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CERTIFICATE OF LIABILITY INSURANCE (201)�� CUM&F-1 OP ID: BLW1 '4`c,.°R° CERTIFICATE OF LIABILITY INSURANCE I DAr05/15/ 2rn 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 PRODUCER %2%-rJ22-%%%% NAME: Wallace Welch & Willingham Inc 727_521-2902 PHONE Fax 300 1 st Ave. So., 5th Floor a�c No ext : �a�c, No�: St, Petersburg, FL 33701 E-MA�� Weyman Willingham ADDRESS: INSURED �umoey r� ra�r inc 2463 Enterprise Rd Clearwater, FL 33763 COVERAGES CERTIFICATE NUMBER: INSURER(S) AFFORDING COVERAGE INSURERA: N8Y1 Fire Ins Co of Hartford wsuReRe:Transportation Ins. Co. iNSUReRC: RetailFirst Insurance Co. iNSUReR�:Architects & Engineers Ins Co INSURER E : :7=V/6�[�7��t�1��d.y=l:i NAIC # 20478 20494 44148 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. INSR TypE OF INSURANCE DDL UBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY GENERAL LIABtLITY EACH OCCURRENCE $ 'I �OOO�OOO A X COMMERCIAL GENERAL LIABILITY C2086949437 03/16/12 03/16/13 DAMAGETO RENTED ,�oo 000 PREMISES Ea occurrence $ r CLAIMS-MADE � OCCUR MED EXP (Any one person) $ 5�� PERSONAL & ADV INJURY $ � �OOO�OOO X Per Project Limit GENERAL AGGREGATE $ Z�OOO�OOO GEN'LAGGREGATELIMITAPPLIESPER: PRODUCTS-COMP/OPAGG $ Z�OOO�OOO POLICY JECT �oc Emp Ben. $ 1,000,000 AUTOMOBILE LIABtLITY COMBINED SINGLE LIMIT � OOO OOO Ea accident $ r r A X ANY AUTO C20$$208783 03/16/12 03/16/13 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 'I �OOO�OOO B EXCESSLIAB CLAIMS-MADE C2086949471 03/16/12 03/16/13 AGGREGATE $ �� DED X RETENTION $ O $ WORKERS COMPENSATtON X WC STATU- OTH- AND EMPLOYERS' LIABtLITY TORY LIMITS ER C ANY PROPRIETOR/PARTNER/EXECUTIVE Y� N 52024651 03/16/12 03/16/13 E.L. EACH ACCIDENT $ �� OFFICER/MEMBER EXCLUDED? � N �A (Mandatory in NH) E.L. DISEASE- EA EMPLOYEE $ �,��,�� If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ ��OOO�OOO p Professional Liab AEICPG11 03/16/11 03/16/14 Ea Claim 1,000,000 Claims Made RETRO DATE 02/19/00 Aggregate 1,000,000 DESCRIPTtON OF OPERATtONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is additional insured on a primary and noncontributory basis with res ect to General Liability if required by written contract per form G17957� Certificate holder is additional insured �nnth respect to Auto Liability per Auto Coverage Form and on the Excess Policy sub"ect to the underlying policy termsn and conditions. A Waiver of Subroga�ion in favor > CERTIFICATE HOLDER City of Clearwater City Clert P.O. Box 4748 Clearwater, FL 33758-4748 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE � n� O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD