CERTIFICATE OF LIABILITY INSURANCE (187)'�`` °R°� CERTIFICATE OF LIABILITY INSURANCE 9Az1M �01 "'
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THIS CERTIFICATE IS ISSUED A5 A MATTER OF INFORMATION ONLY AND CONFERS NQ RIGHTS UPON THE CERTIFICAT� HOLDER. THIS
CERTIFICATE DQES NOT AFFIRMATNELY OR NEGATIVELY AMEND, EX7ENU OR AI�TER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. 7HIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BE7WEEN TH� ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE 012 PRODUCER, AND THE GERTIFICATE MOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies). must be endorsad. If SUBRQGATION IS WAIV�D, subject to
the terms and conditions of the policy, certain pollcies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such �ndors�ment s.
PROdUCER coN T Michaela Bernier
NAME:
George Eidson Ag�ncy �IlC C�7a. Eidson Insurance P��NE .(407) 849-0333 F'� o; (907)425-5694
P.O. Box 540209 E�ESS;mfchaelab�efdsoninsurance.cam
28p7 Edgewater Dr PRODUCER po01�776
Orlando FL 32854 INSURER S AFFORdING COVERAGE NAIC #
INSURED INSURERA�+mex1C2.I� Casualt Com an 0427
Reiss Enviranmental, Inc. 6 iNSU�asAuto-Owners Insurance 18988
Reiss Engineering, Inc. iNSUSERC:Continental Casualt 0443
1p16 Spxing Villas Pt. iNSUReRO:Bridaefield EmAl�vers Ins Co 10701
Winter Springs FL 3270$
COVERAG.ES CERTIFICATE NUMBER:�DATBD 11/12 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LIS7ED eELOW HAVE BEEN ISSUED TO THE INSURED NAMEI7 ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CQNTRACT QR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY-PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES D�SCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS,
EXCLUSIpNS AND CONDITIONS OF SUCH POLICIES. LIMITS SHQWN MAY HAVE eEEN REDUCED BY PAID CLAIMS.
IN5R rypp OF INSURANCE POI.ICY EFF POLICY EXP
L7R POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS
GENERALLIABILITY EACH OCCURRENCE $ 1� OOO � OOO
X COMMERCIAL GENERAL LIABILITY ������� PREMI6E Ea occurcen $ S OO i OOO
A CLAIMS-MADE � OCCUR 075095657 21/2011 9/21/20].2 MEp EXP (Any one person) $ 10 � 00 0
PERSONALBADVINJURY $ �iOOO�OOO
SEP � 3�O� GENERaLAGGREGaTe � 2, OOO., OOO
GEN'L AGGR�GATE LIMIT APPLIES PER: PRODUCTS - CpMP/OP AGG S. a� O OO �.O O O
POLICY X pR� LOC ��K ° Gi ' $
AUTOM091LE IJABILITY �.....•, rr, �r a COMBINEp SINGLE LIMIT
���S�.�l�� w.a4 �w D�f 9 (Ee accident) $ 1. 0 0 0, 0 0 0
X ANY AUTO
47238970D /i9/aoii a/�9�zoiz BODILYINJURY(Perperson) s
B ALL OWNED AUTOS . .
BODILY INJURY (Per eccidenl) $
SCHEDl1LED AUTOS PRpPERTY pAMAGE $
X HIRE� AUT�S (Par accident)
X Nor+-owrre�AUros PIP-BaeiC s 10, 000
Medicsl payments S 5� 0 0 0
}( UMBRELLA LIAB X OCCUR �ACH OCCURRENCE $ 1� 000 � 000
EXCESS LIAB C�p,IMS-MADE AGGREGATE $ 1, O O O� O O 0
�EDUC718LE g
— _ 9 21�2011 9 21/2012
D WQRKERS COMPENSATION X WC STA7U� pTH-
AND EMPLOYERS' LIABILITY Y! N
ANYPROPRIETOR/PARTNERlEXECUTIVE E.LEACHACCIDENT $ 1 OOO OOO
OFFICER/MEMB�R EXCLUDEp7 ❑ N!A
(MandatoryinNN) 389600 9/21/2011 /21/2012 EL.DISEASE-EAEMPLOYE $ 1,0�0,000
If yes, descri6g under
DESCRIPTION OF pPER.qT10N5 delow E.L. pISEASE - POLICY LIMIT $ 1 O O O O O O
C Frofessional Liability- x28B3557.98 /9/2oii /9/2012 Liability-EachClaim: $2,000,000
Claima Made Coverage ed. $10,000./Ratro: svll Liability-Agqregata $2,000,000
DESCRIPTION OF OPBRATIONS / LpCATION5/ VEMIGLES (Alteeh ACORD 107, Addldonal Remarks SChedule, H mo1'e apeee Is requlrcd)
1�:L�1��»:1
TION
SHOULD ANY pF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
7HE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Clearwater ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: City Clerk
P. Q. �OX 4 7 4 B AUTFIORIZE� REPRESEN7ATNE
Clearwater, FL 3375$-4748
MiChaela Bernier/CLH ��'��� ����'�����
ACORD 25 (2009/09) 0 7988-20D9 ACORD CORPpRATION. All rights reserved.
INS025 �2oosoa� 7he ACqRD namv and loao ara registared marks of ACORD