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CERTIFICATE OF LIABILITY INSURANCE (531)1..ORDY CERTIFICATE OF LIABILITY INSURANCE . 09/22/201 /DDIYYYY► 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 Professional Insurance Services 3836 W. Hum hre St. P Y Tampa FL 33614 CONTACT NAME: Deborah M Dickerson AAI ACSR PHONE �,d): (813) 963 -6701 UFA No):(813) 356 -0951 E -MAIL deborah ADDRESS: @proinsuranceflorida.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Bridgefield Employers Insurance Company 10701 INSURED Westfall Construction Inc 5413 W Sligh Avenue Tampa FL 33634 INSURER B : CE RE CE CT0 • OCT C+ p' RECORDS OFFICIAL RECORDS LEGISLATIVE SRS/ INSURER C : INSURER D : $ INSURER E : S INSURER F : COVERAGES CERTIFICATE NUMBER01 REVISI 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 WV!) POLICY NUMBER POLICY EFF POLICY EXP IMM /DD/YYYY► LIMITS LIABILITY COMMERCIAL GENERAL LIABILITY CE RE CE CT0 • OCT C+ p' RECORDS OFFICIAL RECORDS LEGISLATIVE SRS/ `014 2014 �� ANC CS DEFT EACH OCCURRENCE $ DAMAGE TO RENTED PRFMISES (Fa occurrence) S CLAIMS -MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ G�E jN'L AGGREGATE LIMIT APPLIES -1 PRO- POLICY f PER: LOC PRODUCTS - COMP /OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ SCHEDULED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) S 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 D EMPLOYERS' LIABILITY Y/ N N / A 830 -53032 09/29/2014 09129/2015 X TARV i OMITS OFR E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER ER EXCLUDEED ?ECUTIT- (Mandatory in NH) III If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) City of Clearwater is named as Additional Insured with respect to General Liability. Attn: Building Department TIFICATE HOLDER CANCELLATION City of Clearwater 100 S. Myrtle Avenue Suite 2B 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