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CERTIFICATE OF LIABILITY INSURANCE (516)WESTC -6 OP ID: BN '`�klase CERTIFICATE OF LIABILITY INSURANCE DATE 09 /02 /DDIYYYY) 09/02/2014 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 2653 McCormick Dr Insurance Group - Clrwtr 2653 Clearwater, FL 33759 John Hislop NAME: Gina Scolaro PHONE 727 -531 -6800 (A /C, No, ExtI: (NC No): 727- 531 -6855 E-MAIL ADDRESS: gscolaro @sihle.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A:OId Dominion Insurance Company 40231 INSURED West Coast Fence of Tampa Inc dba Allied Fence of Tampa Bay 4151 118th Avenue N Clearwater, FL 33762 INSURER B : Bridgefield Employers Ins. Co. 10701 INSURER C : 09/14/2014 INSURER D: EACH OCCURRENCE INSURER E : DAMAGE (RENTED PREMISES S (Ea occurrence) INSURER F : COVERAGES 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 ADDLSUBR INSR WVD POLICY NUMBER POLICY EFF (MMIDD/YYYYI POLICY EXP (MM/DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X MPG91 CE SEP0 8 2014 s' ® DS AND 09/14/2014 09/14/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE (RENTED PREMISES S (Ea occurrence) $ 500,000 CLAIMS -MADE X OCCUR MED EXP (My one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE 7 POLICY X LIMIT APPLIES F3- PER: LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ A AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS — X SCHEDULED AUTOS NON -OWNED AUTOS OFFICI "' B1 S(ATNE SRYCS DEPT 09/14/2014 09/14/2015 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE JPER ACCIDENT) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below -- YIN N / A - - 83041273 -" - 03/08/2014 03/08/2015 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 A Inland Marine MPG91540 09/14/2014 09/14/2015 Leased Eq 50,000 Inst Fltr 10,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule if more space is required) - Certificate Holder is included as Additional Insured with respects to General Liability as required by written contract. CERTIFICATE HOLDER CANCELLATION CLEARWA CITY OF CLEARWATER 100 SOUTH MYRTLE AVE CLEARWATER, FL 33756 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 bj n