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CERTIFICATE OF LIABILITY INSURANCE (576)APLUS -5 OP ID: GO AC®RL7' 4._.- -- CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 12/18/2014 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 Phone: 813 - 818 -5300 Stahl & Associates Insurance 3939 Tampa Road Fax: 813 - 818 -5396 Oldsmar, FL 34677 Michael Pagano, AAI NAMEACT Sue Goodman FAX (A/C, No, ExtI: 813 - 818 -5350 (A/C, No): 813- 818 -5396 E -MAIL ADDRESS: sue.goodman @stahlinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A:Owners Insurance Company 32700 INSURED A Plus Fireplaces Granite & Marble Inc 8133 Ridge Road Port Richey, FL 34668 INSURER B : Bridgefield Employers Ins. Co. 10701 INSURER C : Southern Owners 10190 INSURER D : $ 1,000,000 INSURER E : $ 300,000 INSURER F : $ 10,000 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 C GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY 20264567 09/12/2014 09/12/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE SESO(Ea occurrence) $ 300,000 MED EXP (Any one person) $ 10,000 CLAIMS -MADE X OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 GEN'L AGGREGATE 7 POLICY X LIMIT APPLIES JFR PER LOC Emp Ben. $ 1,000,000 A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS 4928099401 09/12/2014 09/12/2015 COMBINED SINGLE LIMIT (Ea accident) 1000,000 $ , BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per 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 I N / A 083049754 01/01/2015 01/01/2016 X WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule if more space is required) Certified Residential Contractor #CRC052388 - Guido Mancini CITYCLI City of Clearwater Finance Dept. PO Box 4748 Clearwater, FL 34618 -4748 I 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 ��//�� `��/14-, 'ela< r,0-. 0 �OO ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD APLUS -5 OP ID: GO ACORLO' CERTIFICATE OF LIABILITY INSURANCE `V-- DATE(MM /DD/YYYY) 09/04/2014 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 Phone: 727 - 784 -8554 Stahl & Associates Insurance 3939 Tampa Road Fax: 727 - 789 -2823 Oldsmar, FL 34677 Michael Pagano, AAI CNT NAMEACT Sue Goodman PHONE FAX No, Ext): 813 - 818 -5350 (A/c, No): 813- 818 -5396 E -MAIL g ADDRESS: sue. oodman stahlinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A:Owners Insurance Company 32700 INSURED A Plus Fireplaces Granite & Marble Inc 8133 Ridge Road Port Richey, FL 34668 INSURER B : Bridgefield Employers Ins. Co. 10701 INSURER C : Southern Owners 10190 INSURER D : $ 1,000,000 INSURER E : $ 300,000 INSURER F : $ 10,000 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. INR LTR TYPE OF INSURANCE IANSR SUBR WVD POLICY NUMBER POLICY EFF 3MM/DD/YYYYL(MM POLICY EXP /DD/YYYY1_ LIMITS C GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY 20264567 09/12/2014 09/12/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 300,000 MED EXP (Any one person) $ 10,000 CLAIMS -MADE X OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE 7 POLICY X LIMIT APPLIES JECOT- PER LOC PRODUCTS - COMP /OP AGG $ 2,000,000 Emp Ben. $ 1,000,000 A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS 4928099401 09/12/2014 09/12/2015 COMBINED SINGLE LIMIT (Ea accident) 1 $ 000 ,000 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 $ $ 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 083049754 01/01/2014 01/01/2015 X WRY L M TS OTH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT I_$ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule if more space is required) Certified Residential Contractor #CRC052388 - Guido Mancini CERTIFICATE HOLDER CANCELLATION CITYCLI City of Clearwater Finance Dept. PO Box 4748 Clearwater, FL 34618 -4748 1 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 � ` -%��",,, Q,"( G( i ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD