Loading...
CERTIFICATE OF LIABILITY INSURANCE (690)FLORGAS -01 DAYD .I"-'�� `"' CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 12/15/2015 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 certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Insurance Office of America, Inc. NAME: Debbie Day (NC o No, EMI: (813) 637 -8877 FAX No): (813) 637 -8484 4915 West Cypress Street Tampa, FL 33607 ADDRIESS: Debbie.Day@ioausa.com $ 01/01/2017 r -!D �:rT INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Valley Forge Insurance Company 20508 INSURED INSURER B : National Fire Insurance Co of Hartford 20478 Florida Gas Contractors INSURER C : Continental Casualty Company 20443 P 0 Box 280 INSURER D : X Dade City, FL 33526 INSURER E : $ 1,000,000 GE INSURER F : X CERTIFICATE NUMBER: • ,..moom ,11.,,•11..-... 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 POLIC ES 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 ADD[ INSQ SUBR WVD POLICY NUMBER POLICY EFF D POLICY EXP MM /DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY Cr 5099135473 S rtlt }} 0! O1 r tCIA.L ial.:'1 / yt„ :.`a�,i' °��.`'C`f k-. EY 01/01/2016 " ' ' ORDS .e,i $ 01/01/2017 r -!D �:rT EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR PREMI ES ( RENTED PREMISES (Ea occu rence) $ 100,000 X Poll /Prof agg. limit MED EXP (Any one person) $ 5,000 X 2,000,000 PERSONAL & ADV INJURY $ 1,000,000 GE 'L AGGREGATE POLICY OTHER: X LIMIT APPLIES JERCO- PER LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 Poll /Prof $ 1,000,000 B AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS 5099135490 01/01/2016 01/01/2017 CO aBINEDtSINGLE LIMIT $ 1,000,000 BODILYINJURY(Perperson) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ PIP $ 10,000 C X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 5099135487 01/01/2016 01/01/2017 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED X RETENT ON $ 10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANYIPROPRIETER /PARTNERS ECUTIVE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 6014563480 01/01/2016 01/01/2017 X STATUTE _ ERH F L EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Clearwater Gas 400 North Myrtle Ave !Clearwater, FL 33758 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 r% • C5.-._C.-- ACORD 25 (2014/01) ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD