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A� Q® CERTIFICATE OF LIABILITY INSURANCE DATE TE(MIDDi 9 ) 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 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). PRODUCER Frank H. Furman, Inc. 1314 East Atlantic Blvd. P. 0. Box 1927 Pompano Beach FL 33061 CONTACT se Grilid s Acosta NAME: Y FAX (A/C, Ext).• (954) 943-5050 (A/C No): (954)942-6310 E-MAIL ris@£urmaninsurance.com ADDRESS: g INSURER(S) AFFORDING COVERAGE NAIC 11 INsURERA:Berkley Assurance Co 39462 INSURED Vero Beach Roofing Inc 835 10th Avenue SW Vero Beach FL 32962 INSURER 13:MAPFRE Ins Co FL 34932 INSURERc:Bridge£ield Employers Ins Co 10701 INSURER D : Zurich Ins/US Assure 17965 INSURER E : INSURERF: X COVERAGES CERTIFICATE NUMBER:19/20 MASTER LIABILTIY REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVVITHSTANDINGANY 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. IISR LTR TYPE OF INSURANCE ADM INSD SUER WVD POLICY NUMBER POLICY EFF (MM/DDM'W) POLICY EXP (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY X VUMD0001680 3/24/2019 3/24/2020 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR PARENTED TA PREEMMI ESESS (RENTED occurrence) $ 100,000 MED EXP (Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 GEN'LAGGREGATE POLICY OTHER: X LIMIT APPLIES jERa PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 CyberflexCov $ 100,000 B AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS R SCHEDULED AUTOS NON -OWNED AUTOS 5204070001147 10/2/2018 10/2/2019 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ PIP -BASIC $ 10,000 A X UMBRELLA LIAB EXCESSLIAB X OCCUR CLAIMS -MADE VDMA1071196 3/24/2019 3/24/2020 EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,000 DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory inNH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/ N Y N / A 83051246 7/22/2018 7/22/2019 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 D INLAND MARINE EC08488092 10/2/2018 10/2/2019 Leased/Rented Equipment $100,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: IRC North County RO Plant Roof Replacement IRC -1802. Indian River County is included as additional insured for general liability & auto liability as required by written contract. 30 days NOC applies except 10 days for non payment of premium. CANCELL Indian River County 1801 27th Street Vero Beach, FL 32960 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Dirk DeJong/GA 404-4AO'1r/a/ ACORD 25 (2014/01) INS025 (201401) -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD