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COI, WC 10/24/2022-10/24/2024 i "1 EVERSOL-01 MSTOKES '4o��zo CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDYYYY) 9/25/2023 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 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 CONTMEACT NA Hub International Florida PHONE FAX 1117 Thomasville Road (ac,No,Ext):(850)386-1111 �wc,No);(850)385-9827 Tallahassee,FL 32303 %Mks: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Cincinnati Indemnity Company 23280 INSURED INSURER B:Hartford Casualty Insurance Company 29424 Evergreen Solutions LLC INSURER C:Twin City Fire Insurance Company 29459 2528 Barrington Circle Unit 201 INSURER D: Tallahassee,FL 32308 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD /MMJDD/YYYY1 IMM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _$ 1,000,000 CLAIMS-MADE X OCCUR ENP0586601 8/17/2023 8/17/2024 DAMAGETORENTED 500,000 X X PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ _ANY AUTO EBA0586601 8/17/2023 8/17/2024 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS( yyN� BODILYR INJURYD (Per accident) $ X AU�DS ONLY X AUOTOS ,,LDY {Per agdeM)AMAGE $ • $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 EXCESS LIAB CLAIMS-MADE ENP0586601 8/17/2023 8/17/2024 AGGREGATE $ 2,000,000 DED RETENTION$ $ B WORKERS COMPENSATION X ;MUTE EMPLOYERS'LIABILITY ER Y/N STATUTE ANY PROPRIETOR/PARTNER/EXECUTIVE X 21WECAB81M0 10/24/2023 10/24/2024 1,000,000 �FFICER/MEMgER EXCLUDED? N/A E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT,$ C Professional Liab 21 PG0567622-23 8/17/2023 I 8/17/2024 per claim 2,000,000 C Professional Liab 21PG0567622-23 I 8/17/2023 8/17/2024 aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Okeechobee is listed as an additional insured for general liability with a waiver of subrogation and coverage being primary&non contributory. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Okeechobee THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 55 SE 3rd Avenue Okeechobee,FL 34974 AUTHORIZED REPRESENTATIVE 1.�% 1C—:J ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ____........... EVERSOL-01 MSTOKES ACOR,O CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) `.------- 8/16/2023 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the ter ditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the ce ' t6 h2Id r' of suchCpendorsement(s). PRODUCER /-:-T e NOMEACT Hub International Florida PHHONE FAX 1117 Thomasville Roadr„,-.,;, r- 0 (A/C,No,E,rtk(850)386-1111 1(aC,No):(850)385-9827 Tallahassee,FL 32303 ry N)'I"_p E-MAILDSS: H INSURERS)AFFORDING COVERAGE NAIC# ,.,J 1 6 2023 SURER A:Cincinnati Indemnity Company 23280 INSURED ,/,� SURER B:Hartford Casualty Insurance Company 29424 Evergreen Solutions LLC ¢-K� INSURER c:Twin City Fire Insurance Company 29459 2528 Barrington Circle Unit 201 C INSURER D: Tallahassee,FL 32308 As �d INSURERE: P 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 H POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD ,IMM/DD/YYYY7',IMM/DD/YYYYI A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR ENP0586602 8/17/2023 8/17/2024 DAMAGE TO RENTED 500,000 X X PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY jeT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ _ ANY AUTO _ EBA0586602 8/17/2023 8/17/2024 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOSE� ONLY AUTOS SSyyNEp BODILY INJURYp (Per accident) $ X AURTOS ONLY X AUTOS ONLY (Per acEclRdent)AMAGE $ $ A X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 2,000,000 EXCESSLIAB CLAIMS-MADE ENP0586602 8/17/2023 8/17/2024 AGGREGATE $ 2,000,000 DED RETENTION$ $ B WORKERS COMPENSATION X STATUTE OTH AND EMPLOYERS'LIABILITY ER YIN X 21WECAB81M0 10/24/2022 10/24/2023 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ FFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE,$ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Professional Liab 21PG025884623 8/17/2023 8/17/2024 per claim 2,000,000 C Professional Liab 21PG025884623 8/17/2023 8/17/2024 aggregate 2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Okeechobee is listed as an additional insured for general liability with a waiver of subrogation and coverage being primary&non contributory. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cityof Okeechobee THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 55 SE 3rd Avenue Okeechobee,FL 34974 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD