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CERTIFICATE OF LIABILITY INSURANCE (171)ACORD® CERTIFICATE OF LIABILITY INSURANCE k...� "- DATE(MM/DDIYYYY) 06/12/2813 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). PRODUCER MCGRIFF, SEIBELS & WILLIAMS, INC. P.O. Box 10265 Birmingham, AL 35202 CONTACT NAME: (A/C No. Ext): 800-476-2211 FAX No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :Hartford Fire Insurance Company INSURER B :Trumbull Insurance Company '9682 27120 INSURED Atlantic Service and Supply, LLC 2665 South Bayshore Drive, Suite 904 Coconut Grove, FL 33131 INSURER C :Continental Casualty Company 20443 INSURER D : 07/01/2014 INSURER E : $ 1,000,000 INSURER F : $ 500,000 COVERAGES CERTIFICATE NUMBER:S2LED9YW 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 LTR TYPE OF INSURANCE ADDL INSR SUBR W VD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP /YY (MM/DDYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY 21UENOH2138 p� ttfi ERR .. y i• t 07/01/2013 1 07/01/2014 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 500,000 MED EXP (Any one person) $ 10,000 CLAIMS -MADE X OCCUR PERSONAL &ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 7 POLICY n PET I LOC $ A AUTOMOBILE X _ X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS — X SCHEDULED NON -OWNED AUTOS 21UENOH2137 /) o ., ` _.,y ` �✓'w- 07/01(2013 ) !'` 07/01/2014 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ C X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE L5085121251 07/01/2013 07/01/2014 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 $ DED I I RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? Li (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 21WEOH2136 07/01/2013 07/01/2014 x WC STATU- OTH- I TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000,000 I E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION City of Clearwater 100 S. Myrtle Avenue Clearwater, FL 33756 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 l jj I°" 1+" °s "" Q ACORD 25 (2010/05) Page 1 of 1 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD