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OHLUSAI-01 ELITZ A��Ro CERTIFICATE OF LIABILITY INSURANCE DATE(M /202YYY) v2s2o22 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. TH:`S 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 have ADDITIONAL INSURED provisions or 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 CONTACT OHL Certificates American Global LLC 390 North Broadway 3rd Floor PHONEFAX (AIC, No, Ext): (516) 387-1170 AIC, No): E-MAILD SS, OHLCertificates@americanglobal.com Jericho, NY 11753 VTC2K-CO-7K03062A-IND-21 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Travelers Indemnity Company 25658 EACH OCCURRENCE $ 2,000,000 INSURED INSURER B: Charter Oak Fire Insurance Company 25615 OHLA USA, Inc. 9675 N. W. 117th Avenue INSURER C: Sutle 108 INSURER D: INSURER E: Miami, FL 33178 INSURER F: GEN'L AGGREGATE LIMIT APPLIES PER: POLICY [X] FRO [7 LOC COVERAGES CERTIFICATE NUMBER: RFVIsInN 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 CR 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBERPOLICY EFF M 1 D! POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAItv1 S -MADE OCCUR X Contractual Liab X VTC2K-CO-7K03062A-IND-21 12/31!2021 12/31/2022 EACH OCCURRENCE $ 2,000,000 PREMISES Ee occu � nce $ 500'000 MED EXP (Any oneperson) $ PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY [X] FRO [7 LOC GENERAL AGGREGATE $ 4,000,000 4,000,000 PRODUCTS-COMP/OPAGG $ $ OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 2,000,0�)O Ea accident $ IxANY AUTO SCHEDULED ATOSONLY AUTOS X VTC2JCAP-7K030631JND-21 12/31/2021 12/31/2022 BODILY INJURY Per rson $ BODILY INJURY Per accident $ HIRED X NON-OaVNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accitlent $ UMBRELLA LIABOCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS -MADE AGGREGATE DED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PXCLUDED XECUTIVE YIN (MandaOFFICEtory In ER EXCLUDED? (Mandatory In and If yes, describe under DESCRIPTION OF OPERATIONS below NIA UB - 4R50 1 67 5 -2 1-25-D 12/31/2021 12/31/2022 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,OOb E.L. DISEASE - POLICY LIMIT $ 1,000,0010 DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) RE: Project Number IRC -1638 Project Name: 6th Avenue Milling & Resurfacing From U.S. 1/S.R. to 21st Street Project Address: 6th Avenue From U.S. 1 /S.R. 5 to 21st Street Vero Beach, Florida 32960 and 62962 Indian River County is listed as Additional Insured in accordance with the policy and provisions of the General Liability and Auto Liability Policies. Indian River County 1801 27th Street Vero Beach, FL 32960 ACORD 25 (2016/03) 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 © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD