CERTIFICATE OF LIABILITY INSURANCE (347)MAGESII
OP ID: JO
AC-CPR `_ L CERTIFICATE OF LIABILITY INSURANCE
DATE(MM /DD /YYYY)
04/1412014
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: 941 - 745 -8300
Boyd Insurance & Investment Fax: 941 - 745 -2571
Services, Inc.
717 Manatee Avenue West #300
Bradenton, FL 34205
Phillip B. Baker
NOME CT
PHONE FAX
(ac, No. Ext): (A/C, No):
POLICY EXP
(MM /DD /YYYY)
E -MAIL
ADDRESS:
INSURER(S) AFFORDING COVERAGE
GENERAL LIABILITY
NAIC #
20141
INSURER A : National Trust Ins Co
INSURED Suncoast Investments of
Palmetto, Inc. Suncoast
Properties of Palmetto, LLC
dba Magee Sign Service
Robert Knapp
P.O. Box 1298.
Palmetto, FL 34220
INSURER B : FCCI Commercial Ins. Co.
33472
INSURER C : FCCI Insurance Compann�
$ 1,000,000
10178
INSURER D :
INSURER E :
$ 100,000
INSURER F :
1 CLAIMS -MADE X
CERTIFICATE NUMBER:
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
POLICY NUMBER
POLICY EFF
(MM /DDIYYYY)
POLICY EXP
(MM /DD /YYYY)
LIMITS
A
GENERAL LIABILITY
_
-ter-. y.a�(., Gi �"-
,-
2
GL0016153
.._ . -- - - -
. _
11/15/2013
-
11/15/2014
EACH OCCURRENCE
$ 1,000,000
X 1
COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
PREMISES (Ea occurrence)
$ 100,000
$ 10,000
1 CLAIMS -MADE X
OCCUR
MED EXP (Any one person)
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER
PRODUCTS - COMP /OP AGG
$ 2,000,000
I POLICY
X li ECT r 1 LOC
$
B
AUTOMOBILE LIABILITY
CA0025671
11/15/2013
11/15/2014
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
X
_
X
ANY AUTO
BODILY INJURY (Per person)
$
ALL OWNED
AUTOS
HIRED AUTOS
X
SCHEDULED
AUTOS
AUTOSWNED
BODILY INJURY (Per accident)
$
PROPERTY err accident) DAMAGE
$
$
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
DEC ] ( RETENTION $
$
C
WORKERS COMPENSATION
EMPLOYERS' LIABILITY
ANY PROPRIETOR /PARTNER /EXECUTIVE Y(-1
OFi"ic;ER /MLNIBER EXC..UDEO N
(Mandatory in NH) l
If yes, describe under
DESCRIPTION OF OPERATIONS below
. "J / A
WC1229351
11/15/2013
11/15/2014
X
WC STATU-
TORY LIMITS
OTH-
ER
E L EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1,000,00
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
VLR 11(- IVMI L. I 1 #4 -VLIS
City of Clearwater
P.O. 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
git Mr /c�
v
ACORD 25 (2010/05)
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