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CERTIFICATE OF LIABILITY INSURANCE (708)
CROSS -2 OP ID: PS `{ E' CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 06/22/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR 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 Bradenton Insurance, LLC 1400 Ballard Park Drive West Bradenton, FL 34205 -6719 Robert J. Wentzell NAME: ACT Robert J. Wentzell PHONE 941 - 748 -0511 FAX No): 941 - 748 -6444 (ac, No, Ext►: E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Auto Owners Insurance Co. 18988 INSURED Chuck Crossan Electric Inc. 6104 7th Ave Dr West Bradenton, FL 34209 -3505 INSURER B : Owners Insurance Co. 32700 INSURER C : FL Citrus Business & Ind SIF 03/29/2017 INSURER D : $ 1,000,000 INSURER E : INSURER F : X COVERAGES CERTIFICATE 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POUCY NUMBER POLICY EFF JMM /DD/YYYY) POUCY EXP (MM /DD/YYYY) UMITS A X COMMERCIAL GENERAL LIABILITY 20729515 RECEIVEDMED • JUN 2.4 2616 03/29/2016 03/29/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR PAMAGES(RENTED PREMISES (Ea occurrence) 300 000 $ , EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L X AGGREGATE I POLICY OTHER: LIMIT APPLIES PELT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 $ B AUTOMOBILE X X UABIUTY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON WNED AUTO-OS OFFICAL R. -RL/S DS 48351513iEGISIAT1VE SRVCSIITP16 AND 07/22/2017 COMBINED SINGLE LIMIT (Ea accident) $ 1 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) ( ) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA UAB EXCESS LIAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' UABIUTY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 10637717 04/01/2016 04/01/2017 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) RE: Chuck Crossan #EC13002193 CERTIFICATE HOLDER i CLEAR -1 City of Clearwater Fax 727 - 562 -4576 PO Box 4748 Clearwater, FL 34618c�� 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 ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD