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CERTIFICATE OF LIABILITY INSURANCE (444)PLATI -1 OP ID: SV '-'�.� —"" CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD/YYYY) 11/21/2013 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 Ramey Insurance Inc 4130 Woodmere Park Blvd Ste 9 Venice, FL 34293 Terri Ramey CONTACT NAME: Shannon Via PHONE (a/c, No. Ext):941- 497 -2468 FAX No): 941 -493 -5775 ADDRESS: Shannon rame inc.com Y INSURER(S) AFFORDING COVERAGE NAIC # INSURER A:AIIied Property & Casualty Ins 42579 INSURED The Platinum Group, Inc. Anton C Rochek (EC0001672) Donald H Rohl (CBCO21020) Shannon C Rohl (08M000407) Shannon & Alison Rohl 733 Commerce Drive Ste 3 Venice, FL 34292 INSURER B : AmTrust North America 1 µ�, .�-,�r' R a \:.,... INSURER C : 4/2013 6 FY: '' INSURER D : EACH OCCURRENCE INSURER E : 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 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 ADDLSUBR INSR W VD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POUCY EXP (M LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY ACPGLDO5905 1 µ�, .�-,�r' R a \:.,... _ - I 4/2013 6 FY: '' 03/04/2014 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 CLAIMS MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE X 'L AGGREGATE POLICY LIMIT APPLIES PRO JECT PER: LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X X SCHEDULED AUTOS NON -OWNED AUTOS — o °vs o. pp ",�� r, g ? 7,.. v:'ti v'w� ACPBAPD59053 *4820k � dnu��.' J f 'r^" pp /1 20)1 3 03/04/2014 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) ( ) $ PROPERTY DAMAGE (PER ACCIDENT) $ $ A X UMBRELLA UAB EXCESS LIAR X OCCUR CLAIMS -MADE ACPCAP5905381820 03/04/2013 03/04/2014 EACH OCCURRENCE $ 3,000,000 AGGREGATE $ DED RETENTION $ $ 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 y N / A AWC1027052 11/14/2013 11/14/2014 X WC STATU- TORY LIMITS TH 0- 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 Installation Float ACPCIMP5905381820 03/04/2013 03/04/2014 Exposure 50,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule If more space is required) ERTIFICATE HOLDER CANCELLATION C LEAR01 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