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CERTIFICATE OF LIABILITY INSURANCE (568)12/12/2014 09:49 FROM: 7278192543 -TO: City of Clearwater @17275624052 Page: 1 of 1 GULF2 -1 OP ID: GM .,_,L.:_______.,_...-....._, CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD/YYYY) 12110!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 3arrett Harding Insurance Inc. 10014 Grove Dr. Ste A port Richey, FL 34668 3arrett Harding Insurance Inc. CONTACT NAME: Barrett Harding Insurance Inc. 172.141L. Extl: 727-863 -1149 FAX No): 727 - 819 -2543 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIL II INSURER A : Covington Specialty VBA326341 INSURED Gulf 2 Bay LLC 7922 Leo Kidd Ave Port Richey, FL 34668 INSURER B : EACH OCCURRENCE INSURER C CLAIMS -MADE I - I OCCUR INSURER D : I X i. 2000 dedt. INSURER E : $ 5,000 INSURER F : PERSONAL & ADV INJURY OVERAGES 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 LTR TYPE OF INSURANCE ROUE INSD SUER WVD POLICY NUMBER POLICY EFF I IMM/OD/YYYY) POLICY EXP IMMIDO/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY VBA326341 09!12!2014 09/12/2015 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE I - I OCCUR DAMAGE TO RENTED 1OO 000 PREMISES (Ea occurrEnce)_1 5 , I X i. 2000 dedt. MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE X j POLICY OTHER* LIMIT APPLIES .JECT PER LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGO $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AU I ALL OWNED AUTOS HIRED AUTOS - _ SCHEDULED AUTOS NON -OWNED AUTOS CUMI)INtU SINGLE LIMI I (Ea accident) $ BODILY INJURY (Per per am) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident) $ $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED i I RETENT ON $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) H yes, describe under DESCRIPTION OF OPERATIONS below / N NIA PER STATUTE 0TH - ER E.L EACH ACCIDENT $ E.L. DISEASE - kA EMPLOYEE. $ E.L.. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) :lass code - 98677 Roofing, Class code 91344 Remodelers .iceneetl CGC1508594 ..icense #CCC1329609 ,icensee - Francis H. Furman * *CORRECTED CERTIFICATE ** CERTIFICATE HOLDER CANCELLATION CITYCLW City of Clearwater Fax # 727 - 562 -4052 100 So. Murtle 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 ACORD 25 (2014!01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD