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CERTIFICATE OF LIABILITY INSURANCE (408)AIRNA -1 OP ID: SW �'� -'�"' CERTIFICATE OF LIABILITY INSURANCE DAT01 /14DIYYYY) 01 /14/14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. HOLDER. THIS BY THE POLICIES AUTHORIZED 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 Phone: 727 - 461 -6044 & Brown of Florida, Inc. 83 Park Place Blvd., Ste 101 Fax: 727 -442 -7695 P.O. Box 2456 (33757 -2456) Clearwater, FL 33759 Dana R. Ludwig COMNTACT Sara Walczykiewicz NAE: rykiewicz FAX No): 727 -450 -7084 (PcNo, Ext): ADDRESS: swalczykiewicz @bbpineilas.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :Zenith Insurance Company 13269 INSURED Air National LLC Attn: Barry Andrews 1002 West Busch Blvd Tampa, FL 33612 wwvr•w . w�.. _ INSURER B : INSURER C INSURER D : MED EXP (Any one person) INSURER E : INSURER F : PERSONAL & ADV INJURY • - -" "' "" RCVIOIVIY IIIUm6CR: 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 GENERAL TYPE OF INSURANCE LIABILITY COMMERCIAL GENERAL LIABILITY ADDL INSR SUBR WVD POLICY NUMBER iTh fah / _ r , __ , , r , J �� a.3d .c✓4 POLICY EFF (MM /DD/YYYY) . POLICY EXP (MM /DD/YYYY) LIMITS EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) $ CLAIMS -MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE 7 POLICY LIMIT APPLIES PER: JE0 n LOU PRODUCTS - COMP /OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ SCHEDULED AUTOS NON -OWNED AUTOS N v ty mot° ' -• 9 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENT ON $ $ 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 Ml083002 04/22/13 12106/13 X WC STATU- TORY LIMITS 0TH - 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) PCDTIGIP A• C uAI r.r•r. ANCELLATION CITYCLW 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 ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD