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CERTIFICATE OF LIABILITY INSURANCE (440)CERTIFICATE OF LIABILITY INSURANCE MJMEL -1 OP ID: RC DATE (MM /DD/YYYY) 10/25/2013 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 Brown & Brown of Florida, Inc. P. O. Box 173086 Tampa, FL 33672 Barrett Brown INSURED MJM Electric, Inc. 3225 East 4th Avenue Tampa, FL 33605 COVERAGES Phone: 813- 226 -1300 Fax: 813- 226 -1313 CNTA NAME: CT Rosanna Castro PHONE (A/C, No. Extl: 813472 -7020 ADDRESS: rcastro @bbtampa.com FAX No): 813- 226 -1313 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : WESTFIELD INSURANCE COMPANY 24112 INSURER B : AmeriSUre Insurance Co. 19488 INSURER C : Travelers Prop Cas of Amer 25674 INSURER D : INSURER E INSURER F : • THIS INDICATED. CERTIFICATE EXCLUSIONS INSR _" - . ... _... — KC V IDIUN NUMtItk: IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER CMM4570646 '(3,.— r° `� L ^ �" { r �.1°`i ICI RECORDS LEOIS .�.FgVE S�®;t„r CMM4570646 v =� i9 POLICY EFF (MM /DD/YYYY) ���///ppp 013 (j �l 2013 r AND 6q- 7 f �j� POLICY EXP (MM /DD/YYYY) 11/01/2014 11/01/2014 LIMITS EACH OCCURRENCE $ 1,000,000 A A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES occurrence) $ 150,000 CLAIMS -MADE X OCCUR (Any MED EXP (Any one person) $ 10,000 X $5,000 PD DED PERSONAL & ADV INJURY $ 1,000,000 Contractual Liab GENERAL AGGREGATE $ 2,000,000 GEN 'LAGGREGATELIMITAPPLIESPER:4> 7 POLICY n 78: LOC PRODUCTS - COMP /OP AGG $ 2,000,000 Emp Ben. COMBINED SINGLE LIMIT (Ea accident) 1,000,000 $ 1,000,000 A AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS AU NON TOS -OWNED BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CMM4570646 11/01/2013 11/01/2014 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED X RETENTION $ 0 $ B 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 WC 2079615 -01 11/01/2013 11/01/2014 X WC STATU- TORY LIMITS 0TH - ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000 000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 A C Leased Equipment Install Floater CMM4570646 QT660216P018 11/01/2013 11/01/2013 11/01/2014 11/01/2014 Leased 300,000 Install 1,500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule if more space is required) 0,1 InTIrIA A T•■..w• w...• CANCELLATION CITYOFC 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