosta <br />PHONE (954)943-5050 <br />(A/C. No. Exn: <br />FAX <br />(A/C, No): (954)942-6310 <br />E-MAIL gris@furmaninsurance.com <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURERA:Watford Specialty Insurance Company <br />15824 <br />INSURED <br />Vero Beach Roofing Inc <br />835 10th Avenue SW <br />Vero Beach <br />FL 32962 <br />INSURER B : MAPFRE Ins Co FL <br />34932 <br />INSURER C: Commerce and Industry Ins <br />19410 <br />INSURER D : Bridgefield Employers Ins Co <br />10701 <br />INSURER E : Zurich Ins/US Assure <br />17965 <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER:1B/19 REVISED MASTER 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. NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER COCUMENT 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 />ADDL <br />INRD <br />SUER <br />WYD <br />POLICY NUMBER <br />POLICY EFF <br />(MM/DO/YYYY? <br />POLICY EXP <br />(MMIDDJYYYYj <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />BRCGL0008101 <br />3/29/2018 <br />3/24/2019 <br />EACH OCCURRENCE <br />$ 1, 000, 000 <br />DAMAGE <br />PREM SESOEaENTED occurrence <br />$ 100, 000 <br />CLAIMS -MADE <br />X <br />OCCUR <br />MED EXP (Any one person) <br />$ 5, 000 <br />PERSONAL &ADV INJURY <br />$ 1,000,000 <br />$ 2, 000,000 <br />GEN'LAGGREGATE <br />POLICY <br />OTHER: <br />X <br />LIMIT APPLIES <br />JEST <br />PER: <br />LOC <br />PRODUCTS-COMP/OP AGO <br />$ 2,000,000 <br />B <br />'AUTOMOBILE <br />t___ <br />'X <br />_ <br />X <br />LIABILITY <br />ANY AUTO <br />ALL OWNED <br />AUTOS <br />HIRED AUTOS <br />T <br />SCHEDULED <br />AUTOS <br />NON -OWNED <br />AUTOS <br />5204070001147 <br />10/2/2018 <br />10/2/2019 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ 1,000,000 <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY (Per accident) <br />$ <br />Per OPERTY DAMAGE <br />$ <br />Medical payments <br />$ 0,000 <br />C <br />X <br />UMBRELLALIAB <br />EXCESS LIAB <br />X <br />OCCUR <br />CLAIMS -MADE <br />01B13016017827 <br />3/24/2018 <br />3/24/2019 <br />EACH OCCURRENCE <br />$ 3 000 000 <br />000,000 <br />$ <br />DED <br />RETENTION $ <br />DOFFICER/MEMBER <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />EXCLUDED? <br />(Mandatory in NH) <br />It yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />Y l N <br />y <br />N / A <br />83051246 <br />7/22/2018 <br />7/22/2019 <br />X <br />PER <br />STATUTE <br />TH- <br />ER <br />E.L. EACH ACCIDENT <br />$ 1,000,000 <br />E.L. DISEASE- EA EMPLOYEE <br />$ 1,000,000 <br />E.L. DISEASE - POLICY LIMIT <br />$ 1, 000 , 000 <br />E <br />INAP.NT.1 MARSNE <br />Ec08488092 <br />10/2/2018 <br />10/2/2019 <br />Leased/Rented Equipment $100 , 000 <br />DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) <br />CERTIFICATE HOLDER <br />CANCELLATION <br />lsmith@ircgov.com <br />Indian River County <br />Parks Division <br />1 5500 77th Street <br />Vero Beach, FL 32967 <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 />Dirk DeJong/GA <br />4z.47.4 d2 <br />ACORD 25 (2014101) <br />INS025 (201401) <br />© 1988-2014 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />