CERTIFICATE OF LIABILITY INSURANCE (207)'4 °® CERTIFICATE OF LIABILITY INSURANCE
DATE /2013YY)
07/24/2013
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 POUCIES 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
FEDERATED MUTUAL INSURANCE COMPANY
HOME OFFICE: P.O. BOX 328
OWATONNA, MN 55060
CONTACT
NAME: CLIENT CONTACT CENTER
PHONE
(A/C, No, Ext): 888 - 333 -4949 FAX No): 507 -446 -4664
ADDRESS: CLI ENTCONTACTCENTER FEDI NS.COM
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: FEDERATED MUTUAL INSURANCE COMPANY
13935
INSURED 057_59L -4
PINELLAS PLUMBING LLC
11590 US 19 N
CLEARWATER, FL 33764
INSURER B:
09/01/2013
INSURER C:
$1,000,000
INSURER D:
$100,000
INSURER E:
EXCLUDED
INSURER F:
1CLAIMS-MADE
COVERAGES
CERTIFICATE NUMBER: 13
REVISION NUMBER: 0
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
A
TYPE OF INSURANCE
ADDL
INSR
SUBR
WVD
POLICY NUMBER
POLICY EFF
/YYYYL.JMM(DDIYYYY(_
POLICY EXP
09/01/2014
LIMITS_
GENERAL
X
LIABILITY
COMMERCIAL GENERAL LIABILITY
N
N
._JMMIDD
9040604
09/01/2013
EACH OCCURRENCE
$1,000,000
AMAGE TO
PREMISES Ea RENTED occurrence)
$100,000
MED EXP (Any one person)
EXCLUDED
1CLAIMS-MADE
X
OCCUR
PERSONAL & ADV INJURY
$1,000,000
GENERAL AGGREGATE
$2,000,000
PRODUCTS - COMP /OP AGG
$2,000,000
GEN'L
X
AGGREGATE
POLICY
LIMIT APPLIES
PRO-
JECT
JECT
PER:
LOC
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
ALL OWNED
AUTOS
HIRED AUTOS
SCHEDULED
AUTOS
NON -OWNED
AUTOS
N
N
9040604
09/01/2013
09/01/2014
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
N
N
9040605
09/01/2013
09/01/2014
EACH OCCURRENCE
$1,000,000
AGGREGATE
$1,000,000
DED
RETENTION
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR /PARTNER /EXECUTIVE
OFFICER /MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
D
DESCRIPTION OF OPERATIONS below
Y / N
N / A
N
9361441
09/01/2013
09/01/2014
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
$500,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required)
CERTIFICATE HOLDER
CANCELLATION
057 -594 -4 13 0
CITY OF CLEARWATER
PO BOX 4748
CLEARWATER, FL 33758 -4748
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE IDEUVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
REPRESENTATIVE
,(;k7AUTHORIZED
ACORD 25 (2010/05)
O 1988 -2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
FEDEAA TED
INSURANCEv�
To Whom It May Concern,
RE: PINELLAS PLUMBING LLC
Enclosed is a certificate of insurance that has been renewed for a new policy term. If a copy
of an additional insured or policy endorsement was requested, the document will be sent in a
separate envelope.
If you have any questions regarding this please contact: the Federated Insurance Client
Contact Center at:
Phone: 1- 888 - 333 -4949
Fax: 507 - 446 -4664
E -mail: clientcontactcenter @fedins.com
Thank you,
Client Contact Center
Federated Insurance Companies
Enclosed:
Certificate of Insurance
MISC -0974 (04 -13)