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DORE8IAS•01 _.(iANP}LLAA
<br />CERTIFICATE OF LIABILITY INSURANCE I all
<br />DATE (MI'
<br />AE(MI' of y
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT; If the certificate holder Is an ADDITIONAL INSURED, the polloy(lea) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder In Iteu of such endorsement s)... .
<br />PRODUCER -.
<br />HQMI:tCT. Robert it
<br />Insurance Office of America, Inc,
<br />JNC Ntl Exl):1407). 998.413314133 IN9 Nok (4_q7 )_788 7933
<br />1865 West State Road 434
<br />FL 327501p514
<br />4fiLongwood, Boti:Osterndvrf�a laatrSa,Gom
<br />_ ..
<br />NAlcn
<br />__........
<br />!Nsu>;�ag•:Everost,Inderrini !nsu anpq,porppany 10.8$1
<br />INSURED
<br />Er+s mdif n 1Trav0lers_CasualtY Company - _ 417ti8
<br />Dore & Associates Contracting, Inc,
<br />INsur;eiz c Travelers Property Casualty Company of America 26674
<br />900 Harry Truman Parkway
<br />INSU(lall t3 .. _ ._
<br />Bay City, MI 48108
<br />INSURER P I
<br />cyckhetfNkl UI IaAnrbl
<br />_ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT VIATH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,
<br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
<br />LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />INSR
<br />TYPE Of! jh(SLSi38R
<br />TR INSURANCEz vivoNUMBER
<br />POLIIMIrsB
<br />._........:.. .._._m.:_._........—___< _.pDI.1C1't:FP.-pOLIGYB ��—OAMhE�f.If78D:.....:...
<br />A }( GOMMERC€AL GENERAL LIABILITY
<br />—
<br />i,000,004
<br />...... _--60,000
<br />_.__..
<br />[[ X_GcccUR
<br />EF4ML08083cf71 rTqUf 1 i
<br />04l3012017 041301iole A011, lEn.accu.T
<br />_
<br />X Prafosslon..al Ll� bl i
<br />M[;pTgP[40Y.ara.C70fto=+l 5,...___ _
<br />6 0D0
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<br />P6R.,�HA�e,,ADVINauRv 5
<br />1,040,ODU
<br />GCNL AOGAE0ATE.LRIMpIT APPLIES PER:
<br />,GEN ,4r C,RE Ci4T£_-
<br />2,000,000
<br />— — POLICY I X JEGT ❑LOG
<br />r+kgkti§ OL+P10� AGC� ; -
<br />2,000,000
<br />orrllRn.
<br />�
<br />AUTOMOBILE LIABILITY
<br />-
<br />CCOMB€NNC�11DSINIilE1;tlAkT
<br />ANY AUTO
<br />$�SDILY €NJURY (Per.pgr_son)
<br />. $
<br />_
<br />OWNED — SCH ULED
<br />SS#t71L' 1t¢,I�1RY {P6e n_r'F?�Iq��€
<br />�[RTY
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<br />(� I� p
<br />N €1• 4J D
<br />S AUTOS
<br />AUTOS ONLY .. -- AUTp C€fLv
<br />AMAGE
<br />kt GC+JORI� _
<br />S
<br />A
<br />UNIRR€LLRLIAB X OCCUR
<br />CACltrOCGURR$NC6._.,.,
<br />i.___..
<br />0,000,000
<br />X
<br />EXCESSLIA13 CLAWS -MADE
<br />EF4CU01159.171
<br />04/3012017
<br />0413012DIS
<br />AOGREOA�I;
<br />i. -
<br />Dt:D X REFENTIONS 1t},00i)
<br />Aggregate
<br />9,000,000
<br />B
<br />WORKERS COMPENSA-noN
<br />ANDEMPLOY2RS'LIAa1LITY
<br />X PER STATUTE -. EI>!H -
<br />Y!N
<br />PA0PRIETORIPARTNERIEXECUTIVE
<br />Hip
<br />6EUBOH00425317
<br />0511512017
<br />05116/2018
<br />EANY
<br />1,..0.0.0`,.000
<br />ppITnCCsRRM
<br />nryENR
<br />n
<br />gf
<br />1,tDrD0
<br />It yyes, dovAba under
<br />DESCRIPT€ON OF OPERATIONS below
<br />I
<br />E L DISEASE -POLICY LIMIT
<br />S
<br />1,000,000
<br />A
<br />Pol utlon asbestos
<br />EL060S3.171
<br />F4
<br />0413012017
<br />04130 2018
<br />Occurrence
<br />1,000,000
<br />C
<br />Workers Compensation
<br />6JUBOH10213AIT
<br />0511512017
<br />05I1512018
<br />Limit
<br />1,000,000
<br />DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORn 101, AddlNonal Remarks Schodola, may be shached If more space Is nqulred)
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS,
<br />REPRESENTATIVE
<br />ACORD 25 (20161031 01988.2015 ACORD CORPORATION, All rlohts reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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