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CERTIFICATE OF LIABILITY INSURANCE (277)® A � CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DDNYYY) 12/31/2013 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 Insurance Service of Sarasota Inc. P.O. Box 907 873 S. Tamiami Tr Osprey FL 34229 CONTACT Lorraine Failing g fAHCNW . I?xtl: (941) 966 -5606 I (A/C. No): (941) 966 -6124 E -MAIL ADDRESS: lorrainef @inservsarasota.corn INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:COlOny Ins Co 39993 INSURED Tanner Fire & Safety Equipment Inc and John S Loria ATIMA 216 41st Avenue East Bradenton FL 34208 INSURER B :Auto Owners Insurance Company 18988 INSURERC:Southern Owners Insurance Co. 10190 INSURER D : $ 1,000,000 INSURERE: $ 100, 000 INSURER F : $ 5,000 RTIFICATE NUMBER:CL13123104247 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 AIN.SR SWVD POLICY NUMBER IMM / /DD/YYYYI IMM D/YYYYI LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY GL3917630 1/1/2014 1/1/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100, 000 MED EXP (Any one person) $ 5,000 � I CLAIMS -MADE I ^ I OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 PRODUCTS - COMP /OP AGG $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: ^) POLICY n JECT II LOC $ B AUTOMOBILE _ X _ LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ _ SCHEDULED AUTOS NON -OWNED AUTOS 4131480100 '1/1/2014 -. ,. , 1/1/2015 COMBINED SINGLE LIMIT (Ea accident) _$ $ 100 000 BODILY INJURY (Per person) BODILY INJURY (Per accident) $ 300 000 PROPERTY DAMAGE (Per accident) $ 50 000 PIP $ 10,000 UMBRELLA LIAB EXCESS LIAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED I RETENTION $ C 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 20738076 1/1/2014 1/1/2015 X I WC TA I I OT ER E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) CANCELLATION (727) 562 -4576 City of Clearwater 100 S Myrttle Ave Clearwater, FL 33756 . 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 J Dauenheimer /MIi ! a `) 1 ACORD 25 (2010/05) INS025 (201005).01 ©19882610 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD