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CERTIFICATE OF LIABILITY INSURANCE (561)nts: WEST ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DDrYYYY) 11/24/2014 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 Bouchard Insurance (CLW) 101 N Starcrest Dr. Clearwater, FL 33765 727 447 -6481 CONTACT NAME: PHONE 727 447 -6481 F4X 727 449 -1267 (A/C, No, Exq: (A/C, No): E-MAIL cicerts@bouchardinsurance.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIL # INSURER A : Nationwide Mutual Fire Ins Co 23779 INSURED West Coast Fence Corp 6500 49th St N Pinellas Park, FL 33781 INSURER B : Bridgefield Employers Ins Co 10701 INSURER C : 11/30/2015 INSURER D : $1,000,000 INSURER E : $100,000 INSURER F : $5,000 COVERAGES CERTIFICATE NUMBER: 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 W VD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY Y Y ACP5934727016 11/30/2014 11/30/2015 EACH OCCURRENCE $1,000,000 PREMISESO(Ea olccu RENTED $100,000 MED EXP (Any one person) $5,000 CLAIMS -MADE X OCCUR PERSONAL 8 ADV INJURY $1,000,000 X PD Ded:250 GENERAL AGGREGATE $1,000,000 PRODUCTS - COMP /OP AGG $1,000,000 GE 'L AGGREGATE POLICY X LIMIT APPLIES PRO JECT PER: LOC $ A AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS AUUTOSWNED ACP5934727016 11/30/2014 11/30/2015 COMBINED accident) SINGLE LIMIT (Ea $ 500,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ (Perr accident) DAMAGE $ $ UMBRELLA LIAB EXCESS LIAB 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 083018913 06/30/2014 06/30/2015 X 7pRYTLIMITS OTH- ER E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE $500,000 E.L. DISEASE - POLICY LIMIT $500,000 A Leased /Rented Equipment ACP5934727016 11/30/2014 11/30/2015 $35,000 .�" /"" t"1 DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) A S v �'` ....: a.,. ,,, a " ) (See Attached Descriptions) � :„....7:;'''T CERTIFICATE HOLDER CANCELLATION CITY OF CLEARWATER CENTRAL PERMITTINGP 0 BOX 4748 CLEARWATER, FL 33758 -0000 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) 1 of 2 #S51887/M51844 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BRIBO WEST ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE D/YYYY) /24/2014 11/24/2014 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 Bouchard Insurance (CLW) 101 N Starcrest Dr. Clearwater, FL 33765 727 447 -6481 CONTACT NAME: PHONE FAX (A/C, No, Ext): (A/C 727 447 -6481 (NC 727 449 -1267 , No): E-MAIL cicerts@bouchardinsurance.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC It INSURER A : Nationwide Mutual Fire Ins Co 23779 INSURED West Coast Fence Corp 6500 49th St N Pinellas Park, FL 33781 INSURER B : Bridgefield Employers Ins Co 10701 INSURER C : 11/30/2015 INSURER D : $1,000,000 INSURER E : $1 0O 000 , INSURER F : $ 5,000 COVERAGES CERTIFICATE NUMBER: 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 (MM /DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY Y Y ACP5934727016 11/30/2014 11/30/2015 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $1 0O 000 , MED EXP (Any one person) $ 5,000 CLAIMS -MADE X OCCUR PERSONAL & ADV INJURY $1,000,000 X PD Ded:250 GENERAL AGGREGATE $1,000,000 PRODUCTS - COMP /OP AGG $1,000,000 GEN'L AGGREGATE LIMIT APPLIES POLICY n jEei PER: LOC $ A AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS ACP5934727016 11/30/2014 11/30/2015 COMaccideBINED nt) SI NGLE LIMIT (Ea $ 500,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY (Per ac accident) ( ) $ $ UMBRELLA LIAB EXCESS LIAB _ 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 083018913 06/30/2014 06/30/2015 X WC STAT TS H ER E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE $500,000 E.L. DISEASE - POLICY LIMIT $500,000 A Leased /Rented Equipment ACP5934727016 11/30/2014 11/30/2015 $35,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is requir C77, .. ...�' (See Attached Descriptions) f a:�+ ., V L • i i N W.1 I CITY OF CLEARWATER PO Box 4748 Clearwater, FL 33756 -0000 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) 1 of 2 #S51886/M51844 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BRIBO