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®fig Client#:71430 SUPLLA ACORDC. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 11/30/2016 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(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 CONTACT NAME: Elizabeth Rodriguez Gulfshore Insurance-SFL PHONE 954-248-2723 FAX 239-213-2803 • (AIC,No,Ext): (A/C,No): 1560 Sawgrass Corporate Pkwy ADDRESS: Erodriguez@gulfshoreinsurance.com Fort Lauderdale, FL 33323 INSURER(S)AFFORDING COVERAGE I NAIC S 239 261-3646 INSURER A:Amerisure Insurance Company INSURED INSURER B:Amerisure Mutual Insurance Comp Superior Landscaping&Lawn Service,lnc INSURER C:Amerisure Partners Insurance Co 2200 NW 23rd Ave INSURER D: Miami, FL 33142 INSURER E: 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. EXP LTR TYPE OF INSURANCE INSR SUER POLICY NUMBER (MM/DDYIYYYY) (MM/EFF IDYIYYYY) LIMITS A GENERAL LIABILITY X X GL2090122 12/01/2016 12/01/2017 EACH OCCURRENCE 51,000,000 X COMMERCIAL GENERAL LIABILITY PROMO'\ci°nce) $1,000,000 CLAIMS-MADE X OCCUR I MED EXP(Any one person) _510,000 PERSONAL 8 ADV INJURY $1,000,000 _GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 52,000,000 —1 POLICY X JEC0. []LOC C AUTOMOBILE LIABILITY X X I CA2090120 12/01/2016 12/01/2017 COMB aacci INdED SINGLE LIMIT $1�000,000 (Eenq . X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURYPer accident $ AUTOS AUTOS ( ) X HIRED AUTOS X NON-AUTOOSWNED PROPERTY DAMAGE (Per accident) A X UMBRELLA LIAB X OCCUR CU2090123 12/01/2016 12/01/2017 EACH OCCURRENCE $4,000,000 • EXCESS LIAB CLAIMS-MADE AGGREGATE $4,000,000 DED I X RETENTION SO $ B WORKERS COMPENSATION X WC2090344 12/01/2016 12/01/2017 X ITORY LIM TS 0P.H AND EMPLOYERS'LIABILITY Y N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE 51,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) " Sample " . • CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN " Sample " ACCORDANCE WITH THE POLICY PROVISIONS. e • AUTHORIZED REPRESENTATIVE • ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 2 The ACORD name and logo are registered marks of ACORD #S1078121/M1078024 EBR16 1