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CERTIFICATE OF LIABILITY INSURANCE (448)ACORO CERTIFICATE OF LIABILITY INSURANCE ‘...../ DATE (MM/DD/YYYY) 09/17/2013 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 W.F. DAVISON, AGENT Commercial & Home Insurance Inc 5635 49th Street N St Petersburg FL 33709- CONT NAMEACT For Certificates: Victoria or Jamie PHOE FAX ,AICN No, Ect): (727) 527 -5700 INC , No): (727) 527 -6255 ADDRESS: PRODUCER CUSTOMER ID /AR oof Masters Preferred Inc INSURER(S)AFFORDINGCOVERAGE INSURER A :WESTERN WORLD /FHBIA NAIC# INSURED Roof Masters Preferred Inc- 7301 6th Avenue N St Petersburg FL 33710 -7535 INSURER B :BRIDGEFIELD /SUMMIT LIABILITY COMMERCIAL GENERAL LIABILITY INSURER C :OLD DOMINION INSURANCE CO INSURER D : PGP0763440 •--1r= INSURER E : 09/16/2013 / / / / / / / / / / / / INSURER F : EACH OCCURRENCE 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 (MMIDO/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY OCCUR PGP0763440 •--1r= j - --, 09/16/2013 / / / / / / / / / / / / 03/04/2014 / / / / / / / / / / / / EACH OCCURRENCE $ 300,000 X PR S (RENTED PREEMIMI E SES (Ea occurrence) $ 100,000 CLAIMS -MADE X MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 300,000 GENERAL AGGREGATE $ 600,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 600,000 X PRO - POLICY ECT I LOC NO $ C AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS B1G7102A I�r -, .. _. . s.,., ... 07/09/2013 / / / / / / / / /, / ,f` / 07/09/2014 / / / / / / / / / / / / COMBINED SINGLE LIMIT (Ea accident) $ 100,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ X X $ $ UMBRELLA LIAB EXCESS UAB OCCUR CLAIMS -MADE / / / / / / / / / / / / / / / / EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS Y / N N / A Oif30 -44737 04/13/2013 / / / / / / 04/13/2014 / / / / / / WC STATU- 0TH - �. X . TGRY LIM I i,� E.L. EACH ACCIDENT _ $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 below E . DISEASE - POLICY LIMIT $ 500,000 / / / / / / / / DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks ROOFING CONTRACTOR Schedule, if more space is required) W.F. DAVISON, AGENT CERTIFICATE HOLDER CANCELLATION ( ) CITY OF CLEARWATER 100 S. MYRTLE AVENUE 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 (2009/09) I NS025 (200909) © 1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD