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CERTIFICATE OF LIABILITY INSURANCE (303)ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YVYY) 3/25/2014 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 George H Odiorne Insurance Agency Inc PO Box 830 Brandon FL 33509 CONTACT Megan Manning g g (PAH/c "IV . Ertl: (813) 685 -7731 I A%C. No): (813) 685 -1823 ADDRESS: mmanning@ odiorneinsurance . cora INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:FCCI Commercial Insurance Co 33472 INSURED Lott Sign Service, Inc. 4141 Mowrey Road Wesley Chapel FL 33543 INSURERB:FCCI Insurance Company 10178 INSURERC: 6/28/2014 INSURER D : $ 1,000,000 INSURER E : $ 100 , 000 INSURER F : $ 5,000 COVERAGES CERTIFICATE NUMBER:14 /15 WC Renewal 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 IISR SUBR WVD POLICY NUMBER POLICY EFF IMM /DD/YYYYI POLICY EXP IMM /DD/YYYY1 LIMITS A GENERAL X UABILITY COMMERCIAL GENERAL LIABILITY (� , '6 GL00044028 t � + I k tip. /2013 , b �_ _ 6/28/2014 EACH OCCURRENCE $ 1,000,000 DAMAGE TO PREMISES (Ea occurrence) $ 100 , 000 MED EXP (Any one person) $ 5,000 I CLAIMS -MADE X OCCUR PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OPAGG $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY [PRO- T n LOC IFr $ AANY AUTOMOBILE X LIABILITY AUTO ALL OWNED AUTOS HIRED AUTOS _ _ SCHEDULED AUTOS NON -OWNED AUTOS _ �s c , / " C� �'�'ryT'� L:..'a...,,.! -J—L:. i .j - ...�.. CA00075828 ;',,, / >' t21 e.r�. L -_. . 6/28/2013 6/28/2014 COMBINED SINGLE LIMIT (Ea accident) 1,000,000 $ $ BODILY INJURY (Per person) BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ PIP - Basic $ 10,000 A X UMBRELLA LIAB EXCESS LIAB _ OCCUR CLAIMS -MADE 0MB00089455 6/28/2013 6/28/2014 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 $ DED I X I RETENTION$ 10,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER/EXECUTIVE Y/N OFFICER /MEMBER EXCLUDED? N (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 59442 4/1/2014 4/1/2015 x I TORY LIMU- I0T FR E. L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) LLATION City of Clearwater 100 S Myrtle Avenue Clearwater, FL 33756 I 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 W Vildibill (C) /MANN f'';G��e ACORD 25 (2010/05) INS025 (201005).01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD