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, 10 / 09 / 2003 <br /> M CERTIFICATE OF LIABILITY INSURANCE <br /> DATE <br /> A <br /> PRODUCER ( 954 ) 966 - 9993 THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION <br /> Gulfstream Insurance Agency , Inc . ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER . THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 5833 Johnson Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, <br /> Holly Clod FL 33021 - INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED INSURER A: ZURICH <br /> HVAC Mechanical Inc . INSURERB: First Commercial Ins Co CEIB <br /> 5425 NW 24th Street INSURER C: <br /> Suite 208 INSURER D: <br /> Mar ate FL 33063 - 1INSURER E: <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY <br /> REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN , <br /> THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS , EXCLUSIONS AND CONDITIONS OF <br /> SUCH POLICIES . <br /> AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS . <br /> INSR ADD'L EFFECTIVEPOLICY POLICY ON <br /> LTR INSRD <br /> TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YYDATE MM/DD/Y LIMITS <br /> A X GENERAL LIABILITY / / / / EACH OCCURRENCE $ 11 000 , 000 <br /> DAMAGE TO RENTED 300 , 000 <br /> X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ <br /> CLAIMS MADE FX OCCUR SCP042323676 06 / 19 / 2003 06 / 19 / 2004 MED EXP (Anyoneperson) $ 10 , 000 <br /> PERSONAL & ADV INJURY $ 11 000 , 000 <br /> GENERAL AGGREGATE $ 2 , 000 , 000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 21000 , 000 <br /> POLICY JECOT LOC <br /> A AUTOMOBILE LIABILITY / / / / COMBINED SINGLE LIMIT <br /> X ANY AUTO (Ea accident) $ 110001000 <br /> ALL OWNED AUTOS SCP042323676 06 / 19 / 2003 06 / 19 / 2004 BODILY INJURY <br /> SCHEDULED AUTOS (Per person) $ <br /> X HIRED AUTOS / / / / BODILY INJURY <br /> (Per accident) $ <br /> X NON-OWNED AUTOS <br /> PROPERTY DAMAGE <br /> (Per accident) $ <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO / / / / OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS/UMBRELLA LIABILITY / / / / EACH OCCURRENCE $ <br /> OCCUR FICLAIMS MADE AGGREGATE $ <br /> DEDUCTIBLE / / / / $ <br /> RETENTION $ $ <br /> B WORKERS COMPENSATION AND 17733 - 0 07 / 31 / 2003 07 / 31 / 2004 1 <br /> WSTAT <br /> IMU- OTH- <br /> TOCRYLITS I ER <br /> EMPLOYERS' LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 500 , 000 <br /> OFFICER/MEMBER EXCLUDED? / / / / E.L. DISEASE - EA EMPLOYEE $ 500 , 000 <br /> If yes, describe under <br /> SPECIAL PROVISIONS below E .L. DISEASE - POLICY LIMIT $ 500 , 000 <br /> OTHER <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br /> Additional Insured : Indian River County <br /> Project : Indian River County Bid # 6015 , Douglas Cafeteria <br /> CERTIFICATE HOLDER CANCELLATION <br /> ( 772 ) 567 - 8000 ( 772 ) 770 - 5140 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br /> 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT <br /> Indian River County FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE <br /> Purchasing Dept . INSURERI ITS AGENTS OR REP ES. <br /> 2625 19th Avenue AUTHO EDREPRESENTAT E <br /> Vero Beach FL 32960 - 3335 <br /> ACORD 25 (2001 /08) k,.qI(LdJZg9CORPORATION 1988 <br /> OT,;. INS025 (oloa).05 ELECTRONIC LASER FORMS, INC. - (800)327-0545 Page 1 of 2 <br />