Loading...
CERTIFICATE OF LIABILITY INSURANCE (689)P5260028002 ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 12/22/2015 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 poiicy(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 1- 813 -229 -8021 N. B. Wilson Co., Inc. 300 W. Platt St. Ste 200 Tampa, FL 33606 INSURED Fast of Florida, Inc. 13003 US 19 N. Clearwater, FL 33764 -7224 NAMEACT Kelly B. Sutton, CIC PHONE 813 - 349 -2233 E-MAIL E> ADDRESS: ksutton@mewilson.com INSURER(S) AFFORDING COVERAGE INSURER A: SOUTHERN OWNERS INS CO INSURER B: OHIO SECURITY INS CO INSURER C: MAXUM IND CO -- -- _ -- INSURER D : ZENITH INS CO INSURER E : INSURER F FAX JC, N813 - 229 -2795 (Ao): NAIC S 10190 24082 26743 13269 COVERAGES CERTIFICATE NUMBER: 45675155 THIS INDICATED. CERTIFICATE EXCLUSIONS LTR IS TO CERTIFY THAT THE POLICIES NOTWITHSTANDING ANY REQUIREMENT, MAY BE ISSUED OR MAY AND CONDITIONS OF SUCH TYPE OF INSURANCE.__ OF INSURANCE PERTAIN, POLICIES. ADM INSD SUBR INVD LISTED BELOW HAVE BEEN TERM OR CONDITION OF ANY THE INSURANCE AFFORDED BY LIMITS SHOWN MAY HAVE BEEN .._ _. -.. POLICY NUMBER ISSUED TO CONTRACT THE POLICIES REDUCED BY POLICY EFF (MMIDDIYYYY) THE INSURED NAMED ABOVE FOR THE POLICY PERIOD OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, PAID CLAIMS POLICY EXP (MMIDD/YYYY) LIMITS A X GE _ . COMMERCIAL GENERAL LIABILITY J CLAIMS -MADE I- X I OCCUR 'L AGGREGATE LIMIT APPLIES PER: POLICY X I JET I _._ 1 LOC I OTHER: 132312- 20694635,°+ -., yea �^'�"-fi /�(A + ", '�i��FICIi SL it p[(�,r+t e ... r 'C, ;/ E -.';:- s-� _ 'S.+.S f ..+§.�,�,.�,,�,.. 12/28/16 H,..% ;. , EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP /OP AGG $ 1,000,000 $ 300,000 $ 10,000 ;$ 1,000,000 $ 2,000,000 $ 2,000,000 $ B AUTOMOBILE - - X - LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS .,. BAS (16) 5641lWe `)V `i 142'g'/2t +fit /ZB/16 COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY Per accdent ( ) PROPERTY DAMAGE _ {Per accident) $ 1,000,000 $ - - $ $ C X UMBRELLALIAB EXCESS LIAR DED I RETENTION X $ OCCUR CLAIMS -MADE EXC- 6025701 -02 12/28/15 12/28/16 EACH OCCURRENCE AGGREGATE $ 3,000,000 $ 3,000,000 $ D ANNDEMPLO COMPENSATION YIN ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A Z126919802 12/28/15 12/28/16 1 PER _% j STATUTE I I S F RH E L EACH ACCIDENT -- E.L. DISEASE - EA EMPLOYEE - - - -- E.L. DISEASE - POLICY LIMIT I $ 1,000,000 $ 1,000,000 $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS 11BRAEETDItNS; n AdditIonal Remarks Schedule, may be attached H more space Is required) JAN 0 7 2016 GAS ADMIN ERTIFICATE HOLDER CANCELLATION CITY OF CLEARWATER 100 S MYRTLE AVE CLBARWATER, FL 33758 -4748 USA 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 0,0 ACORD 25 (2014/01) CV01 45675155 ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD