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HomeMy WebLinkAbout2017-009SEAGRAPE TRAIL BEACH PARK LICENSE AGREEMENT Indian River County ("County") hereby authorizes the Marbrisa Homeowners Association and its affiliates, agents, representatives and contractors (collectively "Licensee") to use the established beach access point at Seagrape Trail Beach Park ("Park") for the limited purpose of delivering beach material and locating certain heavy equipment onto the beach to perform dune stabilization projects for the nearby residential development. Use of the Park for this purpose is limited to 27 days between February 2, 2017 and February 28, 2017 (including weekends) between the hours of 7:30 AM — 5:30 PM (the "License Period"), and is subject to the following terms and conditions: 1) Licensee shall operate all equipment, or cause all equipment to be operated, in a safe and prudent manner, and in accordance with any measures deemed necessary for public safety by County staff. 2) Licensee shall (a) keep the gates to the Park securely locked at all times except when opened for the passage of Licensee's equipment, (b) manage in a timely and efficient manner any traffic issues that arise as a result of Licensee's use of the Park, and (c) prohibit any public vehicular or pedestrian use of the Park during Licensee's dune stabilization activities. Licensee shall post "Beach Closed" signs at the Park entrance during Licensee's dune stabilization activities. 3) Any sand needed to establish a "sand ramp" for equipment to access the beach, or to perform the dune stabilization projects for the nearby residential developments, shall be provided by Licensee. No use of existing sand from the Park or beach shall be allowed. Any damage by Licensee to the Park shall be repaired to the satisfaction of the County and at no cost to the County. The agreed upon access route shall be inspected/videoed by County staff with the Licensee present, prior to the equipment mobilization to the identified Beach Park. 4) The County assumes no liability for loss of or damage to Licensee's equipment or personal property staged or stored at the Park. Any such equipment or property shall be staged or stored at the sole risk of Licensee. 5) The Park is located between two residential communities. As such, Licensee shall minimize construction impacts to the residential communities (i.e. work hours 7:30 AM — 5:30 PM, construction noise, equipment vibration, etc) to the greatest extent practical. Licensee shall provide 48 hour notice to the HOAs of the adjacent residents and the County prior to commencing access activity through County property. 6) Licensee shall indemnify the County for any damage to Park structures, roads, vegetation or other Park features or County property resulting from Licensee's performance of the dune stabilization projects, or this License Agreement. Any such damage shall be repaired to the satisfaction of the County, or Licensee shall pay to the County the reasonable cost to repair any such damage. Licensee shall also indemnify and hold harmless the County, and its officers and employees, from liabilities, damages, losses and costs, including, but not limited to, reasonable attorney's fees, to the extent caused by the negligence, recklessness, or intentional wrongful misconduct of the Licensee and persons employed or utilized by the Licensee in the performance of the dune stabilization projects, or this License Agreement. 7) Licensee shall maintain, or cause to be maintained, during the License Period, the insurance policies and coverage limits set forth: Insurance: • Countys and Subcontractors Insurance: The Licensee shall not commence work until they have obtained all the insurance required under this section, and until such insurance has been approved by the County, nor shall the Licensee allow any subcontractor to commence work until the subcontractor has obtained the insurance required for a contractor herein and such insurance has been approved unless the subcontractor's work is covered by the protections afforded by the Licensee's insurance. • Worker's Compensation Insurance: The Licensee shall procure and maintain worker's compensation insurance to the extent required by law for all their employees to be engaged in work under this contract. In case any employees are to be engaged in hazardous work under this contract and are not protected under the worker's compensation statute, the Licensee shall provide adequate coverage for the protection of such employees. • Public Liability Insurance: The Licensee shall procure and maintain broad form commercial general liability insurance (including contractual coverage) and commercial automobile liability insurance in amounts not less than shown below. The County shall be an additional named insured on this insurance on this insurance with respect to all claims arising out of the operations or work to be performed. Commercial General (Public) Liability, other than Automobile $1,000,000.00 Combined single limit for Bodily Injury and Property Damage Commercial General A. Premises / Operations B. Independent Contractors C. Products / Completed Operations D. Personal Injury E. Contractual Liability F. Explosion, Collapse, and Underground Property Damage Automobile $1,000,000.00 Combined single limit Bodily Injury and Damage Liability A. County Leased Automobiles B. Non -Owned Automobiles C. Hired Automobiles D. Owned Automobiles • Proof of Insurance: The Licensee shall furnish the County a certificate of insurance in a form acceptable to the County for the insurance required. Such certificate or an endorsement provided by the contractor must state that the County will be given thirty (30) days written notice prior to cancellation or material change in coverage. Copies of an endorsement -naming County as Additional Name Insured must accompany the Certificate of Insurance. 8) Insurance certificates attached hereto as Composite Exhibit A. 9) At the completion of Licensees project or expiration of the license, whichever occurs first, Licensee shall return the Park to substantially the same condition as it was at the beginning of the lease. to the County's sole satisfaction. 10) Licensee shall perform its work in strict compliance with any permit issued for the project. if at any time Licensee does not adhere to the permit conditions or above conditions. the County may order the work to immediately cease until Licensee brings the project into compliance. Violation of permit conditions and/or the terms of this License Agreement may result in termination of the license Agreement by the County forthwith and at no cost to the County. LICENSEE: MARBRISA HOMEOWNERS ASSOCIATION ION Signed: 1 , Date: Printed Name and I itle: ° d, INDIAN RIVER COUNT Signed: C(I 1NTY Date: 24/ 7/1 7 Printed Name a APPROVED AS TO FORM AN $ $ AL S,JEFIC-FE+ C'Y WILL!A }( DE AAL DEPUTY QO!!NTY ATTORNEY OP ID: MK ,r^-� , ACa../R ©" �.,..� CERTIFICATE OF LIABILITY INSURANCE DATE (MM740fYYYY} 12/08/2016 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 pollcy(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 Stuart Insurance, Inc. 3070 S W Mapp Palm City, FL 34993 EEADDRESS: Joseph E. Coons, CPCU. CIC. CONTACT NAME: Joseph E Coons = WCNo_Erq:772-286-4334 FAX NO 772-286-9389 EMAIL•coons rtsurance.net S stuarti i� PRODUCER CUSTOMER IDN: GUETB-1 INSURER(S) AFFORDING COVERAGE INSURER A :Westfield Insurance NAIC N 24112 _ INSURED Guettler Brothers Construction LLC Ben G. Guettler P.O. Box 12271 Fort Pierce, FL 34979-2271 INSURER 5 X INSURER C : TRA7630158 INSURERD: 06/30/2017 INSURER E $ 1,000,000 INSURER F 8 500,000 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 15 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED ISSUED TO CONTRACT THE POLICIES BY POLICY EFF JMMIDD/YYYY1 THE INSURED OR OTHER DOCUMENT DESCRIBED PAID CLAIMS. POLICY EXP JMMIDD/YVYYI_ NAMED ABOVE FOR THE POLICY PERIOD WITH RESPECT TO WHICH THIS HEREIN IS SUBJECT TO ALL THE TERMS, LIMITS INSR LTR TYPE OF INSURANCE AUOL INSR SUBR WVD POLICY NUMBER A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X OCCUR X X TRA7630158 06/30/2016 06/30/2017 EACH OCCURRENCE $ 1,000,000 DAMAGE 10 RENTED PREMISES (Ea occurrence) 8 500,000 CLAIMS -MADE MED EXP (Any one person) $ 10,000 X X Contractual PERSONAL 8 ADV INJURY $ 1,000,000 INCLUDES XCU GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER, 7 POLICY X PRD JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE X X X X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X X TRA7630158 06/30/2016 06/30/2017 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (PER ACCIDENT) $ PIP $ 10,000 A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE X X TRA7630158 06/30/2016 06/30/2017 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) 11 yes, describe under DESCRIPTION OF OPERATIONS VIN N 1 A WC STATU- OTH- TORY LIMITS ER E L. EACH ACCIDENT $ below E.L. DISEASE - EA EMPLOYEE $ E L DISEASE • POLICY LIMIT $ DESCRIPTION OF PERATION5 / LOCATION5 1 VEHICLES Attach ACORD 101, Additional Remarks Schedule, if more apace Is required) GRADING OF LAND * Blanjc t Add[tion l Insured in regards to General Liabilityand automobile Liability,waiver aiver of subrogation for General 30 day notice Of cancellation (10 day for cion -payment) a rcoTlclr ATC unl nco LLATION IRCBD-1 Indian River County 1800 27th Street 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 ACORD 25 (2009/09) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD � CERTIFICATE OF LIABILITY INSURANCE AC R» DATE (MMIDDlYYW) 12/08/2016 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(les) 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 Bouchard Insurance for WBS P.O.Box 6090 Clearwater. FL 33758-6090 CONTACT NAME: PHONE 666 293-3600 ext. 623 FAX (AIC. ( ) (AIC, Nog E-MAILExtl: IL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC 0 INSURER A : American Zurich Insurance Company COMMERCIAL GENERAL LIABILITY 40142 INSURED Workforce Business Services, Inc. Alt. Emp: Guettler Brothers Construction LLC 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708 INSURER B : INSURER C ; INSURER D : $ INSURER E : INSURER F : 1 I OCCUR THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS IN LTRTYPE OF INSURANCE ADDL D SUER WVD POLICY NUMBER .JMMIDDIYYYYUMMIDD/YYYY) POLICY EFF POLICY EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1 I OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ CLAIMS -MADE MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY I 1 PRO- LOC PRODUCTS - COMP/OP AGG $ JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS —' SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS _ NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION x PER OTH- STATUTE ER AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN WC 90-00-818-05 12/31/2015 12/31/2016 E.L. EACH ACCIDENT $ 1,000,000 A OFFICERIMEMBER EXCLUDED'l (Mandatory In NH) N / A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 Location Coverage Period: 12/31/2015 12/31/2016 Client# 050682 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space la requl ed) Guettler Brothers Construction LLC Coverage Is provided for 4401 White Way Dairy Road only those co -employees of, but not subcontractors Fort Pierce, FL 34947 to: CERTIFICATE HOLDER CANCELLATION I Indian River County 1800 27th Street 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 ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD OP ID: MK ACRD' 41.1..... -"--.CERTIFICATE OF LIABILITY INSURANCE DATE IMMIDDIYYYY) 02/09/2017 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 Stuart Insurance, Inc. 3070 S W Mapp Palm City, FL 34990 NAME CT Joseph E Coons PHONE 772FAX .286-4334 lac, No. Exn: (ac, No):772-286-9389 E-MAIL jADDREcoons@stuartinsurance.net Joseph E. Coons, CPCU. CIC. PRODUCER CUSTOMER ID #: GUETB"1 INSURERS) AFFORDING COVERAGE NAIC # INSURED Guettler Brothers Construction LLC Ben G. Guettler P.O. Box 12271 Fort Pierce, FL 34979-2271 INSURER A:Westfield Insurance 24112 INSURER e TRA7630158 INSURER C : 06/3012017 INSURER D : $ 1,000,000 INSURER E PREDAMMISESAGE TO(Ea RENTEoccurreDnce) INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ' DOI.SUBR JNSR W YD POLICY NUMBER POLICY EFF MI (MDD/YYYY) POLICY EXP IMM/DO1YYYY) LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY X OCCUR TRA7630158 06/30/2016 06/3012017 EACH OCCURRENCE $ 1,000,000 X PREDAMMISESAGE TO(Ea RENTEoccurreDnce) $ 500,000 CLAIMS -MADE MED EXP (Any one person) $ 10,000 X Contractual PERSONAL &ADV INJURY $ 1,000,000 X INCLUDES XCU GENERAL AGGREGATE $ 2,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: POLICY I ^ I jECT n LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS TRA7630158 06/30/2016 06/30/2017 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per acddent) $ X PROPERTY DAMAGE (PER ACCIDENT) $ X X PIP $ 10,000 $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE TRA7630158 06/30/2016 06/30/2017 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS Y IN N 1 A WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ below E.L. DISEASE - POLICY LIMIT $ GS PTI OF PERATI NS 1 LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) RADING OF LAND * Blanket Additional Insured in regards to General Liabilityand Automobile Liability. Blanket Waiver of Subrogation for General Liability. CERTIFICATE HOLDER CANCELLATION MARBH-1 Marbrisa Homeowners Association, Inc 8300 N. AIA Vero Beach, FL 32963 l 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 c5,1 014. E. ,. e_if>1--. • ACORD 25 (2009109) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD .4CORO® CERTIFICATE OF LIABILITY INSURANCE �/ DATE(MM/DD/YYYY) 02/09/2017 THIS CERTIFICATE I5 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(les) must have ADDITIONAL INSURED provisions or 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 Bouchard Insurance for WBS P.O.Box 6090 FL 33758-6090 CONTACT PHONE FAX (Arc. No. Exl); (866) 293-3600 ext. 623 (A/C, No): E-MAIClearwater, ADDRESS: I NSURER(S) AFFORDING COVERAGE NAIC t! INSURERA: American Zurich Insurance Company 40142 INSURED Workforce Business Services, Inc. Alt. Emp: Guettler Brothers Construction LLC 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708 INSURER B : INSURER C : INSURER D : $ INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER:16FL079902691 • THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRLR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/OD/YYYY) POLICY EXP IMM/DD/YYYYI LIMITS COMMERCIAL GENERAL UABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any ono person) $ PERSONAL &ADV INJURY $ GEN'L AGOREGATE POLICY OTHER: LIMIT APPLIES PRO JECT PER: LOC GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ S AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY _ SCHEDULED AUTOS NON -OWNED AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY accident ( ) $ PROPERTY DAMAGE (per accident) $ $ UMBRELLA LIAR_ EXCESS LIAB OCCUR CLAIMS•MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTIONS $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFIC R/MEM EREXCLUDEmrECUTIVE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N/A WC 90-00-818-06 12/31/2016 12/31/2017 X PER OTH- STATUTE ER E.L. EACH ACCIDENT S 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 Location Coverage Period: 12/31/2016 12/31/2017 Client# 050682 DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Coverage Is provided for Guettler Brothers Construction LLC only those co employees 4401 White Way Dairy Road of, but not subcontractors Fort Pierce, FL 34947 to: CERTIFICATE HOLDER CANCELLATION Maribrisa Homeowners Association Inc 8300 N A1A Vero Beach, FL 32963 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 ©1988-2015 ACORD CORPORATION. All rights reserved.