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SUNSLAN-03
<br />DKLAUS
<br />A`" O„ O
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MMIDDIYYYYI
<br />TYPE OF INSURANCE
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE O OCCUR
<br />8/6/2020
<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
<br />R V Johnson Agency, Inc.
<br />2041 SE Ocean Blvd
<br />NAMEACT
<br />PHONE FAX
<br />(AIC, No, Eml: (772) 287-3366 (AIC, No1:(772) 287-4255
<br />Stuart, FL 34996
<br />AMss. info@rvjohnson.com
<br />ADOR
<br />INSURERS AFFORDING COVERAGE NAIC p
<br />INSURER A: Southern Owners Insurance 10190
<br />INSURED
<br />INSURER B:Progressive Express Ins Co 02962
<br />INSURER C:StarStone National Ins Co. Harborside Financial Ctr
<br />Sunshine Land Design, Inc.
<br />3291 SE Lionel Terrace
<br />Stuart, FL 34997
<br />INSURER D:Brid efield Employers Ins. 10701
<br />INSURER E:
<br />INSURER F
<br />COVEkAut:5 CERTIFICATE NUMBER:
<br />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 />/NSR
<br />LTR
<br />A
<br />TYPE OF INSURANCE
<br />X COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE O OCCUR
<br />ADDL
<br />I SD
<br />X
<br />SUER
<br />WVD
<br />POLICY NUMBER
<br />72436125
<br />POLICY EFF
<br />MM/ n'YYYl
<br />7/30/2020
<br />POLICY EXP
<br />IMMIDD/YYYY1
<br />7/30/2021
<br />LIMITS
<br />EACH OCCURRENCE $ 1,000,000
<br />DDAAMAGPREMI�E TO aENTED e $ 100,000
<br />MED EXP An one erson $ 5,000
<br />PERSONAL & ADV INJURY S 1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER
<br />POLICY a JECOT- D LOC
<br />GENERAL AGGREGATE S 2,000,000
<br />PRODUCTS - COMP/OP AGG S 2,000,000
<br />COMBINED SINGLE LIMIT 1,000,000
<br />'AlS
<br />BS
<br />OTHER
<br />AUTOMOBILE LIABILITY
<br />ANY AUTO
<br />OWNED SCHEDULED
<br />AUTOS ONLY X AUTOS
<br />AIRED NWND
<br />U OS ONLY ATOS ONLY
<br />X
<br />02416933-0
<br />7/25/2020
<br />7/25/2021
<br />BODILY INJURY Perperson) S
<br />BODILY INJURY Per accident $
<br />PROPERTY AMAGE
<br />Per accident S
<br />S
<br />EACH OCCURRENCE $ 1,000,000
<br />C
<br />D
<br />X UMBRELLA LIAR X OCCUR
<br />EXCESS LIAB CLAIMS -MADE
<br />-a..
<br />! A
<br />170854202ALI
<br />830-56011
<br />7/30/2020
<br />11/1/2019
<br />7/30/2021
<br />11/1/2020
<br />AGGREGATE S 1,000,000
<br />TX RETENTIONS 10,000
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETOR/PARTNER NECUTIVE ❑
<br />OFFICER/MEMBER EXCLUDED?N
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />S 1,000,000
<br />X PER OTH-
<br />� T
<br />E.L. EACH ACCIDENT S 1,000,000
<br />E.L. DISEASE - EA EMPLOYEE S 1,000,000
<br />E.L. DISEASE - POLICY LIMIT S 1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Certificate Holder is listed as additional insured.
<br />Project:
<br />Indian River County Bid No. 2020037
<br />Indian River Boulevard & 8th Street Signalization Improvements
<br />r`C0T1t71l c7 -1 ---
<br />Indian River County
<br />1600 27th Street
<br />Vero Beach, FL 32960
<br />AcnRn ?S I,)ndClnat
<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 />W 1988-2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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