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CERTIFICATE OF LIABILITY INSURANCE (513)ACOMA -1 OP ID: DAWN '�� —RLY CERTIFICATE OF LIABILITY INSURANCE DATE 08 /26 /2014 Y) 08/26/2014 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 SIHLE INSURANCE GROUP, INC. P. O. BOX 160398 ALTAMONTE SPRINGS, FL 32716 Kenneth G. Sihle CONTACT PHON: Gina Scolaro INC, No. Ext): 727-531 -6800 FAX No): 727 - 531 -6855 E -MAIL ADDRESS: g scolaro@sihie.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Bridgefield Employers Ins. Co. LIABILITY COMMERCIAL GENERAL LIABILITY 10701 13037 INSURED Acoma Roofing, Inc. Acoma Properties LLC 301 Douglas Road E. Oldsmar, FL 34677 -2922 INSURER B: The Cincinnati Specialty Und INSURER C : Westfield Insurance Co 24112 INSURER D : $ 1,000,000 INSURER E : $ 50,000 INSURER F : COVERAGES CERTIFICATE NUMB 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 SUER WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS B GENERAL — X LIABILITY COMMERCIAL GENERAL LIABILITY CSU0050346 RECEIVE` AUG 2 8 2014 OFFICIAL RECO /2014 S AND 08/24/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 50,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE 'L AGGREGATE POLICY X LIMIT APPLIES .IFa PER: LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ C AUTOMOBILE _ X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X X SCHEDULED AUTOS NON -OWNED AUTOS was I�L..ts�llrlfffJ�7 CWP16190 /`V�IV 4 07/17/2015 COMBINED SINGLE LIMIT (Ea accident) $ 1 000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE PER ACCIDENT) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER/EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N Y N / A 083042559 07/31/2014 07/31/2015 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) Santis Squitiro, License #CCC057320 CERTIFICATE HOLDER CANCELLATION CITYCL2 City of Clearwater ty PO 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 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DMD