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CERTIFICATE OF LIABILITY INSURANCE (164) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 3/30/2011 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). CONTACT Michaela Bernier PRODUCER NAME: FAX PHONE (407)849-0333 George Eidson Agency Inc dba Eidson Insurance (407)425-5694 (A/C, No): (A/C, No, Ext): E-MAIL michaelab@eidsoninsurance.com P.O. Box 540209 ADDRESS: PRODUCER 00014776 2807 Edgewater Dr CUSTOMER ID #: OrlandoFL32854 INSURER(S)AFFORDINGCOVERAGENAIC# American Casualty Company 20427 INSURED INSURER A : Auto-Owners Insurance 18988 INSURER B : Reiss Environmental, Inc. & Reiss Engineering, Continental Casualty 20443 INSURER C : 1016 Spring Villas Pt. Transport Insurance 20494 INSURER D : National Casualty Insurance 11991 INSURER E : Winter SpringsFL32708 INSURER F : NEW 2010-2011 COVERAGESCERTIFICATENUMBER:REVISIONNUMBER: 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. ADDLSUBR INSRPOLICY EFFPOLICY EXP TYPE OF INSURANCELIMITS POLICY NUMBER (MM/DD/YYYY)(MM/DD/YYYY) LTR INSRWVD 1,000,000 GENERAL LIABILITY EACHOCCURRENCE$ DAMAGE TO RENTED X 300,000 COMMERCIAL GENERAL LIABILITY$ PREMISES(Eaoccurrence) 9/21/20109/21/2011 A 10,000 X 2075095657 CLAIMS-MADEOCCURMEDEXP(Anyoneperson)$ 1,000,000 PERSONAL&ADVINJURY$ 2,000,000 GENERAL AGGREGATE$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:PRODUCTS - COMP/OP AGG$ PRO- X $ POLICYLOC JECT COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY 1,000,000 $ (Eaaccident) X ANY AUTO BODILYINJURY(Perperson)$ 4472389700 8/19/20108/19/2011 B ALL OWNED AUTOS BODILYINJURY(Peraccident)$ SCHEDULEDAUTOS PROPERTY DAMAGE $ X (Peraccident) HIRED AUTOS X 10,000 $ PIP-Basic NON-OWNED AUTOS 5,000 $ Medical payments X X 1,000,000 UMBRELLA LIAB EACHOCCURRENCE$ OCCUR 1,000,000 EXCESS LIAB CLAIMS-MADEAGGREGATE$ $ DEDUCTIBLE X 9/21/20109/21/2011 C 2091445161 10,000 $ RETENTION$ WC STATU-OTH- WORKERS COMPENSATION DX TORY LIMITSER AND EMPLOYERS' LIABILITY Y / N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACHACCIDENT$ N / A OFFICER/MEMBER EXCLUDED? 9/21/20109/21/2011 WC275094668 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ Ifyes,describeunder 1,000,000 E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below E Professional Liability-7/9/20107/9/2011 $2,000,000 ARO0003831 Liability- Each Claim Claims Made Coverage $2,000,000 Ded:$5,000/Retro:1/1/1998 Liability- Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Clearwater Attn: City Clerk AUTHORIZED REPRESENTATIVE P.O. Box 4748 Clearwater, FL 33758-4748 Michaela Bernier/CLH ACORD25(2009/09)©1988-2009ACORDCORPORATION.Allrightsreserved. TheACORDnameandlogoareregisteredmarksofACORD INS025 (200909)