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40 SECTION 00620 - Sample Certificate of Liability Insurance <br /> CERTIFICATE OF LIABILITY INSURANCE <br /> AM PRODUCER <br /> LRIGHTS <br /> ICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO <br /> N THE CERTIFlCATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND <br /> HE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> rCOMPANIES AFFORDING COVERAGE <br /> INSURED - <br /> -i - <br /> - <br /> I QUMPANYE - <br /> COVERAGES <br /> 4N0TWVvITHSTANDING <br /> TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED <br /> ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED <br /> PERTAIN THE INSURANCE ACCORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. <br /> SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> POLICY <br /> POLICY EFFECTIVE POLICY EXPIRATION <br /> TYPE OFINSURANCE NUMBER DATE MMIDDM' DATE MM/D LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000❑ COMMERCIAL GENERAL LIABILITY FIRE DAMAGE An One Fire § <br /> 50,000 <br /> INS <br /> ❑ CLAIMS MAGE ❑OCCUR MED. EXP. (Any One Person f 5,000 <br /> ❑ PERSONAL & ADV INJURY $ 1 ,000,000 <br /> _ ❑ GENERAL AGGREGATE $ 1,D00,000 <br /> ❑ PRODUCTS — COMP/OP AGG. $ 1,000,000 <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> 11■ A ANY AUTO (Ea. Occurrence) S 1,000,"00 <br /> ❑ ALL OWNED AUTOS BODILY INJURY <br /> ❑ SCHEDULED AUTOS (Per Person) $ <br /> ❑ HIRED AUTOS BODILY INJURY <br /> AM [:I NON-OWNED AUTOS (Per Accident) $ <br /> ❑ PROPERTY DAMAGE § <br /> JAE <br /> ARAGE LIABILITY AUTO ONLY — <br /> EAACCIDENT § <br /> Y■ OTHER THAN EA ACC § <br /> AUTO ONLY AGGCESS LIABILITY EACH OCCURRENCE <br /> / ❑ CLAIMS MADE DEDUCTIBLE <br /> AGGREGATE § <br /> ❑ RETENTION $ <br /> $ <br /> WORKER'S COMPENSATION AND <br /> $ <br /> A EMPLOYER'S LIABILITY OWCSTATUTORYLIMITS <br /> E.L. EACH ACCIDENT $ 10,000 <br /> THE <br />/ PROPRIETOR/PARTNERS/ ❑ INCL EL. DISEASE — EA $ 500,00D <br /> EXECUTIVE OFFICERS ARE: ❑ EXCL E.L. DISEASE-POLICY LIMIT f t00,0D0 <br /> OTHER: <br /> BUILDER'S RISK FULL REPLACEMENT COST <br /> OF THE WORK <br /> IN <br /> DESCRIPTION OF OPERATIONSlLOCATIONS VEHICLES/SPECIAL ITEMS <br /> CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER: CANCELLATION <br /> r <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 <br /> DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. FAILURE <br /> TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND <br /> r <br /> UPON THE COMPANY ITS AGENTS OR REPRESENTATIVES. <br /> ADDITIONAL INSURED: AUTHORIZED REPRESENTATIVE <br /> INDIAN RIVER COUNTY <br /> 1840 26m STREET, VERO BEACH, FL 32960 <br />■ <br /> 00620 - 1 0209-00620 - Sample Certificate of Liability Insurance.doc <br /> F:\EngmeeringiCapital Prpects102094th Street Bridge Over Ceoch Ditch\02094th Street Bridge Over Coocli 0]-20-0610209A0620 - Sample Certificate of Liability Insurance.docRev. 05/01 <br />