CERTIFICATE OF LIABILITY INSURANCE (2)CERTIFICATE OF LIABILITY INSURANCE (MM/DD/YYYY)
03/OZ/2015
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 INSURERS(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
Lockton Affinity, LLC
P.O. Box 873401
Kansas City, MO 64187-3401
INSURED
Habitat for Humanity of Pinellas County, Inc., Pinellas County Habitat for
Humanity Community Housing Development Organiz
13355 49th Street North,
Clearwater, FL 33762
888-553-9002
COVERAGE
ACE American Insurance Co. � 22667
c�vtrwGts GERTIFICATE NUMBER: REVISION NUMBER:
TNlS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LlSTED 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
�N poo� us OLICY EFF OLICY EXP
sR iNSR ' MM/DD/YYYY) MM/DD/YYYY)
LT p
2 TYPE OF INSURANCE POLICY NUMBER LIMITS
GL1064582-15 04/O1/2015 04/O1/2016
A GENERAL LIABILITY X EACH OCCURRENCE $'I,OOO,OOO
DAMAGETO RENTED $ �,OOO,OOO
%� OMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence
LAIMS MADE X OCCUR MED EXP M one rson $ O
� '-'��"�4 �' �� PERSONAL 8 ADV INJURY $ 'I,OOO,OOO
!. � �k �'t"� �, � �,e^� �..,�'��''{f�(� �R GENER,4L AGGREGATE S 2,000,000
EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS — COMP/OP AGG E Z,OOO,OOO
X OLICY i�"i�� i V L��iJ E
COMBINED SINGLE LIMIT
AUTOMOBILE LIABILITY �iyP'i ��tl� �������� Ea axident $
NY AUTO BODILY INJURY Per Person $
LL OWNED SCHEDULED . 173
UTOS AUTOS BODILY INJURY Per accident $
NON-OWNED . PROPERTY DAMAGE
IRED AUTOS AUTOS Per accident �
MBRELLA LIAB OCCUR EACH OCCURRENCE $
XCESS LIAB CLAIMS MADE AGGREGATE $
ED RETENTION $
ORKERS COMPENSATION C STATU- TH-
ND EMPLOYERS' LIABILITY ORY LIMITS R
NYPROPRIEI"OWPARTNER;EXECUTIVE Y/A �
FFICER/MEMBER EXCLUDED? E.L. EACH ACCIDENT $
MANDATORY IN NH)
f es describe under E.L. DISEASE — EA EMPLOYEE �
ESCRIPTION OF OPERATIONS below E.L. DISEASE — POLICY LIMIT $
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEPORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS
AUTHORIZED REPRESENTATIVE
City of Clearwater _
P.O. Box 4748, �Y Z - _�� — -_-.
Clearwater, FL 33758 �!'�-t�
ACORD 25 (2010/051 The ACORD name and loao are reaistered markc nf ACC�Rn
1064582
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