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CERTIFICATE OF LIABILITY INSURANCE (550)
RECEIVED SEP 0 3 2014 ACORD CERTIFICATE ‘.......-/- CERTIFICATE OF LIABILIT��ANCE DATE (MMIDDIYYYY) 9/2/2014 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 CGB Insurance, LLC 2531 Green Forest Lane #101 Lutz FL 33558 CONTACT Audra Browder NAME: (PHC N Est): (813) 749 -7948 FA (E413) No): (813)200 -2120 E DD IIESS:audra @egbinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERAOhio Casualty 24074 INSURED Florida Gas & Plumbing, Inc 3200 Park St St Petersburg FL 33710 INSURER B :Oh iO Security Insurance Company 03491 INSURERC: 9/8/2015 INSURERD: $ 1,000,000 INSURER E : $ 100 000 INSURERF: $ 10,000 COVERAGES CERTIFICATE NUMBER:2014 -2015 Master 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 /DDIYYYY) POLICY EXP (MM /DD /YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY BLO 54246855 9/8/2014 9/8/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100 000 MED EXP (Any one person) $ 10,000 CLAIMS -MADE X OCCUR PERSONAL &ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY n IFS.T n LOC $ B AUTOMOBILE LIABILITY ANY AUTO ALLOWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON-OWNED AUTOS BAS 54246855 9/8/2014 9/8/2015 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 $ BODILY INJURY (Per person) BODILYINJURY(Peraccident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAB EXCESS LIAB _ OCCUR CLAIMS -MADE (JSO 54246855 9/8/2014 9/8/2015 EACH OCCURRENCE $ 1, 000, 000 AGGREGATE $ 1,000,000 $ DED X RETENTION $ 10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABIL TY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A I TORY LIMITS I I0T ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedu e, if more space is required) Clearwater Gas is listed as additional insured for general liability purposes only CERTIFICATE HOLDER CANCELLATION bruce . griffin@ clearwaterga Clearwater Gas Bruce Griffin 400 N Myrtle Ave Clearwater, FL 33755 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 '- Kraig Blancher /AMANDA ACORD 25 (2010/05) INS025 smnnyi m © 1988-2010 ACORD CORPORATION. All rights reserved. The AC:(1Rr1 nnma mnri Inns ire raniciarari mmrlrc of A('fQrl