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CERTIFICATE OF INSURANCE AND <br />BONDING <br />Client#: 35548 CHGARMO <br />ACORDT�, CERTIFICATE OF LIABILITY INSURANCE D 12/02/202YYY) <br />TE 12/02/2024 <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 policy(ies) 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 any rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />NAME, Victoria Wagner <br />EPIC Insurance Midwest <br />925 Wabash Ave. Ste 200 <br />PHONE 317 706-9825 FAX <br />A/C No Ext : A/C No): <br />E-MAIL ADDRESS: g P Victoria.Wa ner@e Icbrokers.com <br />Terre Haute, IN 47807 <br />INSURERS) AFFORDING COVERAGE <br />NAICa <br />INSURER A: The Phoenix Insurance Company <br />25623 <br />INSURED <br />INSURER B: Travelers Property Casualty Co of Amer <br />25674 <br />C. H. Garmong & Son, Inc. <br />Farmington Casual Company <br />INSURER C : 9 Casualty P Y <br />41483 <br />Attn: Greg Bishop <br />3050 Poplar Street <br />Terre Haute, IN 47803 <br />INSURER D: <br />INSURER E: <br />INSURER F <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <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 WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />�Tq <br />TYPE OF INSURANCE <br />NSR ADDLSUBR <br />POLICY NUMBER <br />MIODLICY EFF <br />MMO/LDICY EXP <br />LIMITS <br />A <br />X <br />COMMERCIALGENERALLIABILITY <br />X <br />X <br />DTC01W321910PHX23 <br />12/31/2024 <br />12/31/2025 <br />EACH OCCURRENCE <br />$1000000 <br />CLAIMS -MADE OCCUR <br />PREMISES Eaoxurance <br />$1,000,000 <br />MED EXP (Any one person) <br />$10 000 <br />PERSONAL & ADV INJURY <br />$1,000,000 <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$2,000,000 <br />GEN'L <br />POLICY X JECOT LOG <br />PRODUCTS - COMP/OP AGO <br />$2,000,000 <br />$ <br />OTHER: <br />B <br />AUTOMOBILE LIABILITY <br />X <br />X <br />8101W3188622226G <br />12/31/202412/31/202 <br />EO BINEDSINGLE LIMIT <br />1,000r000 <br />BODILY INJURY (Per person) <br />$ <br />X ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIRED NON -OWNED <br />X AUTOS ONLY X AUTOS ONLY <br />BODILY INJURY (Par accident) <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />B <br />UMBRELLA LIAB <br />X <br />OCCUR <br />X <br />X <br />CUP5W10694822NF <br />12/31/2024 <br />12/31/2025 <br />EACH OCCURRENCE <br />$20000000 <br />AGGREGATE <br />$20000 OOO <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED X RETENTION$$10000 <br />$ <br />C <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory In NH) <br />N/A <br />X <br />UB1W321067 <br />IV31/2024 <br />12Ml/2025 <br />X PER OTH- <br />E.L. EACH ACCIDENT <br />$1 000 000 <br />E.L. DISEASE - EA EMPLOYEE <br />$1 OOO 000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE -POLICY LIMIT <br />1 $1,000,000 <br />B <br />Installation <br />OT6301W892718TIL23 <br />12/31/2024 <br />12/31/2025 <br />$1,000,000 Limit <br />Floater <br />$250,000 Temp Storage <br />$2,500 Deductible <br />DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached If more space Is required) <br />GL Blanket Additional Insured - Automatic Status if Required by Written Contract <br />Per Phoenix/Travelers Form CG D6 04 02 19 <br />GL Designated Project General Aggregate Limit per Phoenix /Travelers Form CG D2 11 01 04 <br />GL Primary/Non-Contributory Insurance If Required per Written Contract <br />Per Phoenix/Travelers Form CG T1 00 02 19 <br />(See Attached Descriptions) <br />CERTIFICATE HOLDER CANCELLATION <br />Sample 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 />AUTHORIZED REPRESENTATIVE <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD <br />#S7061707/M7061706 VWA02 <br />Ih Kennedy Park Renovation <br />GARMONG Garmong Construction 120 <br />