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CERTIFICATE OF LIABILITY INSURANCE (253)DENNY -1 OP ID: SHI ACORE7 4,......--- CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 10/08/2013 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 Phone: 813 -837 -1111 West Coast insurance Group Jason Miller Fax: 4707 Gandy Blvd. #13 Tampa, FL 33611 Jason L Miller CONTACT Jason Miller PHONE FAX (NC. No. Exd): 727-344-5500 (A/C, No): 727-344-5501 ADDRESS: gordie@wcig.org INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Southern- Owners Insurance Co. LIABILITY COMMERCIAL GENERAL LIABILITY INSURED Denny's Plumbing, Inc PO Box 5066 Clearwater, FL 33758 -5066 INSURER B: Owners Insurance Co. 20275755 INSURER C : 09/29 /2014 INSURER D : $ 1,000,000 INSURER E : $ 300,000 INSURER F : $ 10,000 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 ADDL INSR SUBR WVD POLICY NUMBER POLICYEFF (MM/DD/YYYY) POUCY EXP (MM/DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY 20275755 09/29/2013 09/29 /2014 EACH OCCURRENCE $ 1,000,000 MAGISE E S a oc crEurD re nce) $ 300,000 MED EXP (Any one person) $ 10,000 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 LIMIT APPLIES 30 POLICY n PFa PER: LOC H &NO $ 1,000,000 B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS 4927575500 09/29 /2013 09/29/2014 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ 1,000,000 BODILY INJURY (Per accident) $ 1,000,000 PROPERTY DAMAGE (Per accident) $ 1,000,000 $ A X UMBRELLA UAB EXCESSLIAB X OCCUR CLAIMS -MADE 4927575501 09/29 /2013 09/29/2014 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 $ DED RETENT ON $ 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 WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ rS DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule If more space Is required) LLL OCT 14 201 L 51AM MU DEPT CITY OF CLEARWATER PO BOX 4788 CLEARWATER, FL 33758 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 ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD