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.
+