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COI Expires 02/01/2014A� V CERTIFICATE OF LIABILITY INSURANCE YY) 3/19/2013 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 Eastern Insurance Group, Inc. 9570 SW 107 Avenue Suite 104 Miami FL 33176 CONTACT David M. Lopez NAME: P PHONE (305)595-3323 FAX N (305) 5 95-7135 E-MAIADDRESS:LCST@easterninsurance.net INSURERS AFFORDING COVERAGE NAIC # INSURER A Mid —Continent Casualty Company INSURED C 6 W Pipeline, Inc. 170 W 39 Place Hialeah FL 33012 INSURER B Diamond State Insurance Company INSURER C :Brill efield Employers Insuranc INSURERD: INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBERMaster 13-14 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 LTR TYPE OF INSURANCE A DL UBR POLICY NUMBER POLICY EFF MM/DD POLICY EXP MMIDDIYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY ED PREMISES Ea occurrence) $ 100,000 A CLAIMS -MADE FX_1 OCCUR X 4-GL-000870056 /22/2013 /22/2014 MED EXP (Any one person) $ Excluded PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ X POLICY PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED X SCHEDULED AUTOS AUTOS CAP0001076 /1/2013 /1/2014 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ X X NON -OWNED HIRED AUTOS AUTOS PIP -Basic $ 10,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OTH- X WC RY'LIMITS I E.L. EACH ACCIDENT $ ZOO 000 OFFICER/MEMBER EXCLUDED? E (Mandatory in NH) N / A 30-47454 /22/2013 /22/2014 E.L. DISEASE - EA EMPLOYE9 $ 100,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1 $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is r qui Sewer and water main construction AP V GF1111E{�R Project: Doctor's Arm Culvert BY Certificate holder is listed as additional insured. WIC (305)292-4426 Monroe County 1100 Simonton Suite 2-216 Key West, FL Street 33040 AAw_IILOICI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) 0-cl b , IVI-4-AJ C_C Lopez/AMANDA ©1988-2010 ACORD CORPORATION. All rights reserved.