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CERTIFICATE OF LIABILITY INSURANCE (399)NELSTEN -01 AYOUNG H`...`_' —'`"—' CERTIFICATE OF LIABILITY INSURANCE DATE D/YYYY) 2/4/2014 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 Morse Insurance Agency, Inc 1000 Wekiva Springs Road Longwood, FL 32779 CONTACT • NAME: Deldra Malley PHONE 407 8 FAX lac, No. Ext): ( ) 69 -4200 (A/C, No): (407) 862 -7656 AD E-MAIL SS: dmalley @morseagency.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Hartford Fire Insurance Company LIABILITY COMMERCIAL GENERAL LIABILITY INSURED Nelson's Tents and Events, Inc. 1153 Ocoee Apopka Road Apopka, FL 32703 INSURER B : Mapfre Ins. Co. of Florida 21 CES OF5247 O F ICIA.. I F 4150130008480 INSURER C : Commerce & Industry Ins Co . 13 '4 dew @ i' yi g �rf ?° rte, &d' / 06/13/2013 INSURER D : Zenith Insurance Company 13269 INSURER E : Essex Insurance Co DAMAGE TO RENTED PREMISES (Ea occurrence) INSURER F : • • 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 POLIC ES 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 ADM INSR SUBR MID POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X 21 CES OF5247 O F ICIA.. I F 4150130008480 t, t° � 3✓ P FEB R4:0f ^ °� ,'iV'E S.�VCJ` . 13 '4 dew @ i' yi g �rf ?° rte, &d' / 06/13/2013 06/14/2014 06/13/2014 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 300,000 CLAIMS -MADE X OCCUR EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1 , 000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE 7 POLICY LIMIT APPLIES PRO- JECT PER: LOC PRODUCTS - COMP /OP AGG $ 2,000,000 COMBINED SINGLE LIMIT (Ea accident) $ $ 1,000,000 B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X X SCHEDULED AUTOS NON -OWNED AUTOS BODILY INJURY (Per person) $ BODILY INJURY (Per accident) ( ) $ PROPERTY DAMAGE (PER ACCIDENT) $ $ C X UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS -MADE BE012155062 06/14/2013 06/14/2014 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED X RETENTION $ 0 $ D WORKERS COMPENSATION AND AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below / N N / A Z071256303 02/07/2014 02/07/2015 X WC STATU- ORY LIMITS T701. - 0TH - °R E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,00 E Equipment Floater IMS28310 06/14/2013 06/14/2014 Scheduled 111,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) Property Deductibles: 3% wind /hail deductible/ $1000 AOP Certificate holder is listed as an Additional Insured with respects to the General Liability coverage. CERTIFICATE HOLDER City of Clearwater PO Box 4748 Clearwater, FL 33758 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