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CERTIFICATE OF LIABILITY INSURANCE (3)AR D CERTIFICATE OF LIABILITY INSURANCE 1/15/2014D 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 Greene -Hazel Insurance Group 10739 Deerwood Park Blvd Ste 200 Jacksonville FL 32256 CONTACT NAME: IA/C. No.Extl:904- 398 -1234 FAX No):904- 396 -7432 E-MAIL reenehazel.com p@9 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :American Economy Ins Co LIABILITY COMMERCIAL GENERAL LIABILITY INSURED NORTH 18 Northeast II, Inc. dba TC Delivers; TC Specialties Co. 5911 Philips Hwy Jacksonnville FL 32216 Jacksonville INSURER B :Phoenix Insurance Company 25623 24767 10385 INSURER C :ST PAUL FIRE & MARINE INS CO INSURER D :FFVA Mutual Insurance Co INSURER E :Darwin Select Insurance Comp an p INSURER F :Federal Insurance Company 20281 COVERAGES CERTIFICATE NUMBER: 720193536 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 INSR SUBR WVD POLICY NUMBER r-Z POLICY EFF M!DD Y Y) POLICY EXP (MM/DD/YYYYI LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY 01CI1084226 _ � , . , Ii91 (14=" . ._ . ' /15/2015 ,. , EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $1,000,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES PRO- O- JFS X PER LOC PRODUCTS - COMP /OP AGG $2,000,000 $ B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS 915K3663 1/15/2014 1/15/2015 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 $ BODILY INJURY (Per person) BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) _- $ $ C X UMBRELLA UAB EXCESS LIAB X OCCUR CLAIMS -MADE ZUP14P11458A14NF 1/15/2014 1/15/2015 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 DED X RETENT ON $10,000 $ p 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 I A WC84000253882013A 12/31/2013 12/31/2014 X TORY TAT 0TH- ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 mm Prof Liability Crime 03040680 82095695 8/14/2013 1/15/2014 8/14/2014 1/15/2015 Prof Liab Limit 3000000 Crime Limit 1000000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) CERTIFICATE HOLDER CANCELLATION City of Clearwater 100 South Myrtle Avenue 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 ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD