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CERTIFICATE OF LIABILITY INSURANCE (196)ALVAS -2 OP ID: DW ,a4COR° CERTIFICATE OF LIABILITY INSURANCE DATE 07 /22D/YYYY) 07/22/13 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 Phone: 727 - 461 -6044 Brown & Brown of Florida, Inc. Fax: 727 -442 -7695 83 Park Place Blvd., Ste 101 P.O. Box 2456(33757 - 245.6) Clearwater, FL 3759 House Account - Select Coml NAME: cT PHONE FAX (A/C No, Ext ): (NC, No): POLICY EXP (MM /DD/YYYY) E-MAIL ADDRESS INSURER(S) AFFORDING COVERAGE NAIL # INSURER A: Owners Insurance Company 32700 INSURED Alva Systems Inc Carlos A Alvarez 10102 Lake Julia Circle Odessa, FL 33556 INSURER B : 07/02/13 INSURER C EACH OCCURRENCE INSURER D : DAMAGE PREMISES (TO Ea RENTED occurrence) INSURER E : INSURER F : CLAIMS -MADE COVERAGES CERTIFICATE NUMBER: • THIS IS TO CERT :FY 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 W VD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY 20670349 , �'.y"'�, ^ r--, i I -z �� ` 07/02/13 07/02/14 EACH OCCURRENCE $ 1,000,000 DAMAGE PREMISES (TO Ea RENTED occurrence) $ 300,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 X EPLI: 55,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES PRO -� JFCT PER: LOC PRODUCTS - COMP /OP AGG $ 1,000,000 $ - `AUTOMOBILE _ . LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS — SCHEDULED AUTOS NON - OWNED AUTOS "' " "' € COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION S $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) Ff es, describa under DESCRIPTION OF OPERATIONS below Y / N N / A WC STATU- TORY LIMITS 0TH - ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule if more space is required) CERTIFICATE HOLDER CANCELLATION CITYO -1 City of Clearwater P 0 Box 4748 Clearwater, FL 33758 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 ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD