CERTIFICATE OF LIABILITY INSURANCE (245) .' C"R EDOATE(tAWDONYYYI
TI I III LIABILITY ILI INSU 1vCE 17/CLIiS
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 [ICES 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 psolicy(les) must be end-orsed. if SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement can this certificate does not confer rights to the
certificate holster in lieu of such endorsernent(s).
PRODUCER CONTACT 5l Lockett Lockett NAM E ..7,
Vermst & Associates, LLC HOE (727)748-2886 iAC N,.t-ra345 7-4991
1120 Belcher Rd S ADD€ESS:st_acIt tr@vermost,com
suite I INSURER(S)AFFORDING COVERAGE NAJC
Largo TL 3771 iNSURER,p Southern Owmers Insuranc 01911
INSURE.C.. INSURFR.R
Tony Ter andino INSURER C:
25 Causeway Blvd I14S ERG
INSURER E
Clearwater TL 33767-2064 INSURERF
COVERAGES CERTIFICATE NUMBER:CL13101701034 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELflI+"`¢+HAVE BEEN ISSUED TO THE INSU RED NAKED ABOVE FOR THE POLICY PERIOD
INDICATED NOT'u'tr'ITHSTANDING ANY REQUIREMENT TERM OR CONDITION O u^°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,
E CLUSIONS ANt)CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAIMS_
ILTR: TYPE CAF INSURANCE POLICY EFFF POLICY EXP L€rvtlT'S
LTR INSR °dWV'D POLICY NUMBE3°i'. IMMIDONYY'Y $JIMA:1U)YYYY
GENERAL LIABILITY __ � SUI ', .�: ', 1,000,000,
X - ant L` -, aF AL. _ ,RiI i_Y
L? y l4 h I! LD 3CI L1 L+'�.
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A _ r.I:.r Aj7 L 0090830 0/24/2013 1.0/24/2014 M c A ,) lo,()00
L+,rIriU-:rr T 1,000,000
$ 2,000,000
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AND EMPLOYERS LIABILITY YIN 1 r =LS
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OESCP,lPT4L,N Off OPCRATIONSI LOCATIONS 1 VEHICLES (Attach ACORN 101,Additional RRm arks Sch�dul.tn,if moo+ sA aee is mqui:.,r&d'}
Ic'ecrean? ul1op
THE CITY OF CLEARWATER, FL IS NAMED AS ADDITIONAL INSURED
CERTIFICATE HOLDER CANCELLATION
727)462-6957 SHOULD ANY OF TIME ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
CITY J C3 ACCORDANCE WITH THE POLICY PROVISIONS.
Harboxmaster
26 CAUSEWAY SLR AUTHORIZED REPRESENTATIVE
CLEAMIATER, FL 33767-26014
Sue Lccl°ett/LCI S'U
ACORD 25(2010/05) C0,11988-2010 ACORCS CORPORATION. All rights reserved.
INSII75 '3Tho a rf`pn npmp nnrf truce)ara rantctarard mgrke of At-OPr)