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Home My WebLink About2008-375 t PRANGE ISLANDS CONSERVATION AREA ADOPTION AGREEMENT This PRANGE ISLANDS CONSERVATION AREA ADOPTION AGREEMENT ("Agreement" ) is entered into this 18th day of November , 2008 , by and between Indian River County , a political subdivision of the State of Florida , 1801 27th Street , Vero Beach , FL 32960 (" County" ) and Coastal Technology Corporation , a Florida corporation , having a principal place of business at 3625 20th Street , Vero Beach , FL 32960 (" Coastal Tech "" ) . BACKGROUND RECITALS A . The Prange Islands Conservation Area (" PICA" ) was purchased by Indian River County with funding from the 1992 Environmental Bond Referendum and Florida Communities Trust (" FCT") cost-share funds . In accordance with the FCT Cost Share Agreement approved by the Board of County Commissioners on April 12 , 1994 , as more specifically contained in the Management Plan for the Prange Islands Conservation Area , approved by the Indian River County Board of County Commissioners on April 25 , 1996 (the " Management Plan " ) , the County agreed to specific management obligations as described therein . Further , PICA was damaged by the 2004 Hurricanes , and such damage has not yet been repaired B . Coastal Tech has requested to adopt an island within the Indian River Lagoon as part of Coastal Tech ' s volunteer community service . C . Coastal Tech is willing and able to perform the volunteer services as set forth in this Agreement on the terms and conditions set forth below . D . The County is willing to allow Coastal Tech to perform the volunteer services , as set forth in this Agreement , on the terms and conditions set forth below . NOW, THEREFORE , for good and valuable consideration , the receipt and sufficiency of which is hereby acknowledged , and intending to be legally bound hereby , the parties hereby agree as follows : 1 . DESCRIPTION OF SERVICES . The volunteer services that will be performed by Coastal Tech pursuant to this Agreement are assistance in the following areas : (a ) . Assist in the required treatment of exotic vegetation with herbicide that is provided by the County , supervised by a certified pesticide applicator with certification in Natural Areas Weed Management ; (b) . Assist in trail clearing and maintenance of trails according to the Management Plan and Florida Trail Association ( FTA) trail building standards ; (c) . Assist in installation of educational sign at the entrance required by the Management Plan ; the educational sign at the dock required by the SJRWMD permit for the dock ; and interpretive educational signage along the nature trail , all such signage containing the information provided by the County ; and (d ) . Assist in repairing the primitive camping area contemplated in the Management Plan . (all of the foregoing collectively , " Services") . Additional parameters for the performance of the Services , excerpted from the Management Plan , are set forth in Exhibit "A" attached hereto and incorporated herein by this reference in its entirety . All Services 1 shall be performed in furtherance of the Management Plan and supervised by the County . 2 . COORDINATION . The County' s Conservation Lands Manager shall manage and coordinate all Services performed by Coastal Tech hereunder. In addition , Coastal Tech shall keep a log of workers , including the dates and times that the Services are scheduled to be performed ; such log shall be provided to the County' s Conservation Lands Manager at regular intervals . The County and Coastal Tech recognize that PICA is located in relativity close proximity to residential areas and Coastal Tech acknowledges and agrees that all Services hereunder shall be performed with a minimum amount of noise and maximum regard for aesthetics . The County shall manage the Services performed by Coastal Tech to assure that the foregoing requirements are met throughout the term of this Agreement . 3 . TERM . The term of this Agreement is November 18th , 2008 through December 31 , 2011 , 4 . INSURANCE , Coastal Tech has provided a certificate of insurance that shows evidence of Workers' Compensation ; Commercial General Liability insurance ; and Commercial Automobile and Truck liability attached hereto as Exhibit " B " and incorporated herein by this reference in its entirety . 5 . COUNTERPARTS . This Agreement may be executed in one or more counterparts , each of which shall be deemed to be an original copy and all of which shall constitute but one and the same instrument . 6 . GENERAL . The Background Recitals are true and correct and form a material part of this Agreement . IN WITNESS WHEREOF , the County and Coastal Tech haye , - taus-ed 'tf Agreement to be executed in their respective names as of the dab4 rst'set forth abdue... COASTAL TECHNOLOGY CORPORATION INDIAN RIVER COUNTY t Board ounty Co�nr><gi ss10 ers ( sign ) y Prig n me :' 9n (, Wesley S . Davis , Chairt�i ;c e Attest : J . K . Ba on , Clerk Witness : (sign ) By 000� Deputy Cler d e : Print nam Approved by BCC : 1 t 1 1 fit f of APPROVED AS TO FORM AN EGALSUFFICIENGY 2 � Unty Ad ev� , .atrat r A IAN " LL ASSISTANT COUNTY ATTORNEY EXHIBIT "A " Excerpts from the Management Plan ( in italics) have been included in this Exhibit for more specific detail of the Services that Coastal Tech will assist the County with performing to achieve specific FCT obligations on Prange Island . The Parks Division (and more specifically , the Conservation Lands Manager) is responsible for overseeing the management activities on the conservation areas and reporting the progress of accomplishing the goals and objectives annually to the FCT . The process of seeking and recruiting volunteer assistance to accomplish these tasks is specifically stated in the management plan . Pg . 14, Section IV — KEY MANAGEMENT ACTIVITIES SECTION C . STAFFING Volunteer support to help provide public access, interpretive and educational activities, and resource management assistance will be encouraged and coordinated by the Parks Division. The Services to be completed by Coastal Tech are tasks required in the Management Plan or necessary as a result of the 2004 Hurricanes . They are as follows : 1 . Exotics Treatment ( Brazilian Pepper and Australian Pine) - Coastal Tech will assist the County with treating exotics with herbicide . Background Info : The Conservation Lands Manager acquired herbicide from the Department of Environmental Protection for use on Prange Islands Conservation Area . Pg , 8 , Section I — INTRODUCTION SECTION D . Vegetative Assessment The long-term goal for management of these areas will be removal of all exotics . This removal may be completed by use of heavy machinery, or by hand removal, depending on the location of the plants and the availability of funding. The exotic plant removal will be targeted to occur in four phases: (1 ) removal of individuals from the mangrove fringe and the intact maritime hammock on the southern half of Prange Island: (completed in 2002 through USFWS grant) (2) removal within the 8. 5 acre northern lobe of Prange island: (3) follow-up treatment and revegetation of the cleared area to ensure eradication and restore the hammock: and (4) treatment, removal, and re- treatment of the exotics on the 4 . 6 acre area on Little Prange Island, followed by revegetation or maintenance of cleared nesting habitat (completed in 2002 through USFWS grant) . Pg . 14, Section IV - KEY MANAGEMENT ACTIVITIES SECTION C . Staffing "Parks staff, contract labor and volunteer labor will be assigned to tasks such as exotic plant removal and hammock restoration. " Pg . 17 , Section V - RESOURCE MANAGEMENT SECTION A . Exotic Plant Removal/Native Plant Restoration The removal of exotic species will be divided into four phases . The initial phase will involve hand treatment and removal of Brazilian pepper from the mangrove fringe along Prange Island (this was completed through the USFWS grant in 2002) , and removal of individual peppers or Australian pines within the intact maritime hammock. 1 In the second phase, Brazilian pepper in the northern lobe of Prange Island will be treated with herbicides approved for use by State and Federal regulations and cleared (either by use of heavy machinery or manually). Pepper debris will be chipped on site (during non-seeding periods), and spread to provide soil stabilization as well as a base for revegetation efforts. Australian pine trees will be girdled and treated with an approved herbicide. Cleared areas will be inspected and re-treated periodically to prevent return of the exotic plants from seed . (This assistance will be provided by Coastal Tech , Inc . ) 2 . Trail clearing and maintenance — these activities are to be conducted in accordance with the management plan specifications and are needed due to the 2004 hurricanes . Background Info : On June 21 , 2006 , the Conservation Lands Advisory Committee adopted the Florida Trail Association (FTA) trail building standards of 24" to 36" treads , with four to five foot widths and 8' height for shorter urbanized trails . The FTA has a trail guide that is useful in restoring and maintaining trails . This guide should be referred to for restoring the trails at Prange Island . Pg , 12 , Section III — STRUCTURES AND IMPROVEMENTS SECTION B . Proposed Improvements "The nature trail will explore the hammock restoration area, the landward edge of the mangrove fringe, and the northern edge of the intact tropical hammock. Interpretive signs along the trail will identify the native plant and animal species of the island, explain the tropical hammock and mangrove communities, and interpret the resource management activities evident on this part of the island. " 3 . Installation of entry sign and educational signs — Coastal Tech will assist the County with installing a kiosk that will hold 2 of the 3 education signs as required by the management plan and the SJRWMD permit for the dock. Background Info : A professional cabinet maker voluntarily designed and created the components for our conservation area kiosks . 10 kiosks have been created for use at 7 conservation areas , including Prange Island , for only the cost of materials . They are made from marine grade lumber, have a roofed top , Lexan enclosed cabinets to protect the $500 educational signs and a central cabinet that will contain information that may be changed out seasonally . The kiosks are approximately 8 ' wide by 8 ' tall and approximately 3 . 5' deep . All of the construction components were chosen to withstand sun , rain and weather elements . The estimated cost of each kiosk is approximately $700 . The cost of a similar kiosk structure from Wilderness Graphics is $2400 . Pg . 12 -13 , Section III — STRUCTURES AND IMPROVEMENTS SECTION B . Proposed Improvements An identification sign will be placed at the proposed boat dock. The sign will inform arriving visitors of all rules applicable to their visiting the island, the location of grass beds to be avoided by boaters, and provide telephone contacts in case of emergencies. The sign will also identify the site as a natural resource conservation area, and provide credit for funding to Indian River County, the City of Vero Beach and the Florida Communities 2 Trust. Information signs at the dock should inform boaters of the potential presence of the East Indian manatees and green sea turtles in adjacent waters . Interpretive signs on the nature trail will include information on protection of listed plant and animal species and their habitat requirements . 4 . Repair camping area Background Info : The primitive camping area was completely destroyed during the 2004 Hurricanes . Coastal Tech will create a similar campsite in the original location . This will provide users with a designated camping and picnicking area as referred to in the Management Plan , but will not include grills and the portable toilet at this time . Fire rings . made from on -site rock and/or spoil materials , will be established to protect the island from wildfire . Pg . 10 , Section III - STRUCTURES AND IMPROVEMENTS SECTION B . Existing Improvements A primitive camping area is in place at the northwestern peninsula of Prange Island . The camp consists of several wooden tables and platforms, constructed by unauthorized campers of found materials, Australian pine Trunks, and finished lumber. A fire pit and benches have also been constructed. Pg . 10 , Section III - STRUCTURES AND IMPROVEMENTS SECTION B . Proposed Improvements Inland from the dock site a small picnic area with a few scattered picnic tables and grills and a portable toilet is planned . The picnic area will serve day use visitors and campers, and should be the origination point for a nature trail loop that allows visitors to explore the northern half of the island. Pg . 12 , Section III - STRUCTURES AND IMPROVEMENTS SECTION B . Proposed Improvements The traditional activity of camping will continue at the existing campsite, just southwest of the proposed picnic area . Pg . 12 , Section III - STRUCTURES AND IMPROVEMENTS SECTION B . Proposed Improvements Provision for primitive camping in the existing campsite, which is the location of a stand of Australian pines with sparse understory at this time, should cause no impact to native species. 3 Map Page 11 , PICA Management Plan E . 5 CASTAWAY COVE P g A N G 'tXISTING HGNEST;: ( PROTECTED ZONE ) } PRANGE ISLAND � 1 PROPOSED DOCK----, ft 6# �� PROPOSLD NA ' URE 'RAIL 00 -- EXIST(NGfPROPOSFD PROPOSED i / CAMPSITE NESTING AREA FROPOSEO RESTROOM ENHANCEMENT PROPOSED PICK C AREA f OPTIONAL PROPAGATION AREA 1 LITTLE PRANCE ISLAND IA 1AN t x � 4 Background Information on Prange Islands Conservation Area : Activities that have been completed since the purchase of the Conservation Area are : • USFWS Grant received in 1997 to assist with exotics removal and maintenance in the amount of $38 , 800 , for the period of September 1 , 1997 through September 1 , 2002 . Completed Phase One and portions of Phase Two and Phase Four exotics treatments . • Received grant from the Florida Inland Navigation District to build dock on Prange Island . • FCT acknowledgement sign installed ; required by FCT . • Permitted and constructed dock on the east side of Prange Island ; FCT grant requirement. • Seagrass , Mangrove and Manatee signage installed per the Management Plan and as required as a permit condition by the St . Johns River Water Management District ( SJRWMD) for the dock . • Seagrass and no entry signage installed around island to protect seagrasses as required by the SJRWMD for the dock . • Plant inventory begun . • Site visits by staff and the Conservation Lands Advisory Committee . • Repaired dock after hurricanes . • On-going Mosquito Control , provided by the Indian River Mosquito Control District . • Annual Stewardship Reports sent to FCT reporting activities and progress toward goals and objectives . • Acquired free herbicides from the Department of Environmental Protection to use for eradicating Brazilian Pepper and Australian Pine . p �1Sfyn h'ORP'Z+ vpnr u,,,cn /sf,:r AREA ABOVE MEAN AREA ANOW MEAN NICK 'RATER UNE — MGM ■ATTR UNE - O 6 722932.63 S.E. OR 46.65 AC. SSS77S.R3 S.E. OR 6.03 AC M"W0RE YER1J.ts MAMLRCK {ER_mOS 0 A 6 12776032 OR 1.63 AC. !:. -...: ,{� 50146.0.4 S.E. OR 1.15 AC SEACRASS 6E0 ['� 6EA NOW REO 16D11D31 S3.. OR 436 AC. 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Box 650339 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Vero Beach FL 32965 Phone : 772-567 -7774 Fax : 772 - 567-0166 INSURERS AFFORDING COVERAGE NXID # INSURED ms~ & Nationwide 23779 INSURER @ - •- Coastal Technology Corporation INSURERC: 3625 20th Street IMSURERa Vero Beach FL 32960 - INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. T ILTR INSR TYPE OF INSURANCE POLICY NUMBER q I PDATE MWDOIY 0 LIMITS GENERAL WIBtLITY EACH OCCURRENCE I S 1 F OOO , 000 � . ..' DX)QA ET0*MIEO— A X COMMERCIAL GENERAL Limury 77PR569379- 0001 10 /30 / 08 10 / 30 /09 PREMIS$S (Esoauwww $ 100 , 000 CLAIMS MADE FXJ OCCUR MED EXP (Arty am Panm) S 5 000 PERSONAL a ADVI"RY 31j, 000F000 GENERAL AGGREGATE s2 000 000 ( GEMLAGGREGATE LIMIT APPUESPER: PRODUCTS w COMPIOP AGG S1 1000e000 IItI —IIIIPOLICY PRO- i LOC AUTOMOBILE LIABILITY A AAUTO 77SA569379 -0002 10/ 30/ 08 10 /30/ 09 COMBINEDSiNGLEUMfT NY s 1 ► DDOr 000 (Ea aeeidpfl) ALL OWNED AUTOS BODILY INJURY = SCHEDULEDAUTOS (Per per) X HIREOAUTOS BODILY INJURY s X NON4MMEOAUrOS (Fwwdi au t (PP MRTYd)04MAGE S GARAGE LIABILITY AUTO ONLY - EAAOCIOENT 3 ANY AUTO OTHER THAN EAACC S AUTO ON4Y4 I AGO S EXCESWUMBRELLALJAIRMY EACH OCCURRENCE 1331000 , 000 A O= m CLUMSMADE 77CUS69379 -3001 10/ 30/ 08 10 /30/09 AGGREGATE 13300004000 s DEDtICnBLE S RETENTION S S WORKERS COMPENSATION ANDI EMPLOVERS' LIASIUTY ,rowu IRS I IER ANY PROPRIETORIPARTNER)FXECUTIVE EL EACHACGOENT S IOFFICERIMEMBEREXCLUDED? EL DISEASE . EA EMPLOYE S 11 "99 dotaibe urdor SPECIAL PROVISIONS balew EL DISEASE - POLICY LIMIT S OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSION$ ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 80 SHALL Prange island Adoption IMPOSE NO OBUGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZEDREPRESENTATIVE ACORD 25 (2009108) 0 ACORD CORPORATION 1 ACORD„ CERTIFICATE OF LIABILITY INSURANCE OP ID DATE (MMIDDIYYM COAST- 2 10 / 21 / 08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ACEC/MARSH HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 701 Market St . r Ste . 1100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, St , Louis MO 63101 Phone : 800 -338 - 1391 Fax : 888 - 621 -3173 INSURERS AFFORDING COVERAGE MAIC # INSURED INSURER A. Hartford Insurance Company 22357 INSURER B: Coastal Technology Corp . INSURER C: 3625' 20th Street INSURERD: Vero Beach FL 32960 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IMM LTR NSR ON TYPE OF INSURANCE POLICY NUMBER DATE MMIDD ATE (MMPI/DO/YY)POLICY EFFECTIVE PICY LIMITS GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY PREMISES Ea occurence) $ _ CLAIMS MADE F—] OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ POLICY %&_ LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANYAUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTYDAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG S EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND X TORY LIMITS ER A EMPLOYERS' LIABILITY 84WBGGa0278 11 / 01 / 06 11 / 01 / 09 E.L. EACH ACCIDENT $ 11000000 ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBEREXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 1 000 000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1 r 000 000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION FORPROP SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL FOR PROPOSAL PURPOSES ONLY IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR ...... . . . . . . . .REPRESENTATIVES. . . .. . . .. ..... . . . . . . . . AUTHORIZED R ENT TIVE � Xj ACORD 26 (2001 /0S) CACORD CORPORATION 1983 Client#: 2198 COASTEC3 DATE 7DATE tm ACORDTm CERTIFICATE OF LIABILITY INSURANCE 04/14108D ) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Suncoast Insurance Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1. Box 22668 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. dmpa , FL 33622 -2668 813 289-5200 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: XL Specialty Insurance Company 37885 Coastal Technology Corporation INSURERS: 3625 20th Street INSURER C: Vero Beach , FL 32960 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY 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 . AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD DATE MM/DDIYY GENERAL LIABILITYEACH OCCURRENCE $ DAMAGE TO RENTED $ COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) CLAIMS MADE El OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PROECT LOC J AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO ALL OWNED AUTOS BODILY INJURY $ (Per person) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY $ (Per accident) NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR F CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ ATU- OTH- WORKERS COMPENSATION AND TWO ST EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. 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A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) . 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) . DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s) , authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend , extend or alter the coverage afforded by the policies listed thereon . ACORD 25-S (2001 /08) 2 of 2 #M162721