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CERTIFICATE OF LIABILITY INSURANCE (369)FLOR033 OP ID: BN ACOREY CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 03/12/2014 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 Sihle Insurance Group - Clrwtr 2653 McCormick Dr Clearwater, FL 33759 Micky Williams CONTACT Dawn Davis PHONE FAX (A/C, No E: t): 727- 450 -6649 pvc, No): 727 - 531 -6855 a ARESS: ddavis @sihle.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Bridgefield Employers Ins Co. 10701 INSURED Florida Air Systems, Inc. 6600 E. Broadway Ave. Tampa, FL 33619 INSURER B: Old Dominion Insurance Company 40231 INSURER c 09/24/2014 INSURER D : $ 500,000 INSURER E : $ 500,000 INSURER F : $ 10,000 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 ADDL INSR SUBR W VD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS B GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY MPT4082L ..., ( +r 09/24/2013 09/24/2014 EACH OCCURRENCE $ 500,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 500,000 MED EXP (Any one person) $ 10,000 CLAIMS -MADE X OCCUR PERSONAL & ADV INJURY $ 500,000 GENERAL AGGREGATE $ 1,000,000 PRODUCTS - COMP /OP AGG $ 1,000,000 GEN'L AGGREGATE 7 POLICY X LIMIT APPLIES JF(; WI: PER: LOC $ B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS �,., .:. + ._, _- • B1 T4082L =` ' - 09/24/2013 09/24/2014 COMBINED SINGLE LIMIT (Ea accident) $ 500,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE ACCIDENT) $ _TER $ B X UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE CUG8437A 08/23/2011 08/23/2011 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 $ DED X RETENTION $ 0 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N N / A 83033894 03/25/2014 03/25/2015 X WC STATU- TORY LIMITS _ OTH- ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) C CANCELLATION CSCINTE CITY OF CLEARWATER 100 SOUTH MYRTLE AVE 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 0- E 14414 ACORD 25 (2010/05) ©1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD bn