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CERTIFICATE OF LIABILITY INSURANCE (182)RCARR -1 OP ID: KB ,4�coR° CERTIFICATE OF LIABILITY INSURANCE DAT06 /2 „13 ) 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 727 - 784 -8554 Stahl & Associates Insurance 3939 Tampa Road 727_789_2823 Oldsmar, FL 34677 Michael Pagano, AA! CONTACT PHONE FAX (A/C, No. Ext): (A/C, No): (MM /DD/YYYY) ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Southern Owners 10190 INSURED R. Carr, Inc. Tom Shores 250 9th Avenue North Safety Harbor, FL 34695 INSURER B: Owners Insurance Company 32700 INSURER C : FFVA INSURER D : DAMAGE TO RENTED (Ea occurrence) INSURER E : MED EXP (Any one person) 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 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 (MM/ D //YYYY) (MM /DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY fa 20520619 �s' I � x 9 .. .. r r 6bei I a�3 -, r `�``�'`!`� L,, e+ z' .L N, m., 07/01/14 •, 1,000,000 DAMAGE TO RENTED (Ea occurrence) $ 300,000 MED EXP (Any one person) $ 10,000 CLAIMS -MADE X OCCUR PERSONAL &ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 X CGL Plus PRODUCTS - COMP /OP AGG $ 2,000,000 GE 'L AGGREGATE POLICY X LIMIT APPLIES PRO PER: LOC $ B AUTOMOBILE .IFCT LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED NON -OWNED AUTOS 9652061902 J J 07/01/13 07/01/14 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 9652061903 07/01/13 07/01/14 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 $ DED X RETENTION $ 10000 C 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 / A WC84000252002013A 01/01/13 01/01/14 X C STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $ 1,000,000 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) License Holder: Rodney M. Carr License #CFC019221 CLEAR -5 City of Clearwater 100 Myrtle Ave. 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 Q Cr- 'liAt_ J- AtetiL ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD RCARR -1 OP ID: KB T '4`�,.°R° CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 07/12/13 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 727 - 784 -8554 Stahl & Associates Insurance 727.789 -2823 3939 Tampa Road Oldsmar, FL 34677 Michael Pagano, AA! ACT NAME: PHONE FAX INC. No. Extl: (NC, No): E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Southern Owners 10190 INSURED R. Carr, Inc. Tom Shores 250 9th Avenue North Safety Harbor, FL 34695 INSURER B : Owners Insurance Company 32700 INSURER C : FFVA 07/01/13 INSURER D: EACH OCCURRENCE INSURER E : PREM SES Ea occurrence) INSURER F : MED EXP (Any one person) 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 SUER D WV POLICY NUMBER (MM DD //YYYY) IMM /DDIYYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY 20118419 ` .,, : \ . 07/01/13 07/01/14 EACH OCCURRENCE $ 1,000,000 PREM SES Ea occurrence) $ 300,000 MED EXP (Any one person) $ 10,000 CLAIMS -MADE X OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 X CGL Plus PRODUCTS - COMP /OP AGG $ 2,000,000 GE 'L AGGREGATE POLICY X LIMIT APPLIES PF PER: LOC $ B AUTOMOBILE _ LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS 965903, ` I_- 07/01/13 07/01/14 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 9652061903 07/01/13 07/01/14 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 $ DED X RETENTION $ 10000 C 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 / A WC84000252002013A 01/01/13 01/01/14 X C STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1 OOO,OOO E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Equipment Floater 20118419 07/01/13 07/01/14 Leased & 50,000 Rented Ep 500 Ded DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule if more space is required) License Holder: Rodney M. Carr License #CFC019221 City of Clearwater 100 Myrtle Ave. Clearwater, FL 33756 CLEAR -5 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 ,Q�- Q �Or-�/ £ R_J ice-" 1-- ACORD 25 (2010/05) ©1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD