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CERTIFICATE OF LIABILITY INSURANCE (326)„---''''.".611 ® ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD/YYYY) 5/29/2014 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 Bouchard Insurance P 0 Box 6090 Clearwater FL 33758 -6090 CONTACT NAME: (A// /CCC.N o. Ext1:727- 447 -6481 iA/c, No):727 -449 -1267 E-MAIL ADDRESS:cicerts anbouchardinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:Ameris re Insurance Company 19488 INSURED AIRIT -8 Airite Air Conditioning Inc 5334 W Crenshaw St Tampa FL 33634 -2407 INSURER B : INSURER C : INSURER D: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1090606719 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 POLIC1 NUMReR:- "''. r, -POLICY EFF (M D/YYYY) POLICY EXP (MM /DD!YYYY) LIMITS A GENERAL LIABILITY N N CPP20455730701 - — _- • .. -. 6/1/2014 ..... __ .. o/1/2015 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence) $300,000 CLAIMS -MADE X OCCUR MED EXP (My one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $2,000,000 7 POLICY X JFCT LOC $ A AUTOMOBILE LIABILITY N N CA20455720701 6/1/2014 6/1/2015 (EOa BINEDSINGLE LIMIT 1,000,000 $ X X ANY AUTO BODILY INJURY (Per person) ALL OWNED AUTOS HIRED AUTOS X SCHEDULED NON OS -OWNED AUT BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE N N CU20455750701 6/1/2014 6/1/2015 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 DED X RETENT ON $0 $ A WORKERS COMPENSATION WC2091750 4/1/2014 4/1/2015 X WC STATU- TORY LIMITS OTH- ER AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) YIN N / A E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 If 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) CERTIFICATE HOLDER CANCELLATION CITY OF CLEARWATER P 0 BOX 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. CLEARWATER FL 34618 -4748 AUTHORIZED REPRESENTATIVE © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD