CERTIFICATE OF LIABILITY INSURANCE (3)ACORL7 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YVYY)
`..��� 03/04/2016
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATNELY 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 WANED, subject to
the tertns 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 CON ACT
NAME: Lockton Affinity, LLC
Lockton Affinity, LLC
P.O. Box 873401
ICansas City, t� 64187-3401
INSURED
8abitat for 8umanity of Pinellas County�
Inc. Pinellas County Habitat for 8umanity Community 8oua
1335� 49th Street North
Clearwater, FL 33762
INSURER D :
INSURER E :
888-553-9002
Ace
AFFORDING COVERAGE
913-652-3967
COVERAGES CERTIFICATE NUMBER: 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. NOTIMTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT 1MTH 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. IIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
�LTR TYPEOFINSURANCE AD L UBR p�pLICYNUMBER MMIDWYri MAA/DWY � LIMITS
A X �MMERCIALGENERALLIABILITY y GL1064582-16 04/O1/2016 04/O1/2017 EACHOCCURRENCE S 1,000,000
CLAIMS•MADE � OCCUR PREMISES a occurrence S 1, 000 , 000
MED EXP (My one persan) $ 0
PERSONAL&ADVINJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2, 000 , 000
X pOLICY � j�7 � LOC PRODUCTS-COMP/OPAGG $ 2,000,000
OTHER' $
AUTOMOBILELIABILITY COMBtNEDSINGI LIMIT $
a accident
ANY AUTO � BODILY INJURY (Per person) $
ALL OVNJED SCHEDULED BODILY INJURY (Per accident) $
AUTOS AUTOS
NON-OWNED PROPERTV DAMAGE
HIRED AUTOS q�7pg Per acdd�t $
$
UMBRELLA LIAB pCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE S
DED REfENTION$ $
WORKERSCOMPENSATION PER OTH-
AND EMPLOYERS LIABILITY Y� N STATUTE ER
AP:Y PROPRIEfOR/PARTNERlEJ(ECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? ❑ N �A — --------------------
(Mandatory In NH) E.L. DISEASE - EA EMPLOYE $
Ifyes describe under �
DESCRIPTION OF OPERATIONS below � E.l. DISEASE - POLICY LIMIT S
DESCRIP710N OF OPERATIONS / LOCATIONS / VEHICLES (AOORD 101, Additlonal Remarks Schedule, may be attached if more space is required)
Re: 1300 Milton St, Clearwater, FL 33756
GEKIIhIGATE FIDLDER
City o£ Clearwater
P.O. Box 4748
Clearwater, FL 33758
ACORD 25 (2014/01)
18B48098
11C�]►1
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
TIVE
�� c+,�.yQ,8� 2014 ACORD CORPORATION. All rights reserved.
TNe ACORD name and logo are registcred marks of ACORD
1064582