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CERTIFICATE OF LIABILITY INSURANCE (308)
FOUNT -9 OP ID: DJ '4�� Cr CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 03/21/2014 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 Phone:305- 364 -7800 BROWN & BROWN OF FLORIDA INC F 305 14900 NW 79th Court Suite#200 Fax: - 714 -4401 Miami Lakes, FL 33016 -5869 Ramon A Rodriguez CCOOMMEACT PHONE FAX (NC. No. Ext)• (A/C. No): EtAAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : *Zurich American Insurance Co. 16535 INSURED Fountain Engineering Inc Attn: Calicia Landry 21050 sw 172nd Ave Miami, FL 33187 INSURER B: GL05746883 tl (j' INSURER C: 3/2014 }} AND INSURER D : EACH OCCURRENCE INSURER E : PREM SES (Ea occurrence) INSURER F : MED EXP (Any one person) R: 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 TYPE OF INSURANCE INSR w vn POLICY NUMBER IMM/DDY/YYYY1 IMM/DD / EXP YYYY) LIMITS A GENERAL X UABILITY COMMERCIAL GENERAL LIABILITY GL05746883 tl (j' MARL 4 2014 p RECORDS Irc.�viRDS 3/2014 }} AND 03/23/2015 EACH OCCURRENCE $ 1,000,000 PREM SES (Ea occurrence) $ 300,000 MED EXP (Any one person) $ 10,000 CLAIMS -MADE X OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 GE 'L AGGREGATE POLICY LIMIT APPLIES X !Tel: PER: LOC $ A AUTOMOBILE X X LIABILITY ANY AUTO ALLOWNED AUTOS HIRED AUTOS ' X SCHEDULED NON -OWNED AUTOS p� �� L)EGISEA i V E w7a��C BAP5746882 U 2'.x/2 14 03/23/2015 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident/ $ $ UMBRELLA LIAB EXCESS LIAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ 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 / A WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A Equipment Special Form; RC IM5746884 THEFT INCLUDED 03/23/2014 03/23/2015 Leased/ 250,000 Rented DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) CERTIFICATE HOLDER CANCELLATION CLEARWA City of Clearwater PO Box 4748 Clearwater, FL 33758 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'�'t� ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD