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CERTIFICATE OF LIABILITY INSURANCE (272),..-- -_ . A [7 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYl7 12/26/2013 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 Brown & Brown Insurance - Clearwater P.O. Box 2456 Clearwater FL 33757 -2456 NAME: April Wolfe PHONE FAX (A/C, No, Ext): 727-461-6044 (A/C,No):727- 442 -7695 ADDRESS: awolfe @bbpinellas.com PRODUCER CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Thomas Sign and Awning Company, Inc. 4590 118th Avenue North Clearwater FL 33762 INSURERA:National Fire Ins of Hartford 20478 INSURERB:CNA - Continental Casualty Co. 5088655636 INSURERC:Valley Forge Insurance Company 20508 INSURER D : $1,000,000 INSURER E : DAMAGE TO RENTED PREMISES (Ea occurrence) INSURER F : • REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL$UBR INSR W VD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY OCCUR Y 5088655636 12/31/2013 12/31/2014 EACH OCCURRENCE $1,000,000 X DAMAGE TO RENTED PREMISES (Ea occurrence) $ 300, 000 CLAIMS -MADE X MED EXP (Any one person) $10,000 PERSONAL 8ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY X JECOT LOC $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS Y Y 5088520172 12/31/2013 12/31/2014 COMBINED SINGLE LIMIT (Ea accident) $1, 000, 000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE ( Per accident) $ X X $ $ UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 5088655653 12/31/2013 12/31/2014 EACH OCCURRENCE $15,000,000 AGGREGATE $15,000,000 DEDUCTIBLE RETENTION $10,000 $ X $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS YIN N / A 5088647214 12/31/2013 12/31/2014 X WCSTATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $500, 000 E.L. DISEASE - EA EMPLOYEE $500,000 below E.L. DISEASE - POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: James G Thomas; Priscilla G Thomas; Charles B Copp; Matthew W Thomas as license holders. .-„, , ,,,, -.,., --- City of Clearwate r, P O Box 4748 _F . Clearwater FL 33758 „.,.,, °'° ara '._ ,,,.av 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 (2009/09) © 1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD