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�1 RAFINDU -01 OSWALTGE AFRO CERTIFICATE OF LIABILITY INSURANCE DA 3/31/2015 TE(MMIDDITYYY) 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 endorsementfsl. PRODUCER Nillis of Pennsylvania, Inc. Vo 26 Cantu ry Blvd 1.0. Box 305191 Vashville, TN 37230 -5191 INSURED Earth Tech (DE), LLC 2620 Hunt Road Land O'Lakes, FL 34638 FAX (A/c, No):_(888) 467 -2378_ INSURERIS) AFFORDING COVERAGE NAIC# INSURER A: National Un ton Fire Insura nce Company of Pittsburgh 19446 INSURER B: Liberty _ Mutual Fire Insurance Company _. _.23035 _ INSURER C: Insurance Company of the State of Pennsylvania 19429 INSURER O: First Memlnsurance Company INSURER E : 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 CONTRACTOR OTHER DOCUMENTWITH 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- _ -. -_ __. ... _.. .. ___AUDGSUBRL.. -. - _] PbLICYEFF POUCYEXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDD/YYYY ) IMMIDDIYYYYI i LIMITS A X COMMERCIAL GENERAL LIABILITY ! EACH OCCURRENCE $ 1,000,00 -.. _ CLAIMS -MADE LX !OCCUR GL4572157 `DAMAGE TOREN= 04/01/2015 04101/2016 PREMISES Ea ocmrrexa) ,f.E -_ —__. 1,000,000_ MED EMIR (Any one perm) 4 $ 15,009. PERSONAL S ADV INJURY S 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE I$ 2,000,00 - ._ POLICY _ JECT �_ LOC .. _. —_.. PRODUCTS - COMPIOP AGG E -__.— 2,000,00 OTHER: E AUTOMOBILE LIABILITY '�, COMBINED UNGLELIMIT Eaacddentl 1,000,000 B X ANY AS2- 621 -094742.015 04101/2015104/0112016 ..E BODILY INJURY (Par person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident) E ( III X AUTOS X NON OWNED rPROPERTY DAMAGE T AUTOS PwaLmden9, 1$ IX X UMBRELLA LIAR OCCUR - EACH OCCURRENCE 25,000,000 Excess une BE044758716 A t CLAIMS 04/07/20151 04/0112016 AGGREGATE $ 25,000,000 L — LED X RETENTION$ WORKERS COMPENSATION - X I PER 0TH - STATUTE ER ANDEMPLOYERTLIABILITY Y❑ _ C ANY PROPRIETORIPARTNERIEXECUTIVE 077 OFFICER/MEMBER EXCLUDED? N NIA OFFICaMry 04 0 0410112016 E.L. ACH ACCIDENT _ E —1 1,000,000 in NH E.L. DISEASE - EA EMPLOYEE $ 1,000,00(1 DESCRIPTION OF OPERADONS he low ' - -- - - t i E.L DISEASE - POLICY LIMIT I $ _ 1,000,000 D 'Business Auto Buffer i INJ -EX- 0000053113 -01 0410112015. 04/01/2016 Each Occurence: $ 4,000,00 A Workers Compensation 1 1 NVC18721079 I 1 0410112015x. 04/0112016 See Attached DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe aaached 0 more space is required) Ron L. Broadrick CGC061734 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 6 i' ` All Hants reserved ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD