CERTIFICATE OF LIABILITY INSURANCE (316)FLORSII
OP ID: VO
ACOROX
I�„� CERTIFICATE OF LIABILITY INSURANCE
DATE (MM /DD/YYYY)
03/11/2014
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 �o: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: 941 - 745 -8300
Boyd Insurance & Investment Fax: 941 - 745 -2571
Services, Inc.
717 Manatee Avenue West #300
Bradenton, FL 34205
Pat Osburn
CONTACT Vickie Oakes
PHONE 941 - 745 -8300
(A/C, No, E #I: FAX No):
941 -782 -6288
E-MAIL vickieo @boydinsurance.com
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: AUTO OWNERS INSURANCE CO
18988
INSURED Florida Sign Company, Inc. •
1101 29th Ave. W.
Bradenton, FL 34205
INSURER B : Southern Owners Insurance Co..
10190
INSURER C :
03/20/2015
INSURER D :
$ 1,000,000
INSURER E :
$ 300,000
INSURER F :
$ 10,000
•
REVISION NUMBER:
v
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
(MM /DD/YYYY)
POLICY EXP
(MM /DD/YYYY)
LIMITS
A
GENERAL
X
LIABILITY
COMMERCIAL GENERAL
J CLAIMS -MADE
LIABILITY
X I OCCUR
20706414
}
C �. ✓
t , s 4
)c d
03/20/2014
03/20/2015
EACH OCCURRENCE
$ 1,000,000
pRA MISES Ea occur ence)
$ 300,000
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ - 1,000,000
GENERAL AGGREGATE
$ 2,000,000
X
Per Project Aggre'` •
PRODUCTS - COMP /OP AGG ,
$ 2,000,000
GEN'L AGGREGATE
POLICY
• T
LIMIT APPLIES
PRO-
JECT
PER
BLOC
$
A
AUTOMOBILE
X
X
X
LIABILITY
ANY AUTO
ALL OWNED
AUTOS
HIRED AUTOS
PIP 10,000
X
- .
SCHEDULED
AUTOS
00-OWNED
AUT
9542691 30303¢ , s
L
c'd3)Z0 /2014
03/20/2015
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000 000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
$
B
x
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
APPLICATION
03/20/2014
03/20/2015
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$ 1,000,000
$
DED
I RETENTION $
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR /PARTNER /EXECUTIVE f—1
OFFICER. /MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
/ A
WC STATU- 1 0TH -
TORY LIMITS i i ER
E.L. EACH ACCIDENT
$
$
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
VI-1\ I IF IMOM V I IVLIJLI%
CIT4748
City of Clearwater
PO Box 4748
Clearwater, FL 33758 -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)
-2010 ACORD CORPORATION. All rights resery ed.
The ACORD name and logo are registered marks of ACORD