CERTIFICATE OF LIABILITY INSURANCE (295)ACO
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.
CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDD/YYYY)
3/26/2014
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
Bouchard Insurance
P O Box 6090
Clearwater FL 33758 -6090
CONTACT
NAME:
PHONE
(A/C. No. Ext):727- 447 -6481
FAX
(A/C. No):727- 449-1267
ADDREss :dcertsebouchardinsurance corn
INSURER(S) AFFORDING COVERAGE
NAIC t
INSURED
Airite Air Conditioning Inc
5334 W Crenshaw St
Tampa FL 33634-2407
AIRIT -8
INSURER A :Amerisure Insurance Company
INSURER B :
19488
INSURER C :
INSURER D :
INSURER E :
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
INSR
SUBR
WVD
POLICY NUMBER
POLICY EFF
(MMIDD/YYYY)
POLICY EXP
(MM/DD/YYYY)
LIMITS
A
GENERAL LIABILITY
N
N
CPP20455730601 ( ^r l
- - -- -_
r
1 13 _ ,5/1/2014
:d c ;
- v __ . %
i
EACH OCCURRENCE
$1,000,000
X
COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
PREMISES (Ea occurrence)
$300,000
CLAIMS
X
OCCUR
MED EXP (Any one person)
$10,000
$1,000,000
-MADE
LIMIT APPLIES PER
PERSONAL 8 ADV INJURY
GENERAL AGGREGATE
$2,000,000
$2,000,000 $
PRODUCTS - COMP /OP AGG
GEIJ'L AGGREGATE
POLICY X !Ira
LOC
A
AUTOMOBILE LIABILITY
N
N
CA20455720601 L "" "' t -
6�1l213�3�;•,
1/7tb14
t,UMtlINtU SINGLE LIMI I
(Ea accident)
$1,000,000
X
X
AUTO
BODILY INJURY (Per person)
$
ANY
ALL OWNED
AUTOS
HIRED AUTOS
X
SCHEDULED
AUTOS
NON -OWNED
AUTOS
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
$
A
UMBRELLA LIAB
EXCESS LIAB
X
$0
OCCUR
CLAIMS -MADE
N
N
CU2045575
6/1/2013
S/1/2014
EACH OCCURRENCE
$5,000,000
AGGREGATE
$5,000,000
DED
X
RETENTION
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY N
ANY PROPRIETOR/PARTNER/EXECUTIVE
WC2091750
4/1/2014
4/1/2015
x
TORY LIMITS
ER
E.L. EACH ACCIDENT
$1,000,000
In N OFFICER/MEMBER EXCLUDED? IN
In NH)
N!A
E.L. DISEASE - EA EMPLOYEE
$1,000,000
(Mandatory
(Mandatory
ff yes describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
t..Crs 11r Il.N 1 C Mil-I./GIN
CITY OF CLEARWATER
P 0 BOX 4748
CLEARWATER FL 34618 -4748
_. ••- - - - -' . - - -'
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)
- . .
The ACORD name and logo are registered marks of ACORD