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Culpepper & Terpening, COI, GL/Auto/Umbrella/WC, 2016-2017 priSi ,Ala CULP&TE-01 BARWICKT ACORCr i CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDIYYYY) `------ 1/13/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS SCERTIFICATE 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: Teresa Barwick Insurance Office of America,Inc. PHONE 561 776-0660 FAx 7 Abacoa Town Center tac,No,Ext):( ) {ac,No):(561) 76-0670 E-MAIL 1200 University Blvd,Suite 200 ADDRESS:Teresa.Barwick@ioausa.com Jupiter,FL 33458 INSURER(S)AFFORDING COVERAGE NAIC fI INSURER A:Phoenix Insurance Company 25623 INSURED INSURER B:Travelers Indemnity Company of America 25666 Culpepper&Terpening Inc. INSURER C:Travelers Indemnity Company 25658 2980 S.25th Street INSURER D:Bridgefield Employers Insurance Company 10701 Fort Pierce,FL 34981 - 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 EFF POLICY EXP LIMITS LTR INSD MID POLICY NUMBER (MM/DD/YYYY) (MM/DDrYYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 660-9D794955 01/16/2016 01/16/2017 pREM SESO(Ea occu ence) S 100,000 MED EXP(Any one person) S 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X PECOT- LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 fa SEa accident) B X ANY AUTO BA-9D795085 01/16/2016 01/16/2017 BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) PIP s 10,000 X UMBRELLA UAB X OCCUR EACH OCCURRENCE s 5,000,000 C EXCESS UAB CLAIMS-MADE CUP-4194T132 01/16/2016 01/16/2017 AGGREGATE $ 5,000,000 DED X RETENTIONS 10,000 5 WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY _ STATUTE ER YIN D ANY PROPRIETOR/PARTNER/EXECUTIVE 83037409 01/16/2016 01/16/2017 E.L EACH ACCIDENT 5 1,000,000 OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 411;1 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE City of Okeechobee �t 55 ee 3rd Avenue Qj" Okeechobee,FL 34974 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD