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CERTIFICATE OF LIABILITY INSURANCE (455)TAMPSCR -01 DGRECO AWRL 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 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 ASSOCIATES AGENCY, INC. 11470 N 53rd St Temple Terrace, FL 33617 CONTACT NAME: (PA/CNtJ , Ert): (813) 988 -1234 FAX No): (813) 988 -0989 EMAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : FCCI Commercial Ins. Co. 33472 INSURED Tampa Screens and Aluminum, Inc. & Tampa Outdoor Kitchen, LLC PO Box 272363 Tampa, FL 33688 INSURER B : FCCI INSURANCE CO. 10178 INSURER C : 12/1/2013 .1 INSURER D EACH OCCURRENCE INSURER E : PREMISES ( DAMAGE TO Ea RENTED occurrence) INSURER F : 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 POLIC ES 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 /DDYYY) POLICY EXP (MM /DD/YYYY) LIMITS A GENERAL X UABILITY COMMERCIAL GENERAL LIABILITY CPP0011780 4 `�'�a ^� ` 7 12/1/2013 .1 12/1/2014 EACH OCCURRENCE $ 1,000,000 PREMISES ( DAMAGE TO Ea RENTED occurrence) $ 100,000 CLAIMS -MADE X OCCUR MED EXP (My one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES PRO- JECT PER: LOG PRODUCTS - COMP /OP AGG $ 2,000.000 $ A AUTOMOBILE X X UABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ X SCHEDULED AUTOS NON -OWNED AUTOS ' ; __. CA 000 42 T` 1 "..7,,,,,L (` s 42/1/22013 12/1/2014 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 UAB X OCCUR CLAIMS -MADE UMB0011532 4 12/1/2013 12/1/2014 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 $ DED X RETENTION $ 10,000 B WORKERS COMPENSATION AND EMPLOYERS' UABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A 001 -WC13A -64290 5/15/2013 5/15/2014 X TWY TMIUT- S 0R - E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule If more space Is requIred) CERTIFICATE HOLDER CANCELLATION City of Clearwater 100 South Myrtle Avenue Clearwater, FL 33756 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