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CERTIFICATE OF LIABILITY INSURANCE (263)DBCON -3 OP ID: DAWN ASRb CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD/YYY) 12/11 /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 Sihle Insurance Group - Clrwtr 2653 McCormick Dr Clearwater, FL 33759 Micky Williams CONTACT Dawn Davis NAME: 727 - FAX PHONE 6649 450 - (NC, No, Ext): (A/C, No): 727 -531 -6855 ADD less: ddavis @sihle.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: National Trust Insurance Co. 20141 INSURED DB Construction Services, Inc 4309 Raleigh Street Tampa, FL 33619 INSURER B : FCCI Commercial Ins Co GL00112964 JAN o � 2014 �8 RECORDS O F C1AL RECORDS LEGISLATIVE SRVCS INSURER C: 01/01/2015 INSURER D : $ 1,000,000 INSURER E : $ 100,000 INSURER F : $ 5,000 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 TYPE OF INSURANCE IAN.SR WVD POLICY . U ,, =E; MM /DD /YYYY) (MM /DD/Y YY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY GL00112964 JAN o � 2014 �8 RECORDS O F C1AL RECORDS LEGISLATIVE SRVCS /01/2014 �y DEPT DEP! 01/01/2015 EACH OCCURRENCE $ 1,000,000 DAMAGETORENTED PREMISES (Ea occurrence) $ 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 GEM_ AGGREGATE 7 POLICY X LIMIT APPLIES PRO PER: LOC $ A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS AUTO OWNED CA00175684 01/01/2014 01/01/2015 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ APER ACCIDENT) $ PIP $ 10,000 A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE UMB00118304 01/01/2014 01/01/2015 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 $ DED X RETENTION $ 10,000 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 $ B Lease /Rent Equip CM00058724 01/01/2014 01/01/2015 Limit 250,000 Ded 1,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule if more space Is required) CLEARWA CITY OF CLEARWATER 100 SOUTH MYRTLE AVE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CLEARWATER, FL 33756 i �AUUTHHORIZED�RE/ % r t PREES ENTATIVE ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rightsirpmved. The ACORD name and logo are registered marks of ACORD