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CERTIFICATE OF LIABILITY INSURANCE AND EVIDENCE OF PROPERTY INSURANCEACCORD CERTIFICATE CERTIFICATE OF LIABILITY INSURANCE DATE(MMDD/YYYY) 01/01/2014 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 Arthur J. Gallagher RMS, Inc. 2 Pierce Place Itasca IL 60143 CONTACT NAME: Camerina Munoz PHONE N . Ext): FAX No): E -MAIL ADDRESS: camerina_munoz(©ajg corn INSURER(S) AFFORDING COVERAGE NAIL # INSURER A: FL Housing Authorities Risk Mgmt Insureds LIABILITY COMMERCIAL GENERAL LIABILITY INSURED Pinellas County Housing Authority 11479 Ulmerton Rd Largo FL 33778 INSURER B : FHARMI14 INSURER C 01/01/2014 INSURER D : EACH OCCURRENCE INSURER E : DAMAGE TO RENTED PREMISES (Ea occurrence) INSURER F : MED EXP (Any one person) 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 A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY FHARMI14 1' 01/01/2014 01/01/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ CLAIMS -MADE X OCCUR PERSONAL &ADVINJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP /OP AGG $ GEN'L AGGREGATE POLICY LIMIT APPLIES PER: PRO- JECT LOC $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS r a - = ..... w G" :'' "° U, °` `44. W J oe = ` ! °y ,..1; j (Eaacccl debt) SINGLE LIMIT $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICE /MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Norton Apartments located at 1450 S Martin Luther King Ave., Clearwater, FL 33756 City of Clearwater is shown as additional insured with regards to the general liability coverage pertaining to the Norton Apartments; as per FHARMI14 Scope of Coverage Document. CERTIFICATE HOLDER CANCELLATION 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. n � AUT IZIZED REP7SENTATIVE ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD EVIDENCE OF PROPERTY INSURANCE `,...----- DATE(MM/DD/YYYY) 01/01/2014 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. AGENCY PHONE (NC. No. Ext): COMPANY FL Housing Authorities Risk Mgmt Insureds Arthur J. Gallagher RMS, Inc. 2 Pierce Place Itasca IL 60143 FAX E -MAIL (A/C, No): ADDRESS: CODE: SUB CODE: AGENCY CUSTOMER ID #: INSURED Pinellas County Housing Authority 11479 Ulmerton Rd Largo FL 33778 LOAN NUMBER 11785 -1 POLICY NUMBER FHARMI14 EFFECTIVE DATE 01/01/2014 EXPIRATION DATE 01/01/2015 CONTINUED UNTIL IF CHECKED TERMINATED THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION LOCATION /DESCRIPTION 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 EVIDENCE OF PROPERTY INSURANCE 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. COVERAGE INFORMATION COVERAGE / PERILS / FORMS AMOUNT OF INSURANCE DEDUCTIBLE 1450 S Martin Luther King Ave, #201 -207, Clearwater FL 33756 559,718 1,000 1450 S Martin Luther King Ave, #301 -307, Clearwater FL 33756 560,462 1450 S Martin Luther King Ave, #401 -408, Clearwater FL 33756 617,953 LOAN # 11785 -1 1450 S Martin Luther King Ave, #501 -506, Clearwater FL 33756 680,669 A OR¢ED E 1450 S Martin Luther King Ave, #601 -608, Clearwater FL 33756 615,185 1450 S Martin Luther King Ave, #701 -712, Clearwater FL 33756 664,493 1450 S Martin Luther King Ave, Clearwater FL 33756 137,015 REMARKS (Including Special Conditions) "All Risk ;" Subject to standard policy exclusions Replacement Cost Valuation Policy does not include co- insurance City of Clearwater is shown as loss payee pertaining to the Norton Apartments; as per FHARMI14 Scope of Coverage Document. CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. NAME AND ADDRESS City of Clearwater PO Box 4748 Clearwater FL 33758 MORTGAGEE LOSS PAYEE ADDITIONAL INSURED X LOAN # 11785 -1 A OR¢ED E SENT1ITIVE eX. / ), Lie tJ t� ACORD 27 (2009/12) © 1993-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD