CERTIFICATE OF LIABILITY INSURANCE (485)ALANS-1
OP ID: TM
A��RO CERTIFICATE OF LIABILITY INSURANCE
DATE 07 /02 /201 YY)
07102/2014
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
MORROW INSURANCE GROUP
LENORA C. OLNEY /A196064
18936 NORTH DALE MABRY HIGHWAY
TAMPA, FL 33548
NAME: MORROW INSURANCE GROUP
(alc °. No, Eat1:813- 963 -1669 FAX No): 813-9614743
E-MAIL DDSS: TEREASA@MORROWINSURANCE.NET
INSURER(S) AFFORDING COVERAGE
NAIC Y
INSURER A : AXIS SURPLUS INSURANCE CO
26620
INSURED ALAN'S ROOFING, INC
14498 PONCE DE LEON BLVD
BROOKSVILLE, FL 34601
INSURER B: AMERICAN STATES INS CO
19704
INSURER C:EVANSTON INSURANCE CO
X
INSURER D :
DAMAGETO
PREMISES (Ea REN occurrenceED )
INSURER E :
X
GEN'L
X
INSURER F :
MED EXP (Any one person)
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
INSD
SUBR
WVD
POLICY NUMBER
GL104843
POLICYEFF
(MMIDDIYYY Y)
. 07!11!2014
POLICYEXP
(MM1DDfYYYY )
07/11/2015
LIMITS
EACH OCCURRENCE
$ 1,000,000
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE
X
OCCUR
DAMAGETO
PREMISES (Ea REN occurrenceED )
$ 50,000
X
GEN'L
X
CONTRACTUAL LIAB
MED EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,000
AGGREGATE
POLICY
OTHER:
LIMIT APPLIES
PRO-
J
PER.
LOC
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMPIOPAGG
$ 2,000,000
$
B
AUTOMOBILE
X
X
X
LIABILITY
ANY AUTO
ALL OWNED
AUTOS
HIRED AUTOS
FL PIP
-
X
X
SCHEDULED
AUTOS
NON -OWNED
AUTOS
STATUTORY
-
01 C176263310
06/04/2014
06/04/2015
CO eBINEDISINGLE LIMIT
$ 1,000,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
BASIC PIP
$ 10,000
C
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
XOVA606513
07/11/2014
07/11/2015
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$
DED X RETENTION$ NONE
$
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 I A
PER
STATUTE
0TH -
ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS I LOCATIONS! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
OLDER
CANCELLATION
CITYCLR
City of Clearwater
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
ACORD 25 (2014/01)
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