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CERTIFICATE OF LIABILITY INSURANCEOP ID: JT .r . 4COM°- CERTIFICATE OF LIABILITY INSURANCE OAT WYYYY) 1 2113 12/13/10 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 endorsements . RooucER 407-660-8282 NCONTACT AME: Irown &' Brown of Florida, Inc. 407-660-2012 PHONE I FAX (A C N Ext : VC No : .600 Lake Lucien Dr. Ste. 330 E-MAIL , ADDRESS: Maitland, FL 32751-7234 PRODUCER RENAI 2 - 99 s7o ERI louse - Brown & Brown INSURERS AFFORDING COVERAGE NAIC # NSURED Renaissance Planning Group INSURER A -Associated Indemnity Corp 21865 INC INSURER B : Northem Ins. Co. of N.Y. 19372 121 South Orange Ave #1200 INSURER C: Orlando, FL 32801 INSURER D INSURER E : INSURER F : ;OVERAGES 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. POLICY JSR TYPE OF INSURANCE POLICY NUMBER MID EF MM/DD/YYYY LIMITS TR WVD GENERAL LIABILITY EACH OCCURRENCE $ 21000,00 k X COMMERCIAL GENERAL LIA131LITY X AZC80848645 12114/10 12/14/11 PREMISES Ea occurrence $ - .100,00. X OCCUR CLAIMS-MADE E? a E MED EXP (Any one person) X , .. -.. Primary 4 '? " " ' ' /// PERSONAL & ADV INJURY, $ 2+000,00 Non-Contributory , GENERAL AGGREGATE $ 4+000+00 PER: GEN'L AGGREGATE LIMIT APPLIES JAN 7 6 201y I PRODUCTS - COMP/OP AGG $ 4,000+00 . POLICY X PRO j F-1 LOC , $ AUT OMOBILE LIABILITY X COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 ANY AUTO o y MISLAM y d SRVCS DE N BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE 4 X HIRED AUTOS AZC80848645 12114/10 12114/11 (Per accident) $ X NON-OWNED AUTOS $ $ UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 3,000,00 EXCESS LIAB ff MS MADE AGGREGATE $ $,000,OD a DEDUCTIBLE 080848645 12114/10 12114/11 $ RETENTION $ $ WORKERS COMPENSATION X WTORY C LIM ER AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 0003946326 12114/10 12/14111 E.L. EACH ACCIDENT $ 1,000,00 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) NIA E.L. DISEASE - EA EMPLOYEE $ 1,000+00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 000,00 $ + )ESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks SchedLde, H more space Is requlred) ;ertificate holder has additional insured status as granted by the general ability and auto liability policy only with respects to the operations of he named insured. CERTIFICATE HOLDER CANCELLATION CLEARW2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Clearwater ACCORDANCE WITH THE POLICY PROVISIONS. Lauren Matzke, Planning Dept. Municipal Services Bldg 3rd FL AUTHORIZED REPRESENTATIVE 100 South Myrtle Ave Clearwater„ FL 33756 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD