CERTIFICATE OF LIABILITY INSURANCE (213)AIRN -01
OP ID: LS
4WRO CERTIFICATE OF LIABILITY INSURANCE
DATE 07 /25D/YYYY)
07/25/13
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 863 -967 -4454
Mulling Insurance Agency, Inc. 863 - 967 -7592
P 0 Box 308 208 E Park Street
Auburndale, FL 33823 -0308
Mark E. Spann, CIC
CONTACT
PHONE FAX
(A/C, No, Eat): (A/C, No):
(MM /DD //YYYY)
02/23/14
E -MAIL
ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A: United Fire & Casualty 13021
INSURED Air Now
Comfort Technology, Inc. DBA
3420 Recker Hwy
Winter Haven, FL 33880 -1957
INSURER B: Bridgefield Employers Ins. Co. 10701
INSURER C
INSURER D :
60406423
INSURER E :
$ 100,000
INSURER F :
$ 5,000
•
VISION NUMBER:
vTHIS 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
INSR
INSR
WVD
WVD
POLICY NUMBER
(MM/DD / /YYYY)
07/28/13
(MM /DD //YYYY)
02/23/14
LIMITS
EACH OCCURRENCE
$ 1,000,000
A
GENERAL
X
LIABILITY
COMMERCIAL GENERAL LIABILITY
60406423
DAMAGE PREMISES Ea occu ante)
$ 100,000
MED EXP (Any one person)
$ 5,000
CLAIMS -MADE
X
OCCUR
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP /OP AGG
$ 2,000,000
GEN'L
AGGREGATE
POLICY
LIMIT APPLIES
JEST
PER:
LOC
$
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
ALL OWNED
AUTOS
HIRED AUTOS
SCHEDULED
NON -OWNED
AUTOS
60406423 .
07/28/13
02/23/14
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
$
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
$
DED
RETENT ON $
B
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
0830 -44227
02/23/13
02/23/14
X
WC STATU-
TORY LIMITS
X
0TH -
ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule if more space is required)
%.•Irl r 11-wn I I- nvI..vuX
CITYCLA
City of Clearwater
100 S. 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
lief —
ACORD 25 (2010/05)
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