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CERTIFICATE OF LIABILITY INSURANCE (179)WESTC -1 OP ID: BK '4�° W CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD/YYYY) 06!27/2013 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. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone: 727 -447 -6481 Bouchard - Clearwater Fax: 727 -449 -1267 101 Starcrest Drive P 0 Box 6090 Clearwater, FL 33758 -6090 Josh Bouchard, AAI CONTACT PHONE FAX No): (A/C, No, Ext): POLICY EXP (MM /DD/YYYY) ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Bridgefield Employers Ins Co INSURER B : Nationwide Mutual Insurance Co 10701 23787 INSURED West Coast Fence Corp Mr Tom Gavaghan 6500 49th St N Pinellas Park, FL 33781 INSURER C: 11/30/2012 _ •''m''' fW tI t!� INSURER D : EACH OCCURRENCE INSURER E : DAMAGE TO RENTED PREMISES (Ea occuEr nce) INSURER F : MED EXP (Any one person) REVISION NUMBER: ..NOIILI.AVtV ..G........ .- • - - °• -- -- 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 SUER WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS B GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY ACPGLD05924727016 �_ ( 11/30/2012 _ •''m''' fW tI t!� 11/30/2013 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occuEr nce) $ 100,000 MED EXP (Any one person) $ 5,000 CLAIMS -MADE X OCCUR PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 PRODUCTS - COMP /OP AGG $ 1,000,000 GEN'L AGGREGATE POLICY X LIMIT APPLIES NT- PER: LOC $ B AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS r ° ACPBAPD59247V70.16: " s °„ . d ,'„ I1/ 11/30/2013 COMBINED SINGLE LIMIT (Ea accident) $ 500 000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N I A 083018913 06/30/2013 06/30/2014 X WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 000 B Equipment Floater ACPCIMP5924727016 11/30/2012 11/30/2013 RENTED EQ 35,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule if more space is required) VGR I II-Mr/AI G 1-1V1-1-/LR CICLEAR CITY OF CLEARWATER PO Box 4748 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 ACORD 25 (2010/05) - . . The ACORD name and logo are registered marks of ACORD WESTC -1 OP ID: BK AC' 012 CERTIFICATE OF LIABILITY INSURANCE DATE(MM /2013 ) 06/27/2013 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. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone: 727 -447 -6481 Bouchard - Clearwater Fax: 727 -449 -1267 101 Starcrest Drive P 0 Box 6090 Clearwater, FL 33758 -6090 Josh Bouchard, AAI CONTACT PHONE FAX (A/C, No, Ext): (A/C, No): POLICY EXP (MM /DD/YYYY) E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Bridgefield Employers Ins Co INSURER B : Nationwide Mutual Insurance Co 10701 23787 INSURED West Coast Fence Corp Mr Tom Gavaghan 6500 49th St N Pinellas Park, FL 33781 INSURER C r ry � tiff g r INSURERD: 11/30/2013 INSURER E : $ 1,000,000 INSURER F : $ 100,000 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 LTR TYPE OF INSURANCE ADDL INSR SUBR wVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS B GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY ACPGLDO5924727 ,r. �' r ry � tiff g r 11/30/2012 'i''- f4 L. _, :k li 11/30/2013 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 CLAIMS -MADE X OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 PRODUCTS - COMP /OP AGG $ 1,000,000 GE 'L AGGREGATE POLICY X LIMIT APPLIES JFS:T PER: LOC $ B AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON-OWNED UT OWNED AUTOS ACPBAPD59�472T0ii66 ' •,' ` /, ,:1;1 Q ' 11/30/2013 COMBINED SINGLE LIMIT (Ea accident) $ 500,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ (Perr accident) DAMAGE $ $ UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ A WORKERS COMPENSATION EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A 083018913 06/30/2013 06/30/2014 X WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE SOO 000 $ r E.L. DISEASE - POLICY LIMIT $ rjOQ,000 B Equipment Floater ACPCIMP5924727016 11/30/2012 11/30/2013 RENTED EQ 35,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule if more space is required) vI_rlr rr wJ, 11— I IVL✓VI\ CITY OF CLEARWATER CENTRAL PERMITTING P 0 BOX 4748 CLEARWATER, FL 33758 CITYO32 - - ... - --- --. --- 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 ACORD 25 (2010/05) -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD