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POOL RESURFACING - NORTH GREENWOOD AND CLEARWATER BEACH FAMILY AQUATIC CENTER - 08-0020-PR-B - CERTIFICATE OF LIABILITY INSURANCEPINE -21 OP ID: LW Ate—""' CERTIFICATE OF LIABILITY INSURANCE DATE 11 /18D/YYYY) 11/18/13 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 Phone: 727 -461 -6044 Brown & Brown of Florida, Inc. 83 Park Place Blvd., Ste 101 Fax: 727 -442 -7695 P.O. Box 2456 (33757 -2456) Clearwater, FL 33759 Sean Tobe CONTACT NAME: (A/cC, No, Ext): FAX No): E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : FFVA Mutual Insurance Company 10385 INSURED Pinellas Pools Inc. 1234 Alternate 19 Holiday, FL 34691 INSURER B : Ohio Security Insurance Co. 24082 INSURER C : Hartford Casualty Insurance Co 29424 INSURER D : Hartford Underwriters Ins. Co. 30104 INSURER E : $ 1,000,000 INSURER F : $ 300,000 ERAGES CERTIFICATE 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/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS D GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY 21UEN0J2074 4 �r ! "` _' 1 , 1 2013 3 - 11/17/14 fI EACH OCCURRENCE $ 1,000,000 DAMAGETOU RENTED PREMISES (Ea occurrence) $ 300,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 X POP UP COVG GENERAL AGGREGATE $ 2,000,000 GE 'L AGGREGATE POLICY LIMIT APPLIES PRO- PER LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ B AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS vy 4p t 9� LEaSL I Y E 55812668B S v c, 7: 11'.x/ -' ( 11/17/14 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY P (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ C X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 21HHUOJ2075 11/17/13 11/17/14 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 DED X RETENTION $ 0 $ 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 / A WC84000289172013A 11/17/13 11/17/14 X WC STATU- TORY LIMITS OTH- 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) North Greenwood CERTIFICATE HOLDER CITYC -1 City of Clearwater y P. O. Box 4748 Clearwater, FL 33756 -5520 I 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