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CERTIFICATE OF LIABILITY INSURANCE (596)AW ° CERTIFICATE OF LIABILITY INSURANCE 2/ ) i2iisi 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 Stahl & Associates Insurance Inc. 91 Lake Morton Drive P 0 Box 3608 Lakeland FL 33802 CONTACT Debbie MacGillivray PACNN .Ext1: (863) 688 -5495 Not: (863) 688 -4344 ADDRE-MAIL debbie mac illivra @stahlinsurance.com ESS: g Y INSURER(S)AFFORDINGCOVERAGE NAIC# INSURERA:Westchester Surplus Lines Ins 10172 INSURED Odyssey Manufacturing Co. 1484 Massaro Blvd Tampa FL 33619 INSURER B Ace American Insurance Co 22667 INSURER C :Zenith Insurance Company 13269 INSURER D: $ 1,000,000 INSURER E : $ 300,000 INSURER F : I CLAIMS -MADE GES CERTIFICATE NUMBER:1 /1/2015 Master Cert 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 /Y (MM /DDYYY) POLICY EXP (MM /DD/YYYYI LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X G24092975 10/1/2014 10/1/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 300,000 I CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 10,000 GEN'L PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 AGGREGATE POLICY X LIMIT APPLIES PRO - JFCT PER: LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ B AUTOMOBILE X _ _ _ LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ SCHEDULED AUTOS NON -OWNED AUTOS H08450377 10/1/2014 10/1/2015 COMBINED SINGLE LIMIT _(_Ea accident) $ 1,000,000 $ BODILY INJURY (Per person) BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ PIP -Basic $ 10,000 A X UMBRELLA LIAB EXCESS UAB X OCCUR CLAIMS -MADE G24092987 10/1/2014 10/1/2015 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED I RETENTION $ $ C 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 PI N / A Z066828611 1/1/2015 1/1/2016 X I WC STATU- I 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 Pollution /Prof Liability Poll Ded $10K /Prof $25K G24092975 10/1/2014 10/1/2015 Ea Poll Condition /Agg $1,000,000 Prof Ea Claim Aggregate $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is additional insured with respect to general liability if required by written contract. • CERTIFICATE HOLDER CANCELLATION City of Clearwater Attn: Purchasing P.O. Box 4748 Clearwater, FL 33758 -4748 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 Tony Martinez /MACG ACORD 25 (2010/05) INS025 (201005).01 © 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD '4� ° CERTIFICATE OF LIABILITY INSURANCE 9/24/2014 ' 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 CONTACT Debbie MacGillivray Stahl & Associates Insurance Inc. PA/CNW F�rt1: (863) 688 -5495 / No): (863) 688-4344 91 Lake Morton Drive ntoRess: debbie. macgillivray @stahlinsurance.corn P 0 Box 3608 INSURER(S) AFFORDING COVERAGE NAIC # Lakeland FL 33802 INSURERA:Westchester Surplus Lines Ins 10172 INSURED INSURER B Ace American Insurance Co 22 667 Odyssey Manufacturing Co. INSURER C :Zenith Insurance Company 13269 1484 Massaro Blvd INSURERD: $ 10,000 INSURER E : PERSONAL 8 ADV INJURY Tampa FL 33619 INSURER F : GENERAL AGGREGATE CERTIFICATE NUMBER:10 /1/14 Master • 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 IMM /DO/YYYY) POLICY EXP IMM /DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X G24092975006 10/1/2014 10/1/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 300,000 I CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES POLICY I x l ,IF PER: LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ B AUTOMOBILE X _ LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ _ SCHEDULED AUTOS NON -OWNED AUTOS H08450377006 10/1/2014 10/1/2015 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ PIP -Basic $ 10,000 A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE G24092987006 10/1/2014 10/1/2015 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED I RETENTION$ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER (Mandatory ) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N - N N/A Z066828610 1/1/2014 1/1/2015 X I TORY LAM U- I I TH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - Ely EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Pollution /Prof Liability Poll Ded $10K /Prof $25K G24092999006 10/1/2014 10/1/2015 Ea Poll Condition /Agg $1,000,000 Prof Ea Claim Aggregate $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is additional insured with respect to general liability if required by written contract. CERTIFICATE HOLDER CANCELLATION City of Clearwater Attn: Purchasing P.O. Box 4748 Clearwater, FL 33758 -4748 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 Tony Martinez /MACG ACORD 25 (2010/05) INS025 (201005).01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD