CERTIFICATE OF LIABILITY INSURANCE (117)�� OP ID: MM
'4� �O' CERTIFICATE OF LIABILITY INSURANCE DATE(MMNDlYVYY)
- , - - -- - -
09/22/17
7H15 CERtIFICATE IS 155UED AS A MA7TER OF INFORMATION ONLY AND GONFERS NO RIGHT5 UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE bOE3 NOT AFFIRMAT'IVELY .QR NEGATIVELY AMENb, EXTEND OF2 ALTER 7HE COVERAGE AFFORDED BY THE PpLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DpES NOT CQN5TIiU7E A CQNTRACT BETWEEN TME 15SUING INSURER�S), AUTHORIZED
F2EPRE3ENTATIVE OR PRODUCER, ANO THE CERTIFICAT� HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVE�, subJect to
the terms and conditions of the policy, certain policies may require an endorsement A statement on this cert�cate dces not confer rights to the
certificate holder in lieu of such endorsemen s�.
CONTAC7
PRODUCER 386-252-9601 NAME:
Brown & Brown of Florida, Inc.
Daytona Beach Office 386-239�729 PHONE A/C Na :
P.fJ. Box 2412 E-Ma�
Daytona Beach,FL 32115-2412 pRODUCER
Nlatthew Bosang c T MeR io � BAMAC-1
INSURED BAMACO, INC
6869 WES7 HIGHWAY 100
BUNNELL, FL 32110
INSURER�S) AFFORDING COVERAGE
iNSURERA:Starr Indemnity & Liability Co
�NSUaeRe:l-andmark American Insurance Co
iwsuR� c: Technology Ins Co
INSURER D: LLpllf�'s af London
iasuReR E: Auto Owners Insurance Co.
NAIC #
8318
$138
9410
8988
_1_. . . ._. .. _ . . __ _.�.W:__.�. =--.- ---= --.._-_ ... -_.._�__.....__�_uusuKneer-- - -_ - - -=-- --- — --
-- --- - - --- - — - -------- - -- �
COVERAGES GEI2TI�ICA7E NUIIABER: REVISION NUMBER:
THIS IS 70 CER7IFY 7NA7 THE POLICIES OF INSURANCE LIS7Ea BELOW HAVE BEEN ISSUEd 70 THE INSURE� NAME� A80VE FOR TFiE POLICY PERIOD
INDICATED. NOTIMTHSTANDING ANY REQUIREMENT, TERM OFZ CONDITION OF ANY CONTFZACT OR OTHER UOCUMENt WI7H RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESC.RIBED HEREIN IS SUBJECT Tp ALL THE TERMS,
EXCLUSIONS ANQ CONQITIONS OF SUCH POLICIES. LIMITS SHpWN MAY HAVE BEEN REDUCED BY PAI� CLAIMS.
INSR 7ypE DF INSURANCE POLICY Nl1MBER MM�IUOlVYYY MM/DD/YWY LIMI7S
LTR
GENERAL LIABILJTY EACH OCGURRENCE a 1,OOO,a
A X COMMERCIAL GENERAL LIA8ILITY X SIPGGLU003400 12101H0 12/07/11 pREMI5ES Ea ocairrence $ 50,4
CLAIMS-MADE � OCCUR MED EXP (My ona person) 3 5,O
GEN'L AGGREGATE LIMIT APPLIES PEIi:
POLICY X p�a LOC
AUTOMOBILE LIABILITY
E X aNr Auro
ALL OWNED AUTQS
SCHE W LED A11T05
� X HIREDAUTOS
E X NON-0vur�Ep aU705
X 11M6RELLA LIA6 X Q�UR
EXCE55 LIAB C�,qIMSMAQE
B
DE�UCTIBLE
09f22/77 I D9/22/12
SEP x � 20
PERSONAL a ADV /r�JURY S
G£NERALAGGREGATE $
PRODUC7S-COMP/OPAGG $
S
COMBINEDSINGLELIMIT $
(Ea acddenl)
90L�ILY INJURY (Per person) S
BO�ILY INJURY (Per ecciderrt) $
PROPERTY DAMAGE $
(Per accitlent)
VY ��I�W�1.� I�Vr.a./1♦VS �6s�i
°�'�� EACH QCCURRENCE
D54963 12N5N0 12/01H1 AGGREGA7E
S
�'
g 1
$ 7
S
WORKERS COMPENSATION X YK: 51 A I U- U I M-
� AND EMPLOVER5' LIABILITY T� I I�
C ANY PROPRIETOR/PARTNER/EXECUT�VE r� N TW�'.328�:%�J 06l17/11 OB/17/12 E.L EACH ACCI�ENT 5
OFFICER/MEMBER �(CLUDED9 � N � A
(Mandatory In NH) E.L. OISEASE - EA EMPLOYE 3
If yes, describa under .
DESCRIP710N OF OPERA710N5 belaw E.L. DISEASE - POLICY LIMIT S
p PpLLUTIQN LIAB PGIARK012$900 08/11117 p8/71/12 LIMIT
j�?ESCRIPT1pN OF OPERpT1pN5l L GA ONS / ICLES (Attach ACORD 101 Additional emarks Schedule if more s ca is required)
OLLU7'ION LIABILI7Y P LI Y INC UDES $1,D00,000 ASB�STO ABAT�MENY LIABPLITY.
O� CLE4RWATER IS ADDITIONAL INSUR�D WITH REGARD TO GENERAL
AS REQUIRED BY WRITTEN CONTRACT.
CITYCL7
CIiY OF CLEARWATER
ATTENTION: CITY CLERK
CANCELLATION
1
1
1
1
i
SHOULD ANY OF TIiE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCQRDANCE WITH THE POLICY PRpVI$IpN$.
Pp B4X 4748 AU7HORIZED REPRESENTATIVE
CLEARWATEF2, FL 33758�748 � �
U
01988-2009 ACORD CORPORATION. All rights reserved.
AGORD 25 (2009l09) the ACORD name and logo are regist�red marks of ACORp