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CERTIFICATE OF LIABILITY INSURANCE (10)/ 1 ® �``„°RO CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 7/23/2013 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 Gentry Insurance Agency 175 East Main Street PO Box 2 0 4 6 APOPKA FL 32704 -2046 NAME: CT Leslie Briante PA/GNN (407)886 -3301 / •Not (407) 886 -9530 .Ext): s :Leslie @gentryins . com INSURER(S) AFFORDING COVERAGE NAIC # INsuRERA:American Casualty Co of Readin INSURER B:Crum & Forster Indemnity Co L A INSURED Clark Sales Display Inc P 0 Box 1007 Tavares FL 32778 INSURER C :Southern-Owners Ins. Co. 10190 INSURERD: OCCUR INSURER E : INSURER F: ? COVERAGES ',MK11rIVA1C rnunno&n.�- - -• • - • -- - - - -- -- 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 TYPE OF INSURANCE ADDL INCR SUBR wvn POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP IMM /DD/YYYY) LIMITS L A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY OCCUR 2072710292 { '8/1\401 ? 8/1/2014 EACH OCCURRENCE $ 1 , 000 , 000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 300,000 - X MED EXP (Any one person) $ 10 , 000 CLAIMS -MADE X PERSONAL BADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: j� PR I 1 LOC POLICY n $ X B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS -OWNED "' 133- 732881 -9 10/21/2012 16/21/2013 (Ea COMBINED deD SINGLE LIMIT $ 1,000,000 $ BODILY INJURY (Per person) X BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE (Per accident) $ _ X X NON _AUTOS PIP -Basic $ C X UMBRELLA EXCESS LIAB X OCCUR CLAIMS -MADE 4253955704 8/1/2013 8/1/2014 EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,000 $ DED I X RETENTON$ 5,000 WORKERS AND ANY OFFICER/MEMBER (Mandatory If yes, DESCRIPTION COMPENSATION EMPLOYERS' LIABILITY PROPRIETOR/PARTNER /EXECUTIVE EXCLUDED? In NH) describe under OF OPERATIONS Y / N N / A TORY LIMITS T ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION RE and OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Holiday Decorating Services City of Clearwater is included as Additional Insured on General Liability Auto Liability. CERTIFICATE HOLDER (727)562 -4825 City of Clearwater Attn: Kyle Kilian PO Box 4748 Clearwater, FL 33758 -4748 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 D Liebknecht /LESLIE ACORD 25 (2010/05) INS025 (201005).01 cse © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD