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CERTIFICATE OF LIABILITY INSURANCE (498)ACORO® CERTIFICATE OF LIABILITY INSURANCE `.------ DATE(MM/DD/YYYY) 07/16/2014 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 South Pointe Insurance Services 3660 Erindale Drive Valrico FL 33596 NAMEACT Ashley Zinke tai N , Ext): (813) 661 -0382 FAX No); 866 - 614 -8947 EMAIL di isfla.com ense s ADDRESS: denise@spisfla.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : FCCI INSURANCE CO 10178 INSURED Power Electric Services, Inc. 4714 E Hillsborough Ave Tampa FL 33610 INSURER B : GL 00157 FECE1VED JUL 2 9 2014 INSURER C : 08/09/2015 INSURER D : $ 1,000,000 INSURER E : $ 100,000 INSURER F : $ Excluded 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 ADDLSUBR INSR, WVD POLICY NUMBER POLICY EFF (MM /DO/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY GL 00157 FECE1VED JUL 2 9 2014 08/09/2014 08/09/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ Excluded CLAIMS -MADE X OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 GE X 'L AGGREGATE POLICY LIMIT APPLIES PRO- PER: LOC $ A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED NON OWNED AUTOS C RECORDS LEGISLATIVE SRS CA 0024911 AND DEPT 08/09/2014 08/09/2015 (Ea COMBINED SINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE UMB00117285 08/09/2014 08/09/2015 EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,000 $ DED X RETENT ON $ 10,000 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY YIPROPRIETO LU ECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below YNN N / A 001 -W C 13A -71039 08/09/2014 08/09/2015 X WC STATU- TORY LIMITS OTH- ER 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 PO Box 4748 Clearwater FL 33758 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