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CERTIFICATE OF LIABILITY INSURANCE (358)ACQR `./ L! CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 4/7/2014 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 Jack Rice Insurance 13080 S Belcher Rd Largo FL 33773 CONTACT Commercial Lines Division NAME: J 6dt: (727) 530 -0684 FAX Not: (727)532 -9602 E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A:National Trust Ins. Co. 20141 INSURED Tom r s Sod Service, Inc. 11413 49th St N Clearwater FL 33762 INSURER B :FCCI Insurance Co. 10178 INSURER C : 4/1/2015 INSURERD: $ 1,000,000 INSURER E : $ 100,000 INSURER F : $ 5, 000 COVERAGES CERTIFICATE NUMBER:CL144734670 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 /DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS A GENERAL X LIABIUTY COMMERCIAL GENERAL LIABILITY r� "^ GL001521401 f ra \,i1,44.914 - 4/1/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO PREMISES EaEoccu ence) $ 100,000 MED EXP (Any one person) $ 5, 000 CLAIMS -MADE X OCCUR PERSONAL &ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ " 2,000,000 GEN'L AGGREGATE 3 7 1 POLICY LIMIT APPLIES JFPRO- f.T PER LOC $ A AUTOMOBILE X LIABIUTY ANY AUTO ALLOWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS `` • ' '-'ir'" V. L.. CA002386601 ' "" °\ ° L _. s 4/1/2014 4/1/2015 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILYINJURY(Peraccident) $ PROPERTY DAMAGE (Per accident) $ PIP -Basic $ 10,000 A X UMBRELLA LIAB EXCESS UAB OCCUR CLAIMS -MADE UMB001646001 4/1/2014 4/1/2015 EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,000 $ DED X RETENTON$ 10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABIL TY ,(/ ti ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? n (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ B INLAND MARINE CM000750101 4/1/2014 4/1/2015 LEASED EQUIPMENT LIMIT: 100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION CITY OF CLEARWATER P.O. 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 Cynthia Webster/LPW n . L ACORD 25 (2010/05) INS025(70100\m © 1988 -2010 ACORD CORPORATION. All rights reserved. Tho A(11Rr1 nnri Innn *re. rcnicforcrl mmrlre of finnan COMMENTS /REMARKS GENERAL LIABILITY: Automatic Additional Insureds when required by Written Contract without Products /Completed Operations per form CGL088 07/10. Automatic Additional Insureds when required by Written Contract for Lessors (equipment) Operations only per form CGL088 07/10. Automatic Additional Insureds when required by Written Contract for Mortgagees - Premises only per form CGL088 07/10. Waiver of Subrogation for Additional Insureds on an Automatic Basis when required by Written Contract per form CGL088 07/10. OFREMARK COPYRIGHT 2000, ANS SERVICES INC.