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CERTIFICATE OF LIABILITY INSURANCE (284)___ CERTIFICATE OF LIABILITY INSURANCE Date 12/11/2013 Producer: Lion Insurance Company 2739 U.S. Highway 19 N. g y Holiday, FL 34691 (727) 938 -5562 This Certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This Certificate does not amend, extend or alter the coverage afforded by the policies below. Insurers Affording Coverage I NAIC # 1 Insured: South East Personnel Leasing, Inc.& Subsidiaries 2739 U.S. Highway 19 N. Holiday, FL 34691 Insurer A: Lion Insurance Company 11075 Insurer B: Insurer C: Coverages 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. Aggregate limits shown may have been reduced by paid claims. INSR LTR I ADDL INSRD Type of Insurance I Policy Number l Policy Effective Date (MM /DD/YY) Policy Expiration Date (MM /DD/YY) Limits GENERAL LIABILITY Commercial General Liability Each Occurrence $ Damage to rented premises (EA occurrence) $ Claims Made ❑ Occur Med Exp $ Personal Adv Injury $ General aggregate limit applies per: D Policy.. ..Project. LOC General Aggregate $ Products - Comp /Op Agg $ AUTOMOBILE ■ LIABILITY Any Auto All Owned Autos Scheduled Autos Hired AUWS Non -Owned Autos Combined Single Limit (EA Accident) $ Bodily Injury (Per Person) �$ Bodily Injury - (Per Accident) $ Property Damage (Per Accident) $ EXCESS /UMBRELLA Occur Deductible LIABILITY Claims Made Each Occurrence Aggregate A Workers Compensation and Employers' Liability Any proprietor /partner /executive officer /member excluded? No If Yes, describe under special provisions below. WC 71949 01/01/2014 01/01/2015 x WC Statu- tory Limits I 1OTH- I ER E.L. Each Accident $t,000,000 E.L. Disease - Ea Employee $1,000,000 E.L. Disease - Policy Limits $1,000,000 Other Lion Insurance Company is A.M. Best Company rated A- (Excellent). AMB # 12616 Descriptions of Operations /LocationsNehicles /Exclusions added by Endorsement/Special Provisions: Client ID: 15 -60 -019 Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. & Subsidiaries that are leased to the following "Client Company ": East West Electric, Inc. dba Gulfcoast Lighting Maintenance Coverage only applies to injuries incurred by South East Personnel Leasing, Inc. & Subsidiaries active employee(s) , while working in FL. • Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity. A list of the active employee(s) leased to the Client Company can be obtained by faxing a request td (727) 937 -2113 or by calling (727) 938 -5562. Project Name: FAX: 727 - 771 -9361 / ISSUE 04 -02 -12 (SD)Reissued 12/10/12 (SH) / Reissued 12/9/13 (SH) Begin Date 12/23/200 CERTIFICATE HOLDER CANCELLATION CITY OF CLEARWATER P.O. BOX 4748 CLEARWATER, FL 33756 Should any of the above described policies be.cancelled before the expiration date thereof, the issuing insurer will endeavor to mail 30 days Written'notteeto4he.cedificate holder named to the left, but failure to do so shall impose no obligation or liability of any kind upon the insurer, its agents or representatives. CERTIFICATE OF LIABILITY INSURANCE Date 12/11/2013 Producer: Lion Insurance Company 2739 U.S. Highway 19 N. 9 Y This Certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This Certificate does not amend, extend or alter the coverage afforded by the policies below. Holiday, FL 34691 (727) 938 -5562 Insurers Affording Coverage NAIC # Insured: South East Personnel Leasing, Inc.& Subsidiaries Insurer A: Lion Insurance Company 11075 2739 U.S. Highway 19 N. Holiday, FL 34691 Insurer B: Insurer C: Coverages 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 policies f ins been r 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. Aggregate limits shown may have been reduced by paid claims, INSR LTR ADDL INSRD Type of Insurance Policy Number Policy Effective Date (MM /DD/YY) Policy Expiration Date (MM /DD/YY) Limits GENERAL LIABILITY Commercial General Liability Each Occurrence $ Damage to rented premises (EA occurrence) $ Claims Made Occur Med Exp $ Personal Adv Injury $ General aggregate limit applies per: D Policy ❑ Project LOC General Aggregate $ Products - Comp /Op Agg $ AUTOMOBILE LIABILITY Any Auto All Owned Autos Scheduled Autos Hired rwios Non -Owned Autos Combined Single Limit (EA Accident) $ Bodily Injury (Per Person) $ Bodily Injury (Per Accident) $ Property Damage (Per Accident) $ R E LIABILITY Occur ❑ Claims Made Deductible Each Occurrence Aggregate A Workers Compensation and Employers' Liability Any proprietor /partner /executive officer /member excluded? NO If Yes, describe under special provisions below, WC 71949 01/01/2014 01/01/2015 X1 WC Statu- tory Limits I 1OTH- ER E.L. Each Accident ($1,000,000 E.L. Disease - Ea Employee $1000,000 E.L. Disease - Policy Limits $1,000,000 Other Lion Insurance Company is A.M. Best Company rated A- (Excellent). AMB # 12616 Descriptions of Operations /LocationsNehicles /Exclusions added by Endorsement/Special Provisions: Client ID: 15 -60 -019 Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. & Subsidiaries that are leased to the following "Client Company ": East West Electric, Inc. dba Gulfcoast Lighting Maintenance Coverage only applies to injuries incurred by South East Personnel Leasing, Inc. & Subsidiaries active employee(s) , while working in FL. Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity. A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 937 -2138 or by calling (727) 938 -5562. Project Name: FAX: 727 - 771 -9361 / ISSUE 09 -15 -09 (SD) / RENEWAL:1 1,7-O (SF4 /REISSUE 01 -12 -10 (CF) / REISSUE 04 -02 -12 (SD)Reissued 12/10/12 (SH) / Reissued 12/9/13 (SH) - Begin Date 12/23/200 CERTIFICATE HOLDER CANCELLATION CITY OF CLEARWATER 100 S. MYRTLE AVE CLEARWATER, FL 33758 Should any of the above described policies be cancelled before the expiration date thereof, the issuing insurer will endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to do so shall impose no obligation or liability of any kind upon the insurer, its agents or representatives. Date CERTIFICATE OF LIABILITY INSURANCE 112/11/2013 Producer: Lion Insurance Company 2739 U.S. Highway 19 N. g y Holiday, FL 34691 (727) 938 -5562 This Certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This Certificate does not amend, extend or alter the coverage afforded by the policies below. Insurers Affording Coverage 1 NAIC # Insured: South East Personnel Leasing, Inc.& Subsidiaries 2739 U.S. Highway 19 N. Holiday, FL 34691 Insurer A: Lion Insurance Company 11075 Insurer B: Insurer C: Coverages 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. Aggregate limits shown may have been reduced by paid claims. INSR LTR ADOL INSRD Type of Insurance Policy Number Policy Effective Date (MM /DD/YY) Policy Expiration Date (MM /DD/YY) Limits GENERAL LIABILITY Commercial General Liability Claims Made Occur Each Occurrence $ Damage to rented premises (EA occurrence) $ General 3 Med Exp $ Personal Adv Injury $ aggregate limit applies per: Policy ❑ Project ❑ LOC General Aggregate $ Products - Comp /Op Agg $ AUTOMOBILE LIABILITY Any Auto All Owned Autos Scheduled Autos Hired Autos --- Non -Owned Autos Combined Single Limit (EA Accident) $ Bodily Injury (Per Person) $ Bedify�'nj "rye (Per Accident) $ Property Damage (Per Accident) $ EXCESS /UMBRELLA LIABILITY ROccur ❑ Claims Made Deductible Each Occurrence Aggregate A Workers Compensation and Em to ers' Liability Any proprietor /partner /executive officer /member excluded? NO If Yes, describe under special provisions below. WC 71949 01/01/2014 01/01/2015 X I wry Statu- to Limits I 1OTH- ER E.L. Each Accident 1$1,000,000 E.L. Disease - Ea Employee $1,000,000 E.L. Disease - Policy Limits $1,000,000 Other Lion Insurance Company is A.M. Best Company rated A— (Excellent). AMB # 12616 Descriptions of Operations /LocationsNehicles /Exclusions added by Endorsement/Special Provisions: Client ID: 37 -66 -329 Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. & Subsidiaries that are leased to the following "Client Company ": World Class Heating & Cooling, Inc. Coverage only applies to injuries incurred by South East Personnel Leasing, Inc. & Subsidiaries active employee(s) , while working in: FL. Coverage does not apply to statutory employee(s) or independent contractor(s) of rl49gpTl sr_apy, other entity. A list of the active employee(s) leased to the Client Company can be obtained by f g�i reg-tiestfb (2') g37 -2138 or by calling (727) 938 -5562. Project Name: FAX: 727 - 562 -4576 / ISSUE 08 -13 -13 (SD) / Reissued 12/9/13 (SH) L1. ?; Begin Date 3/28/2005 CERTIFICATE HOLDER CANCEL CITY OF CLEARWATER 100 SOUTH MYRTLE AVE CLEARWATER, FL 33756,x. shodiciiiiittifiefrbobve described-goltdie1bS cancelled before the expiration date thereof, the issuing insurer will endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to do so shall impose no obligation or liability of any kind upon the insurer, its agents or representatives. CERTIFICATE OF LIABILITY INSURANCE 112/12/2013 Producer: Lion Insurance Company 2739 U.S. Highway 19 N. Holiday, FL 34691 (727) 938 -5562 This Certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This Certificate does not amend, extend or alter the coverage afforded by the policies below. Insurers Affording Coverage NAIC # Insured: South East Personnel Leasing, Inc.& Subsidiaries 2739 U.S. Highway 19 N. Holiday, FL 34691 Insurer A: Lion Insurance Company 11075 Insurer B: Insurer C: Coverages The policies of insurance listed below have been issued to the insured named above for the policy period indicated. Notwithstanding any requirement, tens 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. Aggregate limits shown may have been reduced by paid claims. INSR LTR ADDL INSRD Type of Insurance Policy Number Policy Effective Date (MM /DD/YY) Policy Expiration Date (MM /DD/YY) Limits GENERAL LIABILITY Commercial General Liability Each Occurrence $ Damage to rented premises (EA occurrence) $ Claims Made Occur Med Exp $ Personal Adv Injury $ General D aggregate limit applies per: Policy ❑ Project ❑ LOC General Aggregate $ Products - Comp /Op Agg $ AUTOMOBILE LIABILITY Any Aulo All Owned Autos Scheduled Autos Hired Autos Non -Owned Autos Combined Single Limit (EA Accident) $ Bodily Injury (Per Person) $ Bodily Injury (Per Accident) $ Property Damage (Per Accident) $ EXCESS /UMBRELLA LIABILITY Each Occurrence Occur Claims Made Aggregate Deductible A Workers Compensation and Employers' Liability Any proprietor /partner /executive officer/member excluded? NO If Yes, describe under special provisions below. WC 71949 01/01/2014 01/01/2015 Xi WC Statu- I tory Limits I I OTH- ER E.L. Each Accident ($1,000,000' E.L. Disease - Ea Employee $1,000,000 E.L. Disease - Policy Limits $1,000,000 Other Lion Insurance Company is A.M. Best Company rated A- (Excellent). AMB # 12616 Descriptions of Operations /Locations/Vehicles /Exclusions added by Endorsement/Special Provisions: Client ID: 37 -69 -344 Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. & Subsidiaries that are leased to the following "Client Company': Wilson, Kehoe & Miller Corp. Coverage only applies to injuries incurred by South East Personnel Leasing, Inc. & Subsidiaries active employee(s) , while working in FL. Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity. ' A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 937 -2138 or by calling (727) 938 -5562. j Project Name: FAX: 727 - 585 -7143 / ISSUE 01 -27 -09 (TD) / RENEWAL 12 -17 -09 (SH)Reissued 12/10/12 (SH) / Reissued 12/9/13 (SH) Begin Date 12/26/200 CERTIFICATE HOLDER CANCELLATION 1 CITY OF CLEARWATER 1 I 1 100 S. MYRTLE AVENUE CLEARWATER, FL 33756 Should any of the above described policies be cancelled before the expiration date thereof, the issuing insurer will endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to do so shall impose no obligation or liability of any kind upon the insurer, its agents or representatives. yy.sa.ra.• 91182 CERTIFICATE OF LIABILITY INSURANCE • Date I 1/21/2014 Producer: Lion Insurance Company 2739 U.S. Highway 19 N. Holiday, FL 34691 (727) 938 -5562 This Certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This Certificate does not amend, extend or alter the coverage afforded by the policies below. Insurers Affording Coverage NAIC # Insured: South East Personnel Leasing, Inc. & Subsidiaries 2739 U.S. Highway 19 N. Holiday, FL 34691 Insurer A: Lion Insurance Company 11075 Insurer B: Insurer C: Insurer D: Insurer E: Coverages 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. Aggregate limits shown may have been reduced by paid claims. INSR LTR ADDL INSRD Type of Insurance Policy Number Policy Effective Date (MM /DD/YY) Policy Expiration Date (MM /DD/YY) Limits GENERAL Commercial LIABILITY General Claims Made Liability Occur Ca 12 n ce I 24 2013 I ed Each Occurrence $ Damage to rented premises (EA occurrence) $ Med Exp $ Personal Adv Injury $ General aggregate limit applies per: ID Policy ❑ Project ❑ LOC General Aggregate $ Products - Comp /Op Agg $ AUTOMOBILE MN — - LIABILITY Any Auto All Owned Autos Scheduled Autos Hired Autos Non -Owned Autos FE 0:71014. LEO ., 0 3 2014 RECORDS AND Lr SRVCS DE Combined Single Limit (EA Accident) $ Bodily Injury (Per Person) $ Bodily Injury (Per Accident) $ Property Damage (Per Accident) $ _ EXCESS /UMBRELLA LIABILITY ROccur a Claims Made Deductible Each Occurrence Aggregate A Workers Compensation and Employers' Liability Any proprietor /partner /executive officer /member excluded? If Yes, describe under special provisions below. WC 71949 01/01/2014 01/01/2015 X I WC Statu- tory Limits I 1OTH- ER E.L. Each Accident $1,000,000 E.L. Disease - Ea Employee $1,000,000 E.L. Disease - Policy Limits $1,000,000 Other Lion Insurance Company is A.M. Best Company rated A- (Excellent). AMB # 12616 Descriptions of Operations /LocationsNehicles /Exclusions added by Endorsement/Special Provisions: Client ID: 93- 67-004 Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. that are leased to the following "Client Company ": Florida Gas Contractor, Inc. Coverage only applies to injuries incurred by South East Personnel Leasing, Inc. & Subsidiaries active employee(s) , while working in FL. Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity. A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 937 -2138 or by calling (727) 938 -5562. Project Name: ISSUE 01 -14 -13 (JG) / Reissued 12/9/13 (SH) Begin Date 12/26/2012 CERTIFICATE HOLDER CANCELLATION CITY OF CLEARWATER ATTN: CITY CLERK PO BOX 4748 CLEARWATER, FL 34618 Should any of the above described policies be cancelled before the expiration date thereof, the issuing insurer will endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to do so shall impose no obligation or liability of any kind upon the insurer, its agents or representatives, CERTIFICATE OF LIABILITY INSURANCE Date I 12/17/2013 Producer: Lion Insurance Company 2739 U.S. Highway 19 N. Holiday, FL 34691 (727) 938 -5562 This Certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This Certificate does not amend, extend or alter the coverage afforded by the policies below. Insurers Affording Coverage NAIC # Insured: South East Personnel Leasing, Inc. & Subsidiaries 2739 U.S. Highway 19 N. Holiday, FL 34691 Insurer A: Lion Insurance Company , 11075 Insurer B: Insurer C: Insurer D: Insurer E: Coverages 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. Aggregate limits shown may have been reduced by paid claims. INSR LTR ADDL INSRD Type of Insurance Policy Number Policy Effective Date (MM /DD/YY) Policy Expiration Date (MM /DD/YY) Limits GENERAL LIABILITY Commercial General Liability ca 1 n Ice! 24 - I ed 013 Each Occurrence $ Damage to rented premises (EA Damage $ Claims Made ❑ Occur Med Exp $ Personal Injury $ General aggregate limit applies per: 3 Policy ❑ Project ❑ LOC General ral Aggregate Aggregre gate Products - Comp /Op Agg $ AUTOMOBILE LIABILITY Any Auto All Owned Autos Scheduled Autos, Hired Autos Non-Owned Autos `p i . : . u .x31,51 FIp I( r s i y '3 '°-�- � °- '°" � L i S. b a y tai .. s ] F E: S Cai CS; .d ti , , .., ' 7.F1 Combined Single Limit (EA Accident) $ Bodily Injury (Per Person) $ Bodily Injury (Per Accident) $ Property Damage (Per Accident) $ MINIM EXCESS /UMBRELLA LIABILITY IOccur ❑ Claims Made Deductible Each Occurrence Aggregate A Workers Compensation and Employers' Liability Any proprietor /partner /executive officer /member excluded? If Yes, describe under special provisions below. WC 71949 01/01/2014 01/01/2015 I x I WC Statu- tory Limits I 1OTH- ER E.L. Each Accident $1,000,000 E.L. Disease - Ea Employee $1,000,000 E.L. Disease - Policy Limits $1,000,000 Other Lion Insurance Company is A.M. Best Company rated A- (Excellent). AMB # 12616 Descriptions of Operations /LocationsNehicles /Exclusions added by Endorsement/Special Provisions: Client ID: 80-65 -345 Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. that are leased to the following "Client Company ": T. Wayne Hill Trucking, Inc. Coverage only applies to injuries incurred by South East Personnel Leasing, Inc. & Subsidiaries active employee(s) , while working in FL. Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity. A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 937 -2138 or by calling (727) 938 -5562. Project Name: ISSUE 02 -22 -12 (SD)Reissued 12/10/12 (SH) / Reissued 12/9/13 (SH) Begin Date 3/29/2010 CERTIFICATE HOLDER CANCELLATION CITY OF CLEARWATER 100 S. MYRTLE AVE 3RD FL. CLEARWATER, FL 33756 Should any of the above described policies be cancelled before the expiration date thereof, the issuing insurer will endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to do so shall impose no obligation or liability of any kind upon the insurer, its agents or representatives. +