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TIMOR -1 <br />OP ID: TJ <br />A�CrO'R� CERTIFICATE OF LIABILITY INSURANCE <br />OA01/10/2020Y) <br />01 /10/2020 <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 Mapp <br />Palm City, FL 34990 <br />CONTACT Tani Jacobson <br />NAME: <br />PHONE 772-286-4334 FAX 772-286-9389 <br />(A/C, No, Ext): (AIC, No): <br />AD-DREt/aco son stuartinsurance.net <br />Rick Halcomb, CIC, ARM <br />X <br />INSURERS AFFORDING COVERAGE NAIC # <br />INSURER A: Everest Denali Ins CO 116044 <br />06/06/2020 <br />'iSUR D <br />motFF1 Rose Contr ctin Inc <br />INSURER B: National Union Fire Insurance 194455 <br />INSURER c :Markel American 28932 <br />1360 OIYd Dixie HwW, Sgte 106 <br />Vero Beach, FL 3262 <br />PERSONAL &ADV INJURY $ 1,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER:2,000,000 <br />POLICY �X PRO LOC <br />JECT <br />INSURER D: <br />INSURER E: <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: 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. 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 />INSRTYPE <br />OF INSURANCE <br />DDL <br />UBR <br />POLICY NUMBER <br />POLICY EFF <br />POLICY EXP iDtYYYYI <br />LIMITS <br />A <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE X OCCURCF3GL00172191 <br />X Contractual Liab <br />X <br />06/06/2019 <br />06/06/2020 <br />EACH OCCURRENCE $ 1,000,000 <br />DAMAGE TOE RENTED 100 000 <br />PREMISES occurrence $ <br />5,000 <br />MED EXP (Any oneperson) $ <br />X Incl XCU <br />PERSONAL &ADV INJURY $ 1,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER:2,000,000 <br />POLICY �X PRO LOC <br />JECT <br />GENERAL AGGREGATE $ <br />2,000,000 <br />PRODUCTS - COMP/OP AGG $ <br />OTHER: <br />A <br />AUTOMOBILE <br />1xxANY <br />LIABILITY <br />AUTO <br />OWNED SCHEDULEDAUTOS ONLY AUTOOS <br />AUTOS ONLY X ATOS ONLYY <br />PIP $10000 <br />X <br />CF3CA00143191 <br />06/06/2019 <br />06/06/2020 <br />COMBINED SINGLE LIMIT $ 1,000,000 <br />BODILY INJURY Per erson $ <br />BODILY INJURY Per accident $ <br />Pe�PcE.RT t AMAGE$ <br />B <br />X <br />UMBRELLA LIAB <br />EXCESS LIAB <br />X <br />OCCUR <br />CLAIMS -MADE <br />BE035882715 <br />06/06/2019 <br />06/06/2020 <br />EACH OCCURRENCE $ 3,000,000 <br />AGGREGATE $ 3,000,000 <br />DED RETENTION $ <br />WORKERS COMPENSATIONPER <br />AND EMPLOYERS' LIABILITY <br />Y/N <br />ANY PROPRIETOR/PARTNER/EXECUTIVEE.L. <br />PFFIC ER/MEMBER EXCLUDED? ❑ <br />(Mandatory in NH) <br />N I A <br />OTH- <br />TAT T ER <br />EACH ACCIDENT $ <br />C <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />Contractors Equip <br />1% DED, MIN $1000 <br />MKLM31MOO51334 <br />06/06/2019 <br />06/06/2020 <br />E.L. DISEASE - EA EMPLOYEE $ <br />E.L. DISEASE -POLICY LIMIT <br />Rented 85,000 <br />Equipment $1000 ded <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />—Indian River County is additional insured with respect to general liability <br />and auto liability when required by written contract. <br />Indian River County <br />1801 27th St <br />Vero Beach, FL 32960 <br />A('ORr) 95 19nfia/nz1 <br />IRCBD-1 <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 />19 <br />v lana-zU-1o ACORu CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />