CERTIFICATE OF LIABILITY INSURANCE (623)�,�., HARRE-1 OP ID: LM
'4C��°� CERTIFICATE OF LfABILITY lNSURANCE oATE`MM,00nriY,
�� 04/17/207 5
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), AUTHORI2ED
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 olicies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(�ECEIVED
PROOUCeR CITY C�F Cf EARWATER
Professional Ins. Services
Tampa, FLu33614 Y St �PR 2`� Zo1�
Jason Levy
RISK MANAGEMEN i
INSURED Harrell Home Services Inc 9173
4620 N. Hale Avenue
Tampa, FL 33614-7043
Jason
813-963-6701
_ __INSURER�S) AFFORDING COVERAGE
�NSUa�R n: Ascendant Commercial Insurance
�nsuRe� e: Technolo�y Insurance Com ap ny
INSURER C :
INStlRER U :
F:
813-356-095t
NAIC #
COVERAGES CERTIFICA7'E NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW_HAJE BE��J ISSUEO TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTAMDING AyY REQUIREMENT, TERM OR CONDITION QF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS �
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE IP�SUF2ANCE AFFQRDED EY TH� POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMI'fS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADDL USTF�— POLICY EFF POLICY EXP LIMITS
LTR TYPE OF INSURANCE I PCILICY NUtdBER MMlDD/YYYY MM/DD/YYYY
A X COMMERCIAL GENERAL LIABIUTY EACH OCCURRENCE $ 'I,OOO,OO
� CLAIMS-MADE �� OCCUR iGL-39800-3 04/01/2095 04/01/2016 pREMISES Eaocourence $ ���,��
' MED EXP (Any one person) $ 5,��
� PERSONAL & ADV INJURY $ 'I,OOO,OO
(�G�EN'L AGGRErGATE IIMIT APPLIES PER: GENERAL AGGREGATE $ Z,OOO�OO
� J� j POLICY I J jE��- � LOC I PRODUCTS - COMP/OP AGG $ �,OOO,OO
r $
OTHFR:
AUTOMOBIL[ LIABILITY � COMBINED SINGLE LIMIT $
i Ea accident
^ ANY AUTO
� BODILY INJURY (Per person) $
� ALL OWNED � SCHEDULED BODILY INJURY (Per accident) $
�J AUTOS __ AUTOS —
NON-OWNED I PROPERTY DAMAGE $
I HIRED AUTOS AUTOS I � Per accident
� -1 $
UMBRELLA LIAB _ OCCUR I � EACH OCCURRENCE $
EXCESS LIAB � CLAIMS-M1IADEJ I AGGREGATE $
DED RETENTION $ � ! $
WORKERS COMPENSATION I —� X PER OTH-
AND EMPLOYERS' LIABILITY STATUTE ER
B ANY PROPRIETOR/PARTNER/EXECUTIVE �/ N N � A TVHC3418903 I O7/ZB/ZO14 i O7/ZB/ZO'I S E.L. EACH ACCIDENT $ ��OOO,OO
I OFFICERl�dEMBER EXCLUDED? � I — � �
(Mandatory in NH) � i ��.L. r+i.riLASE - tA EIYSPL�iYtGC $ _�������
�'.`'yd9. d'eSCfiil� UttrJei �
DESCRIPTION OF OPERATIONS below I � E.L. DISEASE - POUCY LIMIT $ 1,000,00
I I
DESCRIPTION OF OPERATtONS / LOCATIONS / VEHICLES (ACORD 701, Additional Remarks Schedule, may be attached if more space is required)
I
�
�
City of Clearwater
#C-110
199 S. Myrtle Ave
Clearwater, FL 34616
ACORD 25 (2014/01)
CLEAR-2
SHOU� D ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
AC�ORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
� ���_
O 1988-2014 ACORD CORPORATION. All rights reserved.
The RCORD name arsd logo are registsred marks of ACORD
I
` � �
� �`�`i
�C,Cs2,� � �-� `'; °�� ; � � �► � Zr� � 5 --�,�,� ; Q� �, c
� `7
:�C��� ����-
� � � � 5 �-�`� _ ��-�'��c,
�� �