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CERTIFICATE OF LIABILITY INSURANCE (564)K &KEL -1 OP ID: MB '1�." '"' CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD /YYYY) 11/26/2014 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 Brown & Brown of Florida, Inc. P. O. Box 173086 Tampa, FL 33672 Joseph W. LoPresti CONTACT NAME: Mla BUSK (A c, No, Ext): 813- 226 -1337 FAX (A/C, No): 813- 226 -1313 E-MAIL ESS: mbush @bbtampa.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Amerisure Insurance Co. 19488 INSURED K &K Electric Inc 2517 Country Club Rd Sanford, FL 32771 INSURER B : Alterra America Insurance Co 21296 INSURER C 12/01/2015 INSURER D : $ 1,000,000 INSURER E : $ 1,000,000 INSURER F : • - - -- - -- r\L VI*J1Wr\ 1\VIIIr7CR. 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 CPP2090340 r " J V �0I ri n; a G k a LE J./.:s�k (r /2014 �� 4 12/01/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 1,000,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE I POLICY X LIMIT APPLIES PRO - JFST PER: LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ A AUTOMOBILE X X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS Comp 1,000 X X SCHEDULED AUTOS NON -OWNED AUTOS Coll 1,000 ., r - -.. La.:-LL-V1 e ,b,,'y CA 2090339 y.✓ :" $ f,,.J ..,, -.." $ 12/01/2014 12/01/2015 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (PER ACCIDENT) $ PIP $ 10,000 A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CU2090341 12/01/2014 12/01/2015 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DED X RETENT ON $ 0 $ A 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 / A WC2090342 - 12/01/2014 12/01/2015 X WC STATU- TORY LIMITS 0TH - ER E. L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Leased or Rented Equipment CPP2090340 12/01/2014 12/01/2015 Limit 150,000 Ea Item 150,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule if more space is required) See "Certificate Attachment -K &K Electric, Inc." dated 12 -1 -14 attached. CANCELLATION CITYCLE City of Clearwater P.O. 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 " . fLI i ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NOTEPAD INSURED'S NAME K &K Electric Inc K &KEL -1 PAGE 2 OP ID: MB Date 11/26/2014 CERTIFICATE ATTACHMENT -K &K ELECTRIC, INC. Coverage Form General Liability coverage form CG0001 applies. Additional Insured Certificate Holder is a General Liability Additional Insured and an Auto Liability Designated Insured, when required by written contract prior to the loss. Primary / Non - Contributory Additional Insured Primary and non - contributory General Liability Additional Insured provision applies, when required by written contract prior to the loss. Per Project General Aggregate General Liability Per Project General Aggregate applies Contractual Liability General Liability and Auto Liability Insured Contract contractual liability provisions apply. Separation of Insureds General Liability and Auto Liability Separation of Insureds provisions apply. Waiver of Subrogation Waiver of Transfer Of Rights Of Recovery Against Others To Us provision as respects General Liability, Auto Liability, Excess Liability & Workers Compensation applies in favor of Certificate Holder, when required by written contract prior to the loss. Excess Liability Underlying Insurance Excess Liability schedule of underlying insurance includes General Liability, Auto Liability, and Workers Compensation Employers Liability. 12 -1 -14