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CERTIFICATE OF LIABILITY INSURANCE (594)ACORDTM 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 Gulfshore Insurance - Naples 4100 Goodlette Road North Naples, FL 34103 -3303 239 261 -3646 CONTACT Maria Jebb � HON o, Ext): 239 435 -7120 FAX 213 -7720 (AIC, No): E -MAIL ADDRESS: mjebb©gulfshoreinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: HDI- Gerling America Insurance C LIABILITY COMMERCIAL GENERAL LIABILITY INSURED McMullen Oil Company, Inc. 11965 49th St N Clearwater, FL 33762 INSURER B : EGGCD000161314 INSURER C 12/19 /2015 INSURER D : $2,000,000 $100,000 $ INSURER E : INSURER F : CLAIMS -MADE 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. INS LTR TYPE OF INSURANCE ADDLSUBR INSR WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP JMM /DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY EGGCD000161314 12/19/2014 12/19 /2015 EACH OCCURRENCE $2,000,000 $100,000 $ PREMISES (Ea oNcl ante) CLAIMS -MADE X OCCUR MED EXP (Any one person) PERSONAL & ADV INJURY $2,000,000 GENERAL AGGREGATE $2,000,000 GE 'L AGGREGATE POLICY LIMIT APPLIES PRO- JECT PER: LOC PRODUCTS - COMP /OP AGG $2,000,000 $ A AUTOMOBILE X X XDrive LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS Oth Car X _ SCHEDULED AUTOS NON -OWNED AUTOS EAGCD000161314 12/19/2014 12/19/2015 EOa acBcINIELSINGLE LIMIT $2,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE EXAGD000161314 12/19/2014 12/19 /2015 EACH OCCURRENCE $3,000,000 AGGREGATE $3,000,000 DED X RETENTION $O $ 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 11,I] — N / A EWGCD000161314 12/19/2014 12/19/2015 X TORY LIMITS ERH 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) Certificate Holder is included as Additional Insured on a primary and noncontributory basis with respects to General Liability per form ENAIPNC 0411; completed operations per form CG2037 0413 and ongoing operations per form CG2010 0413 only as required by written contract, Waiver of Subrogation per form CG2404 0509. Additional Insured in regards to the Auto Liability on a primary and noncontributory basis per form (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION City of Clearwater PO 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 ACORD 25 (2010/05) 1 of 2 #S813141/M812980 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MJE • DESCRIPTIONS (Continued from Page 1 ENCAAIPNC 0911 and Waiver of Subrogation per FLCA0444 0312 only as required by written contract. Waiver of subrogation in regards to the Workers Compensation only as required by written contract per form WC000313 0484. SAGITTA 25.3 (2010/05) 2 of 2 #S813141/M812980