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CERTIFICATE OF LIABILITY INSURANCE (394)Client#: 1408579 131ATLANTOW ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 2/14/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. THIS POLICIES 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 BB&T -J. Rolfe Davis Insurance PO Box 4927 Orlando, FL 32802 -4927 407 691 -9600 CON NAME: TACT PHONE Ex: 691 -9600 FAX Ne), 888-6354183 E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Navigators Specialty Ins Co 36056 INSURED Atlantic Tower Services Inc dba ATS 2544 E Landstreet Rd #600 Orlando, FL 32824 INSURER B: Landmark American Insurance Co 33138 INSURER C: Hartford Insurance Company of S 38261 INSURER D: Hartford Casualty Insurance Com 29424 INSURER E : CLAIMS -MADE INSURER F : OCCUR UMBER: • 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 LIABILITY COMMERCIAL GENERAL LIABILITY X X GAI3CGL118222IC C FEB 2 4 2014 RD5Iv'� 12/14/2013 ��g 12/14/2014 EACH OCCURRENCE $1,000,000 $50,000 DAMAGE TO RENTED PREMISES Ea occurrence) CLAIMS -MADE X OCCUR MED EXP (Any one person) $Excluded X BI /PD Ded:5,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE 7 POLICY X LIMIT APPLIES PRO- JECT PER: LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ D AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -WNED AUTOS X X f 211ll + (�,j ) S CS idi- LEG1S� 2013 08/23/2014 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE X X LHA065893 12/14/2013 12/14/2014 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 $ DED X RETENTION $0 C 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 X 21 WBQT4607 02/19/2014 02/19/2015 X WC LI TORY Y LI MMIT ITS OTH- ER E.L. EACH ACCIDENT $1,000,000 $1,000,000 E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Additional Insured status is granted with respect General Liability if required by written contract per endorsement: Additional Insured - Owners, Lessees or Contractors- Scheduled Person or Organization, Form #CG20 10 07 04. Additional Insured status is granted with respect to Auto Liability if required by written contract per form: Auto policy Section II Liability Coverage, Form CA 00 01 03 06 Page 2 of 12. Umbrella is follow form. Primary & Non Contributory with respect to General Liability if required by written contract (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION City of Clearwater 100 S 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 ,x.44 V4� © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 2 The ACORD name and logo are registered marks of ACORD #S11859530/M11856651 MOCO DESCRIPTIONS (Continued from Page 1) per endorsement U407 -0707. The General Liability policy contains a severability of interest provision per endorsement: Cross Suits Exclusion, Form #U267 -0205. Contractual Liability- Railroads, Form #CG24 17 10 01; Crane operators & Riggers Property Damage Coverage Extension, Form U194 -0310. General Liability includes a Blanket Waiver of Subrogation per form U251 -0310; Auto Liability includes a Blanket Waiver of Subrogation per form PI -CA- 001(05/10). Workers Compensation includes a Blanket Waiver of Subrogation per form WC000313. SAGITTA 25.3 (2010/05) 2 of 2 #S11859530/M11856651