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CERTIFICATE OF LIABILITY INSURANCE (267)AW °® CERTIFICATE OF LIABILITY INSURANCE 10/25/2014 DATE(MM /DD/YYYY) 10/23/2013 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 LOCKTON COMPANIES, LLC-1 KANSAS CITY 444 W. 47TH STREET, SUITE 900 KANSAS CITY MO 64112 -1906 (816) 960 -9000 CONTACT NAM : (A/C, No, Ext): I Fax (A/C, No): E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Zurich American Insurance Company 16535 INSURED LUKE BROTHERS, INC. 1343426 5532 AULD LANE HOLIDAY FL 34690 INSURER B : American Guarantee and Liab. Ins. Co. 26247 INSURER C : Pennsylvania Manufacturers' Assoc Ins Co 12262 INSURER D : $ 1,000,000 INSURER E : $ 1,000,000 $ 10,000 INSURER F : • • 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 INVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP IMM /DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY N N GL06555467 -04 10/25/2013 10/25/2014 EACH OCCURRENCE $ 1,000,000 PREMISESO(ERENTED cccc nce) $ 1,000,000 $ 10,000 MED EXP (Any one person) 1 CLAIMS -MADE X OCCUR PERSONAL & ADV INJURY $ 1,000,000 $ 5,000,000 GENERAL AGGREGATE PRODUCTS - COMP /OP AGG $ 2,000,000 $ GEN'L AGGREGATE 7 POLICYI LIMIT APPLIES PER j I JECOT n LOG AUTOMOBILE X _ LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS N N BAP6555466 -04 10/25/2013 10/25/2014 (Ea OMaccident) SINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident $ XXXXX�QC PROPERTY DAMAGE (Per accident) $ $XXXXXXX B X UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS -MADE N N AUC 6555463 -04 10/25/2013 10/25/2014 EACH OCCURRENCE $ 5 000 000 AGGREGATE $ 5,000,000 $ XXXX� °�X DED I X I RETENTION $0 C AND ANYIPROPRIE (Mandatory If yes, DESCRIPTION EMPLOYERS' LIABILITY Y / N ER EXRTNER /E ECUTIVE N in NH) N OF OPERATIONS below N / A N 201380 8779795 12/31/2013 10/25/2014 X ITORY LIMITSI IOFR E L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 $ 1,000,000 E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES /(Attach ACORD 101, Additional Remarks Schedule, if more space is required) Evidence of Coverage CERTIFICATE HOLDER CANCELLATION 11495323 City Of Clearwater 100 S. Myrtle Avenue Clearwater FL 33751 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) ©9 8 -2010 AC ORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD