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CERTIFICATE OF LIABILITY INSURANCE (368)ACO- CERTIFICATE OF LIABILITY INSURANCE `� DATE (MMIDD/YYYY) 04/01/2014 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 W.F. DAVISON, AGENT Commercial & Home Insurance Inc 5635 49th Street N St Petersburg FL 33709- CONTACT CT For Certificates: Victoria or Jamie PHONE (ABC,, No, Est): (727) 527 -5700 FAX No); (727) 527 -6285 E-MAIL ADDRESS: PRODUCER Roof Masters Preferred Inc CUSTOMER ID �. INSURER(S) AFFORDING COVERAGE NAIC # INSURED Roof Masters Preferred Inc- 7301 6th Avenue N St Petersburg FL 33710 -7535 INSURER A :WESTERN WORLD GENERAL INSURER B :BRIDGEFIELD OCCUR INSURER C :OLD DOMINION INSURANCE CO gU�oL �p� i'YC INSURER D 03/04/2014 / / / / / / St' � , INSURER E EACH OCCURRENCE INSURER F : 300,000 COVERAGES 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 �� INSR �UBR Y�tlB.,� POUCY NUMBER BCD EFF ( EXP UMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY OCCUR gU�oL �p� i'YC PGP0763440 �j cc/A� G �`"i Poi- SFe� poI Y t.an qD�/ icyC Ce' /e A ~ %C� `,a anC(Jll �9`r,14 O1 nC O I(�cQ G�� /fir, r% 03/04/2014 / / / / / / St' � , 03/04/2015 / / / / / / / / / / / / EACH OCCURRENCE $ 300,000 X PREMISES SES Ea oxurrence) $ 10 0 , 000 CLAIMS -MADE X MED EXP (Any one person) $ 5, 000 PERSONAL &ADVINJURY $ 300,000 GENERAL AGGREGATE $ 600,000 GEN'L AGGREGATE LIMIT APPLIES PER: n I ' LOC PRODUCTS - COMP /OP AGG $ 600,000 PRO- -27E POLICY JFCT NONMD $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 8107102A S S`r. `11Cn �- /0149 .9 �� 4 "/44 / / / / / / / / 07/09/2014 / / / / / / / / / / COMBINED SINGLE LIMIT 100,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ X X $ $ UMBRELLA LUIS EXCESS UAB OCCUR CLAIMS -MADE / / / / / / / / / / / / / / / / EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS YIN N I A 0830 -44737 - -' 04/13/2014 / / / / / / 04/13/2015 / / / / / / X T C STA UT LIMITS E.LEACHACCIDENT $ $ 100,000 100, 000 E.L. DISEASE - EA EMPLOYEE below EL DISEASE - POLICY LIMIT $ 500,000 / / / / / / / / DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, IT more space Is required) ROOFING CONTRACTOR W.F. DAVISON, AGENT ( ) CITY OF CLEARWATER 100 S. MYRTLE AVENUE CLEARWATER ( FL ) 33756- 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 .., a .Ile.— ■...,.. 04,0-1...a..„,--......., ACORD 25 (2009/09) © 1988-2009 ACORD CORPORATION. All nghts reserved. TI,e An_nan nnmm and innn are renistarad marks of ACORD AR �® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 04/01/2014 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 W.F. DAVISON, AGENT Commercial & Home Insurance Inc 5635 49th Street N St Petersburg FL 33709- CDNTACT won: For Certificates: Victoria or Jamie FAX No): (727) 527 -6285 (AICNNo, Ext): (727) 527 -5700 ADDRESS: PRODUCER Roof Masters Preferred Inc CUSTOMER ID li. INSURER(S)AFFORDINGCOVERAGE NAIC# INSURED Roof Masters Preferred Inc- 7301 6th Avenue N St Petersburg FL 33710 -7535 INSURER A WESTERN WORLD INSURER B :BRIDGEFIELD PGP0763 4 I = j ' L G n~ ' 3 •J -' ° ' /�.� ,.° Cl , 3.. i � -' t " ass .� ( . � �'0 -u f .'` I r•7:7 INSURER C :OLD DOMINION INSURANCE CO 03/04/2015 / / / / / / / / / / / / INSURER D : $ 300,000 INSURER E : DAMAGE TO RENTED PREMISES (Ea occurrence) INSURER F : COVERAGES 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 SUER WVD POLICY NUMBER POLICY EFF (MMIDDIYYYY) POLICY EXP (MMIDDIYYYY) LIMITS A GENERAL UABIUTY COMMERCIAL GENERAL LIABILITY OCCUR PGP0763 4 I = j ' L G n~ ' 3 •J -' ° ' /�.� ,.° Cl , 3.. i � -' t " ass .� ( . � �'0 -u f .'` I r•7:7 03/04/2014 / / / / / / / / / i:;6 / 03/04/2015 / / / / / / / / / / / / EACH OCCURRENCE $ 300,000 X DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 CLAIMS -MADE X MED EXP (Any one person) $ 5,000 PERSONAL BADV INJURY $ 300,000 GENERAL AGGREGATE $ 600,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 600,000 POLICY PE? LOC NOWND $ `+ AUTOMOBILE UABIUTY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 81G7I0FIX- 07/09/2013 / / / / / / / / / / / / 07/09/2014 / / / / / / / / / / / / COMBINED SINGLE LIMIT (Ea accident) $ 100,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ X X $ $ UMBRELLA LIAB EXCESS UAB OCCUR CLAIMS -MADE / / / / / / / / / / / / / / / / EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' UABIUTY ANY PROPRIETORIPARTNERIEXECUTIVE Y / N OFFICERIMEMBER EXCLUDED? ❑ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 0830 -44737 04/13/2014 / / / / / / 04/13/2015 / / / / / / ]( TORY LId11T OTR E.L. EACH ACCT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 $ 500,000 E.L. DISEASE - POLICY LIMIT / / / / / / / / DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space 's required) ROOFING CONTRACTOR W.F. DAVISON, AGENT ( ) - CITY OF CLEARWATER 100 S. MYRTLE AVENUE CLEARWATER ( FL ) - 33756- 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 ACORD 25 (2009/09) INS025 (200909) -2009 ACORD CORIPORATION. All nonts reserved. The ACORD name and logo are registered marks of ACORD