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CERTIFICATE OF LIABILITY INSURANCE (482)PENIMEC -01 TTODD 4 4CCPREY CERTIFICATE OF LIABILITY INSURANCE `--f DATE D/YYYY) 7/1/2014 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 ASSOCIATES AGENCY, INC. 11470 N 53rd St Temple Terrace, FL 33617 CONTACT NAME: PHONE Exc►: (813) 988 -1234 ra, No): (813) 988 -0989 E -MAIL ADDRESS: INSURERS) AFFORDING COVERAGE NAIC q INSURER A: Southern Owners Insurance Co 10190 INSURED Peninsular Mechanical Contractors, Inc. 13690 Roosevelt Boulevard Clearwater, FL 33762 INSURER S: OWNERS INSURANCE CO. 32700 INSURER C : 07/01/2015 INSURER D : $ 1,000,000 INSURER E : INSURER F : X 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 INSD SUBR WVD POLICY NUMBER (MM/DD�YY) (MMIDD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 20917050 07/01/2014 07/01/2015 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE PREMISETO S (Ea RENTED ocwrrence) $ 300,000 X Contractual Liab. MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L X AGGREGATE POLICY OTHER: LIMIT APPLIES PRO PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 $ B AUTOMOBILE X X LIABILITY ANY AUTO • ALL OWNED AUTOS HIRED AUTOS X — SCHEDULED AUTOS NON -0WNED AUTOS 49- 917050 -00 07/01/2014 07/01/2015 COMBa MSINGLE LIMIT (Ea $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAB EXCESS UAB X OCCUR CLAIMS -MADE 14 -304 07/01/2014 07/01/2015 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 $ DED RETENT ON $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below / N N / A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A Leased/Rented Equip 20917050 07/01/2014 07/01/2015 $500 deductible 50,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H more space is required) GL- Additional Insured - Owners, Lessses or Contractors- Automatic Status when Required in Construction Agreement wiht Blanket Additional Insured Form #55373. Blanket Waiver of Subrogation CG 2404 CERTIFICATE HOLDER CANCELLATION I City of Clearwater ty P.O. Box 4748 Clearwater, FL 34618 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 J � ` ACORD 25 (2014/01) ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABIUTY 55373 (1 -07) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM. A. Under SECTION It - WHO IS AN INSURED, the following is added: A person or organization is an Additional Insured, only with respect to liability arising out of 'your work' for that Additional insured by or for you: 1. if required in a written contract or agreement; or 2. if required by an oral contract or agreement only if a Certificate of insurance was issued prior to the loss indicating that the person or organization was an Additional Insured. B. Under SECTION ill - LIMITS OF INSURANCE, the following is added: The limits of liability for the Additional Insured are those specified In the written contract or agree- ment between the insured and the owner, lessee or contractor or those specified in the Certificate of Insurance, if an oral contract or agreement, not to exceed the limits provided in this policy. These limits are inclusive of and not in addition to the limits of insurance shown in the Declarations. C. SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Is amended as follows: 1. The following provision is added to 4. Other Insurance: This Insurance is primary for the Additional insured, but only with respect to liability aris- ing out of 'your work' for that Additional In- , sured by or for you. Other insurance avail- able to the Additional Insured will apply as excess insurance and not contribute as pri- mary insurance to the insurance provided by this endorsement. 2. The following provision is added: Other Additional insured Coverage Issued By Us if this policy provides coverage for the same loss to any Additional Insured specifically shown as an Additional Insured in another endorsement to this policy, our maximum limit of insurance under this endorsement and any other endorsement shall not exceed the limit of insurance in the written contract or agree- ment between the insured and the owner, les- see or contractor, or the limits provided in this policy, whichever is less. Our maximum limit of insurance arising out of an 'occurrence', shall not exceed the limit of insurance shown in the Declarations, regardless of the number of insureds or Additional Insureds. All other policy terms and conditions apply. Includes copyrighted material of Insurance Services Office, Inc.. with its permission. Copyright Insurance Services Office, inc., 1984, 2003. Page 1 of 1