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CERTIFICATE OF LIABILITY INSURANCE (390)ELITE -1 OP ID: AC '`+� °ROW CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD/YYYY) 02/27/2014 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 West Coast Insurance, Inc. 8377 Gunn Highway Tampa, FL 33626 GEORGE LACKEY CONTACT NAME: PHONE FAX (A/C. No. Ext: (A/C, No): EMAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:BRIDGEFIELD EMPLOYERS INS. CO. 10701 INSURED ELITE ROOFING SERVICES, INC. P.O. BOX 89848 TAMPA, FL 33689 INSURER B: AXIS SURPLUS INSURANCE CO. 030114 PP��,, L.F01 /! Gti "w `4L INSURER C: HANOVER INSURANCE COMPANY 22292 INSURER D : $ 1,000,000 INSURER E : $ 50,000 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 SUBR WVD POLICY NUMBER POLICY EFF (MM/DD /YYYYL, POLICY EXP (MM /DD /YYYY) LIMITS B GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY 030114 PP��,, L.F01 /! Gti "w `4L 014 % 6 ..Y 03/01/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 50,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 1,000,000 GE 'L AGGREGATE POLICY LIMIT APPLIES PRO- PER: LOC $ C AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS a�imp �w'°E Ai AZJ9429886 ' d u ., :.' �r. .. wb..,.., 2014 02/08/2015 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (PER ACCIDENT) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE Y / N OFFICER /MEMBER EXCLUDED? n (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 830 -38045 06/06/2013 06/06/2014 X WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule it more space is required) CITYCLE CITY OF CLEARWATER PO 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 ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD