LAKE

COUNTY

SCHOOLS

Leading our Children to Success Procurement Services 29529 CR 561 Tavares FL 32778 (352) 253-6760 Fax: (352) 253-6761 http://lake.k12.fl.us

“Equal Opportunity in Education and Employment”

Superintendent: School Board Members:

Susan Moxley, Ed.D. District 1 Bill Mathias District 2 Rosanne Brandeburg District 3 Marc Dodd District 4 Debbie Stivender District 5 Stephanie Luke

April 13, 2016 Mr. Bruce Bentley Bentley Striping, Inc. 1800 NW 20th Avenue Crystal River, FL 34428 RE: Bid #3680DG – Asphalt Paving, Striping & Sealcoating – Primary Vendor Dear Mr. Bentley, The Lake County School Board has accepted your offer to extend your contract for the above referenced bid. The extension period shall begin on April 22, 2016 through July 21, 2016. We look forward to working with you during this extension period. If you have questions, please call me at (352) 253-6763 or boodramb@lake.k12.fl.us. Sincerely,

Bibi Boodram Procurement Specialist

- . · CERTIFicA fe: OF LIABILITY INSURANc:E I 07'/1~'/'2'(;ffi'" THIS CERTIFICATE; IS ISSUED AS A MATTER OF INFORMATION ONLY AND CON~ERS NO RIGHTS'UPON THE: CERTIFICATE HOLDt=:R THIS CERTIFICATE DOES NOT AJ:tFIRMA11VELY OR NEGATIVELY AMEND, EXTEND OR AL.TER THE Cc:•vERAGE AIF'FORDED BY THE POLICIES BEL.OW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTirUTE A CONTRACT BElWEEN tHE ISSUING INSURER(S), AUTHORIZED RI:PRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

IMPORTANT: If tile certmcat& holder Is an ADDITIONAL INSURED, the pollcy(l9s) must be endorsed.· I If SUBROGATION IS WAIVED, subjaet to tl'le term~ and conditions of the policy, certain policies may require an ondor'$elllent. A statement on til'l$ certificate does not confer rights to the certificate holder In lieu of such endorsementrs).

P~oouceR Insurance Den, Inc. ~~ll~~c· · ____ -~===--------~ 5447 s Oakridge Drive r..:Jg.N:o.E>:tl:352-628-2331 ' Jl~ Nol; 352-628"5619 Homosassa FL 34448 · ···· ·· ·· ·- "W'oA~, insuranceden@ao:i __ c_o.;.;_m'--_ --~---r-----t

INSURED Bentley Striping Inc Bruce Bentley 1800 NW 2oth Ave Crystal River FL 34428

r----------=IN~6~U~==~~AfFOl~D~IN~G~C~O~V~~AA~G,~·E~~-------+--~N~A~IC~#~~

INSUR.E~A; LLOYDS OF LONII(ON ·-·--------+-----l 'INsuReR~= Infinity '"'SURt:RC: roRus NATIONA~[iNsco·-_ -------"f----·"­IN$UR.!Oft D: NATIONAL LIABILITY ANt:! FIRE ·-·----------1----------1

f-'1'-"NS._,U~R~I!R:!..!I!:..:::_ ________________ ~-------------+--------1

ll'l!lURERF:

COVERAGES CERTIFICATE NUM8ER: ·~EVISION NIUMBER: THIS IS TO CERTIFY IHAT THE POLICIES OF INSUMNCE LISTED BELOW HAVIS BEEN ISSUED TO 11-lE INSURI!~D NAMED ABOVE FOR THE POliCY PERIOD INDICATED. NOT'NIItiSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER I~OCUMENT V'IITH RESPECT TO \NHICH THIS CERTIFICATE MAY Bl:: ISSUED OR MAY PERTAIN, rHE INSURANCE AFFORDED 13Y THE POLICIES DESCRIBEII. HI':R!i:IN IS SUBJECT TO ALL THE TeRMS, ~CLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN Rt;;OUCEO BY PAID CLAIMS

~~~ TYPE OF INSURANCE lc..,cn I wvn POUCY NUMBER I 1:8J~~I ~·-------- LIMIY$

COMMER.CIAL GENERAL LIABILITY I. EACI-I occuRR,_tiN_C_E-=.::r.s ---1-,0-0-0-,0-0-lO

~tJ cLAIMs.MADE D occuR •· ~~~I'S~sYs~u"J1gN"':!o!I!ll=u10~-_w$~--___.!.1~00~,~0~0~0 AI--------~--------- N N CIBFL0004468

GEN'L AGGREGATE LIMIT APPLIS$ PeR:

i MED E<XP (AflY ''"&person) S

11/02/2014 11/02/.ZOHIPERSONAL&A;JVINJURY $

GENERALAGGI~AT!> $

1,000,000 2,000,000 n· POLICV o ~~& o LOG .f'RDOUCTS -COMP/OPAGG $

n OTHER: ~~· l ~~ Li'7ia7b,_,lllriilty .,._+-$----:--:-::-::-:-:-:-1 f---+-AU-TO~MOII.!:!S!.IL~E-L-IA-81-UTY--------+-+--+-------------+-----t"-------j'F, ~ColE LIM! S 1,000,000 f-- -----~----~~~~ 1- ANY AUTO BODILY INJURY (Pet per!!oll) $

2,000,000

8 ALL OWNED ~~ SCI-I!<DU~EO BODILY INJURY (Per accident) $

r- AUTOS f-- ~~~c:gWNED N N 509-8000-8975-001 07/05/2015 07/05/2016 'f.ROPERTY DAII<IAGE $ 1-- HIREDAUTOS f-- AVTOS ,jPet•sido!!l\ ··----+---------~

$

UMBRI!ll.All~ H OCCUR c 1- EXCIOSS LIAB CLAIMS-MAD&: N N 81517 G 141 All OED I I R~Y~NTION $

fACH OCCURR~~:N;.:C:::E:.__ __ -+=-$-----=2:.t:0,_,0,_,0:.::0:o:0=-:::j0 07/14/.20"15 07/14/2016 if>.GGREGATE ---+"-$---------!

$ WORKERS COMPENSATION l PER I I! \?~ 11-ANDEMPLDYI!RS'UAI:IIUTY Y/N STATUTE :

ANY PROPRIETORJPARTNERIEXECUTIV£ D E.L EACH ACCir.:;'e!.!CN'r'---+"-s -------1 f;:~~;~~'i;'~~~ ..XO~UDED? N I A fL. DISEASE·~~ ..... EMPl,OYEE $ 1ryea, deacl1be under .

1--t'D<-"E"'-'SC""-R"'IPT~IO~N,:.:O:...F O~P.=E::.oRA""T"-'IO"'N"'-S-"'be,low"'------[--n-+--t---------~-------+-----t-----+ t.L DISEASE- P:,JL::::lC:.:,Y.;::;LI:::;MI~T..~..=...$ -------1

D 0 7 APR322a7 0 071 ,..,_, 1,000,000E!ACHOCCURJ;NCE COMMERCIAL AUT N N 3 5 07/10/2 15 I Ul-"015 2,00o.occ GENERALABClR.E:!>ATE

DESCRIPTION OF OP!'RA TIONS I LOCATIONS I VEHICI.J;S CACORO 101, Addltfonot Rlomor!Qj 5ChtdUIII, may be o!toohgd If mo.,;~ epaC918 requi.._,,l)

CERTIFICATE HOL.DER CANCELI.A liON

Lake County Schools $HOUL.D ANY OF THI': ABOVE DEii~RIBED POLICIES BE CANCE(.I.EO BEFORE

Att: Purchasing THI': I':XPIR,o.TION DATE THERI OF, NO'f)Ci; WILL BE OELIVEREO IN

29529 County Rd 561 ACCORDANCIO WITH THE POLICY PROVISIONS.

Tavares FL 32778 ' .AIJTllQRIZED REPRESENT A TIVI!!

Fax: 352-253·6761 ~ -~:~~. I

@ 1988-2014 ACOI,lD CORPORATION. All r1ght.s reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of A. CORD

CERTIFICATE OF LIABILITY INSURANC:~E DATE (l'otMIDPNYYY)

07/17/2015 THIS CERTIFICATE: IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONfERS NO Rlf3HTS,UPON THI::: 1:ERTIFICATE HOLDI:R. THIS CERTIFICATE DOES NOT AI"FIRMATIVELY OR NEGATIVELY AMEND, EXlENO OR AL.TER THE CCiivERAGE AFFORDED av THE POLICIES BEL.OW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTiiUTE A CONTRACT BElW!;EN "'tHE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

IMPORTANT: If tlie certmcato 1\oldBr !san ADDITIONAL INSURED, the pollcy(llls} must bB endorser;!., If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain pollciBs m11y require an llndOI'$Gment. A statement on tl~i$ cartificatt does not confer rights to the cBrtlflcate holder In lieu of such endorsement s).

PR(Iouc!OR Insurance Den, Inc. 5447 S Oakridge Drive Homosassa FL 34448

INSURED Bentley Striping Inc Bruce Bentley 1800 NW 2oth Ave Crystal River FL 34428

11\lSURERc: TORUS NATIONA,b INS CO IN$URE'R g: NATIONAL LIABILITY Allll'!i-F_IR_E ___ ------+------1 INSUR~R I!:

1N$URERF:

COVERAGES CERTIFICATE NUMBER; REVISION NUMBER; THIS IS TO CERTIFY 'I'HAT THE POLICIES OF INSUMNCE LISTED BELOW I-IAVC BEEN ISSUED TO THE INSURI~D NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWI'I'IiSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER POCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, rHE INSURANCE AFFORDIOO BY THE POLICIES DESCR,IBEII> H~Ril:IN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS S~IOWN MAY HAVE BEEN REDUCED BY PAID CLAIMI:,,

~~~ TYPE OF INSURANCI! IIN~D wvn !1:aM~1 .~QIJCYI'i11P' L.MI'I'$ POUCY NUMIIEIR I fll'lMibll!YYYY1 ,

COMMJiOitciAL GENERAL LIABILITY EACH OCCURRENCE s 1,000,000 1--t=l CLAIMS-MADE D DCCUI'! i5R~MI§U '({.'~~ncFJl 100,000 1--

$

A 1--MED E;XP (A'lY_'?f''-' person) s

N N CIBFL0004468 11/02/2014 , , to212o1 e! PeRSONAL &NJV INJURY $ 1,000,000 r-2,000,000 GEN'L AGGREGATE LIMIT APPLIES Pi!:R: GENERAL AGGREGATE .$ R' POLICY 0 )~8r D LOG f'R0DUCT5 -COMP/OP AGG $ 2,000,000

OTHER: Fire Legal Liability__ $

AUTOMOBILE LIABIUTY fE~~~ri~t)SINGLE LIMI' 5 1,000,000 r---ANY AUTO BODILY INJURY (Pet per!!cn} $

1--- ALL OWNED - SCH!;f:lll~eo --B AUTOS AUTO$ BOD I~ Y INJURY (Per accident} $

1--- - NON-Ow-JED. N N 509-8000-8975-001 07/05/2015 07/05/201€1 IFRO~~~~fAiiiAGE $ 1-- HIRED AUTOS - AVTOS Peta d~ .

$ --UMBRI!U..A Ll~

HOCCUR EACH OCCUR~'I;NCE: $ 2 000 000 c - EXCIOSSLIAB N N 81517G141ALI 07114/2015 07/14/:.201~1 AGGReGATE CLJ\IMS,MADE $

OED I I RE'I'ENTION $ s WORKERS COMPENSATION I PER I I ~~>1-AND EMPLDYI!RS' UAI'IILlTY YIN

STATUTE ANY P~OPRIETQRIPARTNERIEXECUTIVE D NIA E.L. EACH ACCIDEN'r $ OFFICER!ME.M8SR I;.)(C~UDED• (Mandatory In NHJ i E.L. DISEASE ·_riA EMPl.OYEE $ lf~a, dii8C/1be undec D SCRIPTION OF OPERATIONS bGiow i E.L DISEASE -_POLICY LIMIT $

D COMMERCIAL AUTO N N 73APR322875 07/10/2015 0111 0/2015 i, 1,000,000 ~CH OCCURJ;NCE

2,000,0CO GENERAL ABBR.EW\TE

i! I·

DESCRIPTION OF' OPJ:RA TIONS I LOCATIONS I VEH(CI.,ES (ACORD 101, Addltfon•l RJun•r~Q~ Schedule, Mliy be .U..ched If more epac& Is requi.litd)

CERTIFICATE HOL.DER

Lake County Schools Att: Purchasing 29529 County Rd 561 Tavares Fl ~2778

Fax: 352-253-6761 I

ACORD 26 (2014/01)

CANCELL.A liON

$HOUL.D ANY OF THIO ABOve ohCR.IBED POL.ICIES BE CANCEI..I.I::D BEFORE THE EXPIRATION DATE THI~EOF, NO't'IIC:E Wti..L BE DELIVEREO Jill ACCORDANCE WITH THE POucjy PROVISION!~.

AIJTI-ILATIVI!~f'v' rO([}.""Y\~~· ::-:-:'---:'~~---~_J @ 1988-2014 AC,~RA TION. All right9 reserved.

The ACORD name and logo are registered marks of A. CORD

LAKE

COUNTY

SCHOOLS

Leading our Children to Success Procurement Services 29529 CR 561 Tavares FL 32778 (352) 253-6760 Fax: (352) 253-6761 http://lake.k12.fl.us

“Equal Opportunity in Education and Employment”

Superintendent: School Board Members:

Susan Moxley, Ed.D. District 1 Bill Mathias District 2 Rosanne Brandeburg District 3 Tod Howard District 4 Debbie Stivender District 5 Kyleen Fischer

April 21, 2014 Mr. Bruce Bentley Bentley Striping, Inc. 1800 NW 20th Avenue Crystal River, FL 34428 RE: Bid #3680DG – Asphalt Paving, Striping & Sealcoating - Primary Vendor Dear Mr. Bentley, At their meeting held on April 14, 2014 the Lake County School Board accepted your offer to renew your annual contract for the above referenced Bid. The contract terms and conditions in this agreement will be firm through April 21, 2015. Enclosed, for your records, is an executed copy of your agreement with the Lake County School Board. Per contract specifications, it is your responsibility to provide the Purchasing Department with current copies of your certificate of insurance naming the School Board of Lake County, Florida, as an additional insured and to maintain the required coverages for the duration of the contract term. If you have not already done so, please forward this information as soon as possible. Failure to submit a fully completed original certificate of insurance signed by an authorized representative of the insurer providing such coverage may cause your company to be in default and subject to cancellation of the contract. We look forward to working with you during this contract period. If you have questions, please call me at (352) 253-6765. Sincerely,

Deborah Gardner, CPPB Assistant Purchasing Agent

EXTENSION TO AGREEMENT FOR CONTRACTOR S~RVICES

\JI{ ll . This Contract Extension is made as of the~ day of tA~.Jui.) , 2014, between the

School Board of Lake of County, Florida ("School Board"), and Ben ey Stnpmg, Inc. ("Contractor").

WITNESSETH:

THAT, on April22, 2013 the parties entered into an Agreement for Contractor Services whereby the Contractor agreed to provide asphalt paving, striping and sealcoating services to School Board (the "Agreement"). NOW, the parties wish to extend the term of the Agreement for an additional 12 months up through and including April21, 2015.

NOW, THEREFORE, in consideration of the mutual benefits accruing to the parties and for other good and valuable considerations, the receipt and sufficiency of which are hereby acknowledged, the parties agrees as follows:

1. Recitals. The above recitals are true and correct and by reference are incorporated herein and made a part hereof.

2. Extension. The Agreement is hereby extended through April21, 2015.

3. Modification. Except as specifically modified by this Contract Extension, the terms and conditions of the Agreement shall continue in full force and effect as originally executed. Nothing herein shall be deemed or construed to modify any other contract or undertaking between the parties other than as defined above.

4. Public Records Retention. CONTRACTOR shall keep and maintain public records that ordinarily and necessarily would be required by SCHOOL BOARD in order to perforrn the services being provided by CONTRACTOR herein. CONTRACTOR shall provide the public with access to public records on the same terms and conditions that the SCHOOL BOARD would provide the records and at a cost that does not exceed the cost provided in Chapter 119, Florida Statutes. CONTRACTOR shall ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law. CONTRACTOR shall meet all requirements for retaining public records and transfer, at no cost, to the SCHOOL BOARD all public records in possession of the CONTRACTOR upon termination of this Agreement and destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. All records stored electronically must be provided to the SCHOOL BOARD by CONTRACTOR in a format that is compatible with the information technology systems of the SCHOOL BOARD.

IN WITNESS WHEREOF, the parties hereto have made and executed this Contract Extension on the respective dates under each signature:

SCHOOL BOARD OF LAKE COUNTY, FLORIDA BENTLEY STRIPING, INC.

~~ ~ Chairperson

Date: ---------------------

Attest:

iTu})eriilte11dent

Bentley Striping Inc.

LAKE COUNTY SCHOOLS

Leading our Children to Success

Procurement Services 29529 CR 561 ·Tavares • FL 32778 (352) 253-6760 • Fax: (352) 253.fi761 • http:/hake.lc12.fF.us

Mr. Bruce Bentley Bentley Striping, Inc. 1800 NW 20ttl Avenue Crystal River, FL 34428

RENEWAL OPTION

3525632122 p.1

Superintendent: &:haDIBoan:IIKembers: SUsan Moxley, Ed.D. District 1

Bill Mathias District 2 Rosanne Brandeburg District 3 Tad Howard District4 Debbie Stivender Dlstnct5 Kyleen Fischer

RE: Bid #3680DG -Asphalt Paving, Striping & Seal coating - Primary Vendor

Dear Mr. Bentley,

The above referenced contract is currently awarded to your company, but unfortunately win expire on April 21, 2014. The School Board of Lake County would be interested in renewal of this contract, per contract specifications, by your company if possible.

Please retum the form below to our office by March 11, 2014.

Thank you in advance for your assistance in this contract renewal. Please contact me at 352-253-6765, if you have any questions.

Sincerely, ...... ,{;

j I 1 j I J,...·," "-'::.!..!~.A...... />:.. .. /-u:!.d..,Ul..IZ..

Deborah Gardner, CPPB Assistant Purchasing Agent

Bentley Striping, Inc. is in agreement for renewal of the above referenced contract at the approved contract prices. Period of agreement shall be through April 21, 2015.

w at approved contract prices. fi<J Yes 0 No

tiY~

"Equal Opporl.unlty in education and Employment"

LAKE COUNTY SCHOOLS Leading our Children to Success Procurement Services 29529 CR 561 Tavares FL 32778 (352) 253-6760 Fax: (352) 253-6761 http://lake.k12.fl.us

“Equal Opportunity in Education and Employment”

Superintendent: School Board Members: Susan Moxley, Ed.D. District 1 Bill Mathias District 2 Rosanne Brandeburg District 3 Tod Howard District 4 Debbie Stivender District 5 Kyleen Fischer

NOTICE OF AWARD April 25, 2013 Mr. Bruce Bentley Bentley Striping, Inc. 1800 NW 20th Avenue Crystal River, FL 34428 RE: Bid #3680DG – Asphalt Paving, Striping & Sealcoating - Primary Vendor Dear Mr. Bentley, At their meeting held on April 22, 2013, the Lake County School Board approved the award of the above referenced bid to your company. A complete copy of the award recommendation letter and the bid tabulation may be viewed on the Lake County Schools Purchasing Department website located at http://Iake.k12.fl.us. An executed copy of your contract is enclosed for your records. Per contract specification, it is your responsibility to provide the Purchasing Department with current copies of your certificate of insurance naming the Lake County School Board as an additional insured and to maintain the required coverage’s for the duration of the contract term. If you have not already done so, please forward this information as soon as possible. Failure to submit a full completed original certificate of insurance signed by an authorized representative of the insurer providing such coverage may cause your company to be in default and subject to cancellation of the contract. The contract and will be in effect from April 22, 2013 through April 21, 2014. Purchase orders will be issued as needed. We look forward to working with you. If you have questions, please contact me at 352-253-6765 or gardnerd@lake.k12.fl.us . Sincerely,

Deborah Gardner Assistant Purchasing Agent

CERTIFICATE OF LIABILITY INSURANC:~E DATE (l'otMIDPNYYY)

07/17/2015 THIS CERTIFICATE: IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONfERS NO Rlf3HTS,UPON THI::: 1:ERTIFICATE HOLDI:R. THIS CERTIFICATE DOES NOT AI"FIRMATIVELY OR NEGATIVELY AMEND, EXlENO OR AL.TER THE CCiivERAGE AFFORDED av THE POLICIES BEL.OW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTiiUTE A CONTRACT BElW!;EN "'tHE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.

IMPORTANT: If tlie certmcato 1\oldBr !san ADDITIONAL INSURED, the pollcy(llls} must bB endorser;!., If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain pollciBs m11y require an llndOI'$Gment. A statement on tl~i$ cartificatt does not confer rights to the cBrtlflcate holder In lieu of such endorsement s).

PR(Iouc!OR Insurance Den, Inc. 5447 S Oakridge Drive Homosassa FL 34448

INSURED Bentley Striping Inc Bruce Bentley 1800 NW 2oth Ave Crystal River FL 34428

11\lSURERc: TORUS NATIONA,b INS CO IN$URE'R g: NATIONAL LIABILITY Allll'!i-F_IR_E ___ ------+------1 INSUR~R I!:

1N$URERF:

COVERAGES CERTIFICATE NUMBER; REVISION NUMBER; THIS IS TO CERTIFY 'I'HAT THE POLICIES OF INSUMNCE LISTED BELOW I-IAVC BEEN ISSUED TO THE INSURI~D NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWI'I'IiSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER POCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, rHE INSURANCE AFFORDIOO BY THE POLICIES DESCR,IBEII> H~Ril:IN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS S~IOWN MAY HAVE BEEN REDUCED BY PAID CLAIMI:,,

~~~ TYPE OF INSURANCI! IIN~D wvn !1:aM~1 .~QIJCYI'i11P' L.MI'I'$ POUCY NUMIIEIR I fll'lMibll!YYYY1 ,

COMMJiOitciAL GENERAL LIABILITY EACH OCCURRENCE s 1,000,000 1--t=l CLAIMS-MADE D DCCUI'! i5R~MI§U '({.'~~ncFJl 100,000 1--

$

A 1--MED E;XP (A'lY_'?f''-' person) s

N N CIBFL0004468 11/02/2014 , , to212o1 e! PeRSONAL &NJV INJURY $ 1,000,000 r-2,000,000 GEN'L AGGREGATE LIMIT APPLIES Pi!:R: GENERAL AGGREGATE .$ R' POLICY 0 )~8r D LOG f'R0DUCT5 -COMP/OP AGG $ 2,000,000

OTHER: Fire Legal Liability__ $

AUTOMOBILE LIABIUTY fE~~~ri~t)SINGLE LIMI' 5 1,000,000 r---ANY AUTO BODILY INJURY (Pet per!!cn} $

1--- ALL OWNED - SCH!;f:lll~eo --B AUTOS AUTO$ BOD I~ Y INJURY (Per accident} $

1--- - NON-Ow-JED. N N 509-8000-8975-001 07/05/2015 07/05/201€1 IFRO~~~~fAiiiAGE $ 1-- HIRED AUTOS - AVTOS Peta d~ .

$ --UMBRI!U..A Ll~

HOCCUR EACH OCCUR~'I;NCE: $ 2 000 000 c - EXCIOSSLIAB N N 81517G141ALI 07114/2015 07/14/:.201~1 AGGReGATE CLJ\IMS,MADE $

OED I I RE'I'ENTION $ s WORKERS COMPENSATION I PER I I ~~>1-AND EMPLDYI!RS' UAI'IILlTY YIN

STATUTE ANY P~OPRIETQRIPARTNERIEXECUTIVE D NIA E.L. EACH ACCIDEN'r $ OFFICER!ME.M8SR I;.)(C~UDED• (Mandatory In NHJ i E.L. DISEASE ·_riA EMPl.OYEE $ lf~a, dii8C/1be undec D SCRIPTION OF OPERATIONS bGiow i E.L DISEASE -_POLICY LIMIT $

D COMMERCIAL AUTO N N 73APR322875 07/10/2015 0111 0/2015 i, 1,000,000 ~CH OCCURJ;NCE

2,000,0CO GENERAL ABBR.EW\TE

i! I·

DESCRIPTION OF' OPJ:RA TIONS I LOCATIONS I VEH(CI.,ES (ACORD 101, Addltfon•l RJun•r~Q~ Schedule, Mliy be .U..ched If more epac& Is requi.litd)

CERTIFICATE HOL.DER

Lake County Schools Att: Purchasing 29529 County Rd 561 Tavares Fl ~2778

Fax: 352-253-6761 I

ACORD 26 (2014/01)

CANCELL.A liON

$HOUL.D ANY OF THIO ABOve ohCR.IBED POL.ICIES BE CANCEI..I.I::D BEFORE THE EXPIRATION DATE THI~EOF, NO't'IIC:E Wti..L BE DELIVEREO Jill ACCORDANCE WITH THE POucjy PROVISION!~.

AIJTI-ILATIVI!~f'v' rO([}.""Y\~~· ::-:-:'---:'~~---~_J @ 1988-2014 AC,~RA TION. All right9 reserved.

The ACORD name and logo are registered marks of A. CORD