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CERTIFICATE OF LIABILITY INSURANCE (519)A`°R°5 CERTIFICATE OF LIABILITY INSURANCE 8�2��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 J Kevin Campbell Agency P 0 Box 9435 Panama City Beach FL 32417 CONTACT House NAME: PHONE .Entl: (800) 508 -9126 I (A/C. No): (877)234 -6089 noolle55:hbeckham @workcompspecialists.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:FFVA Mutual Insurance 10385 INSURED Prime Air Conditioning and Refrigeration, Inc. 6838 3rd St. N St. Petersburg FL 33702 INSURER B RECEIVE® SEP O 9 2014 OFFICIAL INSURERC: INSURERD: $ INSURER E : INSURERF: $ COVERAGES CERTIFICATE NUMBER:CL148508019 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 ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MMIDD/YYYY) LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY RECEIVE® SEP O 9 2014 OFFICIAL EACH OCCURRENCE $ PREMISES (Ea occurrence) MED person) $ CLAIMS -MADE OCCUR PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP /OP AGO GEN'L AGGREGATE 7 POLICY LIMIT APPLIES PER JE: LOC $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ SCHEDULED AUTOS NON -OWNED AUTOS 1GIg p�y(�_�'� Cep " -" DEP COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENT ON $ A WORKERS AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/ H N / A 30671 8/10/2014 8/10/2015 WC STATU- I TORY LIMITS OTH- ER E.L. EACH ACCIDENT $ 100 , 000 E.L. DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) CERTIFICATE HOLDER CANCELLATION City of Clearwater 100 S Myrtle Ave Clearwater, FL 33756 -5520 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 Kevin Campbell /HOLLY ACORD 25 (2010/05) INS025 femme/ 01 © 1988-2010 ACORD CORPORATION. All rights reserved. Tho At fPIl name and Inn aro ronictorort markc of A(:(1Rrt