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A Q CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 10/02/2020 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 (fes) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED, 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 CONTACT NAME: PHONE: (800) 277-1620 X 4800 FAX: (727) 797-0704 E-MAIL ADDRESS: FrankCrum Insurance Agency, Inc. 100 South Missouri Avenue INSURERS(S) AFFORDING COVERAGE NAICff INSURER A: Frank Winston Crum Insurance Company 11600 Clearwater, FL 33756 INSURED INSURER B: PERSONAL& ADV INJURY $ INSURER C: AGG $ INSURER D: FrankCrum UC/F One Source Restoration And Building Service Inc 100 South Missouri Avenue INSURER E: INSURER F: Clearwater, FL 33756 COVERAGES CERTIFICATE NUMBER: 676551 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. NOTWITHSTANDING ANY 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. INSR LTR TYPE OF INSURANCE ADDL INSRD SUER WVD POLICY NUMBER (POLICY POLICY EFF POLICY EXP (MMIDDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS MADE❑ OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ElPROJECT EJLOCPRODUCTS-COMP/OP OTHER EACH OCCURENCE $ DAMAGE TO RENTED PREMISES (Ea E occurence) MED EXP (Any one person) $ PERSONAL& ADV INJURY $ GENERAL AGGREGATE $ AGG $ a AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS SCHEDULED ONLY AUTOS HIREDAUTOS NON -OWNED ONLY AUTOS ONLY COMBINED SINGLE UNIT (Ea accident) $ BODILY INJURY (Per person) E tP BODILY INJURY (Per accident) ( ) E PROPERTY DAMAGE (Per accident) $ E UMBRELLA LIAB XCESS LB :::I! OCCUR CLAIMS MADE EACH OCCURENCE $ AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICEWMEMBEREXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A WC202000000 01/01/2020 01/01/2021 X PER STATUE OTHER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -FA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Effective 03/25/2020, coverage is for 100% of the employees of FrankCrum leased to One Source Restoration And Building Service Inc (Client) for whom the client is reporting hours to FrankCrum. Coverage is not extended to statutory employees. CERTIFICATE HOLDER CANCELLATION ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 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 Additional Insured: Indian River County 1801 27th Street Vero Beach, FL 32960 ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD