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ACORDCERTIFICATE OF LIABILITY INSURANCE 7/23/220 8 PRODUCER ( 561 ) 746 - 4546 FAX : ( 561 ) 746 - 9599 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Te este A NLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4u Agency ,yr Inc ,. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 218 S . US Highway One ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Suite 300 Tecruesta FL 33469 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERANational Fire Insurance 20893C J . W . Cheatham , LLC INSURERB: National Fire Insurance 20893C 7396 Westport Place INSURERaValley Fore Insurance 20508C INSURER D: Trans ortation Ins , Col 120894C West Palm Beach FL 33413 INSURER E: OVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING AN 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 . AG, �anRrErz �IE-LIWI5 19HOWN MAY HAVE M REDUCED BY PAID CLAIMS. INSR ADD'LEFFECTIVE PEXPIRATION TYPE OF INSURANCE POLICY NUMBER DATE MWDDDATE MMWD JJJL INSRn LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 r 000 r 000 X TED COMMERCIAL GENERAL LIABILITY PREMISES ETORE =rrrrence $ 50 r 000 A X CLAIMS MADE ® OCCUR 02083039906 3 / 1 / 2008 3 / 1 / 2009 MEDEXP (Any oneperson ) $ 5 r 000 PERSONAL 8 ADV INJURY $ 1 r 000 r 000 GENERAL AGGREGATE $ 2 r 000 r 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP A $ 2 r 000 r 000 POLICYX E CF�j LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT X ANYAUTO (Ea accident) $ 11000 , 000 B ALL OWNED AUTOS 02055533016 3 / 1 / 2008 3 / 1 / 2009 BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANYAUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 10 , 000 , 000 X OCCUR 7 CLAIMS MADE AGGREGATE $ 10 r 000 r 000 D DEDUCTIBLE 02067525954 3 / 1 / 2008 3 / 1 / 2009 $ X RETENTION $ 10 , 000 C WORKERS COMPENSATION AND X I WC STATU- OTH- EMPLOYERS' LIABILITY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 500 , 000 OFFICERIMEMBEREXCLUDED? wc2055533047 3 / 1 / 2008 3 / 1 / 2009 E.L. DISEASE - EA EMPLOYEE $ 500 , 000 IT yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 500 r 000 OTHER DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS The Certificate Holder is an additional insured per form G140331A atttached to the General Liability Policy . Form G140331A is attached for reference . Job Desc : Ponerline Road from CR510 North to the Sebastian City Limits . County Project # 0217 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE INDIAN RIVER COUNTY EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1800 27TH STREET 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT VERO BEACH , FL 32960 FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Mark Kasten / DEBBIE ACORD 25 (2001 /08) a ACORD CORPORATION 1988 IUQAO) 4 1^4n0g no.. 0*ro I .do