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CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 3/10/2022 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 CONTACT Bowen, Miclette & Britt of Florida, LLC NAME: Michelle Rushing PHONE 1020 N. Orlando Avenue a/c No Ext :4O7-647 1616 a/c No): 407-628-1635 Suite #200 E-MAIL Maitland FL 32751 ADDRESS:mrushing@bmbinc.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Amerisure Mutual Insurance Company 23396 INSURED DELAHOZBUI De La Hoz Builders, Inc. INSURER B : Amerisure Insurance Company19488 400 Gus Hipp Dr. INSURER C: Owners Insurance Co. 32700 Rockledge FL 32955 INSURER D: COVERAGES CERTIFICATE NUMBER: 15321_°4653 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY 'ERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONCITION 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 ADDL SUBR LTR TYPE OF INSURANCE i= WVD POLICY NUMBER POLICY EFF POLICY EXP MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y GL2109570C3 9/1/2021 9/1/2022 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE a OCCUR DAMAGET RENTED PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 10,000 I, GEN'L AGGREGATE LIMIT APPLIES PER: PERSONAL & ADV INJURY $ 1,000,000 POLICY jE a LOC GENERAL AGGREGATE $ 2,000,000 OTHER: PRODUCTS - COMP/OP AGG $ 2,000,000 C AUTOMOBILE LIABILITY 51575404019/1/2021 9/1/2022 COMBINED SINGLE LIMIT X Ea accident $1,000,000 ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE $ Per accident $ UMBRELLA LIABOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTION $ B WORKERS COMPENSATION Y WC -2109571-04 9/112021 9/1/2022 PER OTH- $ AND EMPLOYERS' LIABILITY Y / N X STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED?❑ N / A E.L. EACH ACCIDENT $ 1,000,000 (Mandatory in NH) If yes, describe under E.L. DISEASE - EA EMPLOYEE $ 1,000,000 DESCRIPTION OF OPERATIONS below 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) The following policy provisions and/or endorsements form part of the po:icies of insurance represented by this certificate of insurance. The terms contained in the policies and/or endorsements supersede the representations made herein. Electronic copies of the policy provisions and/or endorsements listed below are available by emailing: certificates@bmbinc.com When required by written contract, those parties listed in said contract, including the Certificate Holder, are added as an Additional Insureds with respect to the General Liability as afforded by the policy and/or endorsements. When required by written contract, a Waiver of Subrogation, with respect to the General Liability and Worker's Compensation is granted to those parties listed in See Attached... CERTIFICATE HOLDER CANCELLATION Indian River County 1800 27th St. Vero Beach FL 32960 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 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014!01) The ACORD name and logo are registered marks of ACORD