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CERTIFICATE OF LIABILITY INSURANCE (530)FOUNT -9 OP ID: DJ '"'�� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 09/25/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. HOLDER. THIS BY THE POLICIES AUTHORIZED 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 Phone: 305-364-7800 BROWN & BROWN OF FLORIDA INC 14900 NW 79th Court Suitet#200 Fax: 305 - 714 -4401 Miami Lakes, FL 33016 -5869 Ramon A Rodriguez CONTACT NAME: PHONE FAX (NC No. Ext): (A/C No): EMAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC S INSURER A : *Zurich American Insurance Co. 16535 INSURED Fountain Engineering Inc Attn: Calicia Landry 21050 sw 172nd Ave Miami, FL 33187 "f1\ /Gm A face. --- . -. - - -- --- . - - - -- INSURER B :*Bridgefield Employers Ins Co 10701 INSURER C EACH OCCURRENCE INSURERD: DAMAGES (RENTED PREMISES (Ea occurrence) INSURER E : INSURER F : CLAIMS -MADE -- - - — - -- -- - - - - - RC1/h71VI7 rumDCR: 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 DM SUBR wvn POLICY NUMBER POLICY EFF (MM/DD/YYYYI POLICY EXP (MMIDD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY GL05746883 �r� �r SEP 2 9 201 �0 /23/2014 4 03/23/2015 EACH OCCURRENCE $ 1,000,000 DAMAGES (RENTED PREMISES (Ea occurrence) $ 300,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP /OP AGG $ 1,000,000 $ 2,000,000 $ 2,000,000 GEN'L AGGREGATE 7 POLICY X LIMIT APPLIES jF PER: p RECORDS p�� OFFICIAL AND LOC A AUTOMOBILE X X LIABILITY LEGISLATIVE SRrCS DEPT BAP5746882 03/23/2014 03/23/2015 (Ea acBINEDtSINGLE LIMIT $ 1,000,000 ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -0W NED AUTOS BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LWB EXCESS LIAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N 083075369 10/01/2014 10/01/2015 X W C STATU- TORY LIMITS OTH- ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N I A E.L. EACH ACCIDENT $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Equipment Special Form; RC IM5746884 03/23/2014 THEFT INCLUDED 03/23/2015 Leased/ 250,000 Rented DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) f'Gnr.r.n A T, • Iw• wow CANCELLATION CLEARWA 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