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CERTIFICATE OF LIABILITY INSURANCE (333)
A �® CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 5/7/2014 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 Lassiter -Ware Insurance of Tampa Bay 4401 West Kennedy Blvd Suite 200 Tampa FL 33609 CONTACT Shelia Robertson NAME: (ac°Nrvo Eut): (800) 845 -8437 Not: (888)883 -8680 nD ORIESS :sheliar(�lassiter- MAIL INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:United Fire & Casualty Company 13021 INSURED Marshall Electricworks, Inc. Professional Electrical Consultants Inc 16143 Ivy Lake Dr Odessa FL 33556 INSURER B: , ( 60393793 ,, INSURERC: 6/2/2015 INSURERD: $ 1,000,000 INSURER E : $ 100,000 INSURER F: $ 5,000 14 -15 GL AU 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 SHOW N MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ... •SUBR INSR WVD POUCY NUMBER POUCY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY) UNITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY , ( 60393793 ,, --'--, 6 � 22014 6/2/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 MEDEXP(Anyoneperson) $ 5,000 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 X is- LIMIT APPLIES PER: LOC $ A AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS } `" ' ` °" ° ` 60393793 — ' W "` 6/2/2014 6/2/2015 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 RETENT ON $ WORKERS COMPENSATION AND EMPLOYERS' LIABIL TY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A j I TORY LIMITS I I T 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) ....-rung nvwr_rn (727) 562 -4576 City of Clearwater 100 S Myrtle Ave 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 Dana Snyder /SHELIA ACORD 25 (2010/05) INS02c (7n1nn�i m ©1988 -2010 ACORD CORPORATION. All rights reserved. Them a(`ARr1 namo and Innn arem roniefororl marks of A(:fPr1