CERTIFICATE OF LIABILITY INSURANCE (649)�CORD� DATE(MM/DD/YYYY)
�,,,,. CERTIFICATE OF LIABILITY INSURANCE g/2/2015
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 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
PRODUCER
Wallace Welch & Willingham, Inc.
300 1 st Ave. So., 5th Floor
Saint Petersburg FL 33701
INSURED INTESIG-01
International C&C Corp
Sign X-Press; International Sign Company
and International Linear Matrix Corp
10831 Canal Street
Largo FL 33777
:lay Crum
727-522-7777
INSURER(S) AFFORDING COVERAGE
INSURER A :/41118iISUi2 (f1S. CiO.
INSURER B :
INSURER C :
INSURER D :
INSURER E :
727-521-2902
19488
COVERAGES CERTIFICATE NUMBER: �76445696 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 TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS
LTR INSD WVD POLICY NUMBER MMIDD/YYYY MM/DD/YYYY
A X COMMERCIAL GENERAL LIABILI7Y Y CPP20870320201 4/15/2015 4/15/2016 EqCH OCCURRENCE $1,000,000
CIAIMS-MADE ❑X OCCUR DAMAGE TO RENTED
PREMISES Ea occurrence $100,000
MED EXP (Any one person) $5,000
PERSONALBADVINJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
%� POLICY a �E � � LOC PRODUCTS - COMP/OP AGG $2,000,000
OTHER: $
F+ AU70MOBILE LIABILITY CA20870340201 4/15/2015 4/15/2016 Ea accident � $1,000,000
X ANY AUTO BODILY INJURY (Per person) $
AUTOS NED AUTOSULED BODILY INJURY (Per accident) $
HIRED AUTOS NON-OWNED PROPERTY DAMAGE $
AUTOS Per accident
$
A X UMBRELLA LIAB X OCCUR CU20870350202 4/15/2015 4/15I2016 EACH OCCURRENCE $1,000,000
EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000
DED X RETENTION$0 $
q WORKERS COMPENSATION WC20892830201 9/15/2015 9/15/2016 PER OTH-
AND EMPLOYERS' LIABILITY Y� N X STATUTE ER
ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACHACCIDENT $1,000,000
OFFICER/MEMBER EXCLUDED? � N � A`
(Mandatory in NH) E.L. DISEASE - EA EMPLOYE $1,000,000
If yes, describe under
DESCRIPTION OF OPERA710NS below E.L. DISEASE - POLICY LIMIT $1,000,000
A Leased/Rented Equip CPP20870320201 4/15/2015 4I15I2016 Limit 100,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 707, AddiUonal Remarks Schedule, may be attached if more space is requlred)
City of Clearwater and the Philadelphia Phillies are Additional Insureds with respect to General Liability if required by written contract.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Clearwater ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Purchasing Department #42-15
P.O. Box 4748 AUTHORIZED REPRESENTATIVE
Clearwater FL 33758-4748 „ i,
C�f /
�O 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD