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CERTIFICATE OF LIABILITY INSURANCE (349)°OULU 1 ® A� R� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD!YYYY) 4/14/2014 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 Commercial Lines - (813) 639 -3000 Wells Fargo Insurance Services USA, Inc. 2502 N. Rocky Point Drive, Suite 400 Tampa, FL 33607 CONTACT Certificates Dept NAME: p PHONE FAX (A/C. No, Est): 813.639.3000 (A/C, No): 855.299.7117 E -MAIL lw.Certre llfo.COm c uest wesar ADDRESS: 4 G g INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: First Mercury Insurance Company 10657 INSURED John Hogan Roofing Inc. 1389 Hibiscus Street Clearwater FL 33755 INSURER B : NJCGL000002701202 INSURER C 4/14/2015 INSURER D $ 1,000,000 INSURER E : $ 50,000 INSURER F COVERAGES CERTIFICATE NUMBER: 7597099 REVISION NUMBER: See below 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 INSD SUBR WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY NJCGL000002701202 4/14/2014 4/14/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 50,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ Excluded X $2,500 ded. per Claim PERSONAL & ADV INJURY $ 1,000,000 including LAE policy GENERAL AGGREGATE $ 2,000,000 GE 'L AGGREGATE POLICY OTHER: X LIMIT APPLIES JE 0 PER: LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ AUTOMOBILE UABIUTY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ SCHEDULED NON -OWNED AUTOS f w - - COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA UAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Proof of Coverage. CERTIFICATE HOLDER CANCELLATION Licensing Dept City of Clearwater ty 100 S Myrtle Avenue Clearwater, FL 33756 1 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 91,,. The ACORD name and logo are registered marks of ACORD ACORD 25 (2014/01) ©1988 -2014 ACORD CORPORATION. All rights reserved.