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CERTIFICATE OF LIABILITY INSURANCE (279)A� 1J CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDIYYYY) 07/17/2013 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 - - Mutual Insurance -Inc - 1900 1st Ave North PO Box 12350 St Petersburg FL 33713 csIe°e"e : Cr William Wanless ext 2213 PA Cis ,„). (727) 896 -0006 FAX No).(727) 821-7483 E-MAIL DSS wwanless @mutualinsuranceinc.com INSURERISI AFFORDING COVERAGE t INSURER A :ATS /Admiral Ins Co LIABILITY COMMERCIAL GENERAL LIABILITY INSURED Compass Engineering & Surveying Inc Deuel & Associates 565 S Hercules Ave Unit 11 & 12 Clearwater FL 33764 INSURER B : Auto Owners Insurance Co 18988 INSURER C :SUM /Bridgefield Cas Ins 10/13/2013 INSURER D :Southern Owners Ins 10190 INSURER E : $ 300,000 INSURER F : $ 10,000 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 LTR TYPE OF INSURANCE ADDL INSR SUBR wvn POLICY NUMBER POLICY EFF (MMIDOIYYYY) POLICY EXP (MMIDDIYYYY) LIMITS D GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY 20689391 (,"' 10/13/2012 10/13/2013 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PRFMI.SFR (Fa nccurrnnra) $ 300,000 MED EXP (Any one person) $ 10,000 CLAIMS -MADE X OCCUR PERSONAL & ADV INJURY $ 1,000,000 X No Deductible GENERAL AGGREGATE $ 1,000,000 PRODUCTS - COMP /OP AGG $ 1,000,000 GEN'L AGGREGATE POLICY X LIMIT APPLIES IF(T PER: LOC B AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED NON -OWNED AUTOS 469917300, ` -- 10/13/2012 10/13/2013 (Fe errNden SINGLE LIMIT S 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA LIAB EXCESS LIAB X _ OCCUR CLAIMS -MADE 4700541901 10/13/2012 10/13/2013 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 $ DFO RFTENT ON $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE Iv I OFFICER/MEMBER EXCLUDED? �! f (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 019615870 08/01/2013 08/01/2014 X WC TA U- 0TH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE 1,000,000 $ E . DISEASE - POLICY LIMIT 1,000,000 $ A Architects & Engineers Professional Liability - Claims Made $5,000 Deductible E0000009046 -06 06/15/2013 06/15/2014 Each Occurrence 1,000,000 Aggregate 1,000,000 DESCRIPTION OF OPERATIONS! LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) 30 days notice of cancellation except for 10 day days notice for non - payment of premium. City of Clearwater Attn: City Clerk 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 A ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD