The URL can be used to link to this page

CERTIFICATE OF LIABILITY INSURANCE (223)CROSS -2 OP ID: PS A L CERTIFICATE OF LIABILITY INSURANCE DATE 08 /21D/YYYY) 08/21/13 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 941 - 748 -0511 Bradenton Insurance, Inc. 1400 Ballard Park Drive West 941- 748 -6444 Bradenton, FL 34205 -6719 Robert J. Wentzell CONTACT NAME: PHONE FAX (A/C. No. Ext): (A/C, No): E -MAIL ADDRESS: 1NSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Auto Owners Insurance Co. 18988 INSURED Chuck Crossan Electric Inc. 6104 7th Ave Dr West Bradenton, FL 34209 -3505 INSURER B: Owners Insurance Co. 32700 INSURER C : FL Citrus Business & Ind SIF DAMAGE TO RENTED PREMISES (Ea occurrence) INSURER D : INSURER E : X INSURER F : MED EXP (Any one person) 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 WVD POUCY NUMBER POUCY EFF ,MM /DD/YYYYL(MM 4 3/29/13 } POUCY EXP /DD/YYYYL 03/29/14 LIMITS EACH OCCURRENCE $ 1,000,000 A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY 20729515, • ", e ' DAMAGE TO RENTED PREMISES (Ea occurrence) $ 300,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE X 'L AGGREGATE POLICY LIMIT APPLIES JF/ F PER: LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ B AUTOMOBILE X _ LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS / -� ' " K., 483515136* •w -' { . i 07/22/13 07/22/14 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 RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 10637717 04/01/13 04/01/14 X WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule If more space Is required) RE: Chuck Crossan #EC13002193 CERTIFICATE HOLDER CANCELLATION CLEAR -1 City of Clearwater Fax 727 - 562 -4576 PO Box 4748 Clearwater, FL 34618 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 Go74' ACORD 25 (2010/05) ©1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD