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CERTIFICATE OF LIABILITY INSURANCE (249)CERTIFICATE OF LIABILITY INSURANCE I�;,;;;�;�°°""", THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLCIER. 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), AUT'HORI2ED 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, sub�ect 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(sl. _ PRODUCER Wallace, Welch & Willingham P.O. Box 33020 St. Petersburg FL 33733 INSURED Cumbey & Fair Inc 2463 Enterprise Rd Clearwater FL 33763 COVERAGES CUM&F-1 CERTIFICATE NUMBER: R45��OFOti PHONE INSURER F : REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLIC:Y PERIOD INDICATED. NOTIMTHSTANDING 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 Tf-IE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 7ypE OF INSURANCE ADDL R POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A GENERALLIABILITY 2086949437 /16/2013 /16/2014 EACHOCCURRENCE $1,000,000 X DAMAGETO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence 5100,000 CLAIMS-MADE � OCCUR MED EXP (Any one person) $5,000 , PERSONAL&ADVINJURY $1,000,000 GENERALAGGREGATE $2,0OO,OQO Q� ��"`� GEN'LAGGREGATELIMITAPPUESPER: ��.��r��:��j`�� Rj PRODUCTS-COMP/OPAGG $2,000,000 POLICY X PR� LOC � � � �� $ A AU70MOBILE LIABILITY C2088208783 /16/2013 /16/2014 Ea accident 1 000 000 X �' � �' � ' � � s�' BODILY INJURY (Per person) $ ANYAUTO E � a� i �p .+„ ;y,l _ ALLOWNED SCHEDULED BODILYINJURY(Peraccident) $ AUTOS AUTOS _ NON-OWNED ^� �^�^+ t= _ ; �_ . -: . PROPERTY DAMAGE $ HIRED AUTOS AUTOS 4 � �.'��' �� -�„ ;;, �.;,,; �`�;�`,► „�, ' . , Per accident . 7 4 � ^�^ $ 4 eF A X UMBRELW LIAB OCCUR C2086949471 /16/2013 /16/2014 Ep,CH OCCURRENCE $1,0OO,OQO EXCESSLIAB CLAIMS-MADE AGGREGATE $1,000,000 DED X RETENTION$0 S g WORKERS COMPENSA710N 52024651 /16/2013 /16/2014 X � STATU- OTH- AND EMPLOYERS' LIABILITY Y� N - OFFICER/MEMBER/EXCLUDED ECUTIVE � N� A E.L. EACH ACCIDENT $1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $1,000,000 If yes, describe untler DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,0OO,OqO C Professional Liab EICPGI1 /16/2011 /16/2014 Each claim $1,000,000 Claims Made Aggregate $1,000,00() DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 707, Additional Remarks Schedule, if more space is required) Certificate holder is additional insured on a primary and noncontributory basis with respect to General Liability if required by written contract per form G17957G. Certificate holder is additional insured with respect to Auto Liability per Auto Coverage Form and on the Excess Policy subject to the underlying policy termsn and conditions. A Waiver of Subrogation in favor of Certificate Holder applies to General Liability & Auto Liability if required by written contract. TE City of Clearwater City Clert P.O. Box 4748 Clearwater FL 33758-4748 ACORD 25 (2010/05) 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. AU7HORIZED REPRESENTATIVE �� O 1988-2010 ACORD CORPORATION. Ali rights reserved. The ACORD name and logo are registered marks of ACORD �� CERTIFICATE OF LIABILITY INSURANCE I� QA�n1MINlDD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLpER. 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), AU7HORIZED 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, subaect 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(sl. PRODUCER Wallace, Welch & Willingham P.O. Box 33020 St. Petersburg FL 33733 INSURED Cumbey & Fair Inc 2463 Enterprise Rd Clearwater FL 33763 COVERAGES CUM&F-1 CERTIFICATE NUMBER: 1846323583 a: INSURER E : INSURER F : REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLIC'Y PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT 1MTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THIE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TypE OF INSURANCE POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICYNUMBER MM/DD/YYYY MM/DD/YYYY , A GENERALLIABILITY C2086949437 /16/2013 /16/2014 EACHOCCURRENCE $1,000,0(10 X COMMERCIAL GENERAL LIABILITY . DAMAGE TO RENTED PREMISES Eaoccurrence 5100,000 CLAIMS-MADE � OCCUR MED EXP (Any one person) $5,000 _ PERSONAL & ADV INJURY $1,000,0(ID GENERALAGGREGATE $2,000,0C10 GEN'LAGGREGATELIMITAPPLIESPER: yq �, PRODUCTS-COMP/OPAGG $2,000,000 POLICY X PRO- LOC �� """�� ' � $ A AUTOMOBILE LIABILITY C2088208783 /16/2013 /16/2014 q Eaaccident 1,000,0CI0 X ANY AUTO �� g g� �il� "��, !�. BODILY INJURY (Per person) $ - AL�OWNED SCHEDULED s � '�°��:�� AUTOS AUTOS BODILY INJURY (Peraccident) $ HIREDAUTOS NON-OWNED . PROPERTYDAMAGE p� '" �''"° � � t�' �� Peraccident $ AUTOS � b.�D,?'si9a�n�� :�`.�.. e� c' .s f"v� ".. - v.�:.<a m�^ ,�a P "'"k'- $ A X UMBRELLALIAB OCCUR C2086949 �"�`��`� 'i' "� 1 2 3 /16/2014 EACHOCCURRENCE $1,000,0(10 EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,0C10 DED X RETENTION$0 $ g WORKERS COMPENSAiION 52024651 /16/2013 /16/2014 X � STATU- OTH- � AND EMPLOYERS' LIABILITY Y � N - ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $1,0OO,OC10 OFFICER/MEMBER EXCLUDED9 � N � A ' (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $1,000,0C10 If yes, describe under - DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,0C10 � Professional Liab EICPG11 /16/2011 /16/2014 Each claim $1,0OO,ODf,� Claims Made Aggregate $1,00O,OOl'� DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Atfach ACORD 101, Addkional Remarks Schedule, if more space is required) Certificate holder is additional insured on a primary and noncontributory basis with respect to General Liability if required by written cantract per form G17957G. Certificate holder is additional insured with respect to Auto Liability per Auto Coverage Form and on the Excess F'olicy subject to the underlying policy termsn and conditions. A Waiver of Subrogation in favor of Certificate Holder applies to General Liability & Auto Liability if required by written contract. City of Clearwater City Clert P.O. Box 4748 Clearwater FL 33758-4748 ACORD 25 (2010/05) TION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIWERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �� O 1988-2010 ACORD CORPORATION. All righta> reserved. The ACORD name and logo are registered marks of ACORD