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CERTIFICATE OF LIABILITY INSURANCE (521)AyRb® ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 9/8/2014 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 - Clrwtr 2653 McCormick Dr Clearwater FL 33759 CONTACT NAME: Dawn Davis PHONE 727- 531 -6800 FAX 727 - 531 -6855 (A/C, No, Fat) • (NC Noy 1-gfamddavis@sihle.com ADDRESS: �! INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:OId Dominion Insurance Company 40231 INSURED FLOR033 Florida Air Systems, Inc. 6600 E. Broadway Ave. Tampa FL 33619 INSURER B : Bridgefield Employers Ins Co. 10701 INSURER C : 9/24/2015 INSURER D $500,000 INSURER E : INSURER F : X COVERAGES CERTIFICATE NUMBER: 1819455743 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 WNTH 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 MD P I POLICY EFF (MM /DD/YYYY) POLICY EXP (MMIDD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY MPT4082L WED/24/2014 SEP11 2014 c /.� RECORDS AND Oi f ICIAL RECORDS AND � SLATIVE SRVCL^ �• �` J�rN 9/24/2015 EACH OCCURRENCE $500,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $50,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $500,000 GEN'L AGGREGATE POLICY OTHER: X LIMIT APPLIES JECCT PER: LOC GENERAL AGGREGATE $1,000,000 PRODUCTS - COMP/OP AGG $1,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED HIRED AUTOS SCHEDULED NON -OWNED AUTOS YF B1 T4082L 014 9/24/2015 (Ea ac NED SINGLE LIMIT (Ea accident) $ 500000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ X UMBRELLA LIAB EXCESS LIAB X 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 Y / N N N / A 83033894 3/25/2014 3/25/2015 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE $500,000 E.L. DISEASE - POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION 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 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD bjn