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CERTIFICATE OF LIABILIT INSURANCE
-_ -- DATE(MM/DD/YYYY) ---= CERTIFICATE OF LIABILITY INSURANCE F5/9/2013 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. Astatement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: TAMMY MURRAY CANNELLA INSURANCE SERVICES INC PHONE Ext: (813) 258-8084 FAX,No):(813)258-3861 1220 S Dale Mabry Hwy #202 ADDRESS: TMURRAY@CANNELLAINS CE.COM Tampa, FL 33629 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: HARTFORD CASUALTY INSUPANCE CO INSURED TRICON INTERNATIONAL,INC INSURER B: NORTHERN INSURANCE COMPANY OF NEW YORK INSURER C: 777 S HARBOUR ISLAND BLVD # 870 INSURER D: TAMPA, FL 33602 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 ADDL SUBR PULIU LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2 000 1000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ 300 000 CLAIMS-MADE FXI OCCUR MED EXP(Any one person) $ 10 000 A 21 SBA RP1004 SA 04/29/13 04/29/14 PERSONAL&ADV INJURY $ 2 ,000,000 GENERAL AGGREGATE $ 4 ,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS -COMP/OPAGG $ 4 000 000 POLICY PRO LOC X PRO $ AUTOMOBILE LIABILITY Ea accident $ ANYAUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER Y/N g C y �y 00 05/2 1 12 05/2 1 13 100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE ® N/A YY I. ®52197 V 6 V V / / E.L.EACH ACCIDENT $ B OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 Ifyes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if morespace is required) ENGINEERS & ENGINEERING SERVICES CERTIFICATE HOLDER IS AN ADDITIONAL INSURED ON THE COMMERCIAL GENERAL LIABILITY POLICY CERTIFICATE HOLDER CANCELLATION The City Of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Clerk THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O BOX 4748 ACCORDANCE WITH THE POLICY PROVISIONS. Clearwater, Fl 33758-4748 AUTHORIZED REPRESENTATIVE Ma. iAl r. M G Grray © 1988-2010 ACORD CORPORATION.All rights reserved. ACORD25(2010/05) The ACORD name and logo are registered marks of ACORD