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CERTIFICATE OF LIABILITY INSURANCE (716)AC RD® Policy Number: Date Entered: 6/16/2016 CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 6/16/2016 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 have ADDITIONAL INSURED provisions or 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 Florida Suncoast Insurance Agency, Inc. 600 BYPASS DRIVE, SUITE 206 CLEARWATER, FL 33764 INSURED GATOR MECHANICAL OF TAMPA BAY, INC. CHRISTOPHER LOVE 6901 49th Avenue No. ST. PETERSBURG, FL 33709 COVERAGES NAME:°CT SARA F. IVANY PHONE (727) 796 -6566 FAX (A/C. No. Eat): (A /C, No): (727) 799 -9681 ADDARESS: saraivany@floridasuncoastins.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : FCB&I FUND INSURER B : OHIO SECURITY INSURANCE CO /HALCYON INSURER C : INSURER D : INSURER E : INSURER F : • _ __ _ _ ... _... _ .........r.., KtVI5IUN NUMBER: THIS INDICATED. CERTIFICATE EXCLUSIONS INSR IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD1.1.alD LIMITS B X COMMERCIAL GENERAL LIABILITY BKS (16) 54571 ECE JUN 2.8 2.8 p�/�pr� OFFICIAL RECOR (((�����lppp���y 1 irk 2016 9/19/2016 EACH OCCURRENCE $1,000,000 CLAIMS -MADE OCCUR PREMSESO(Ea occurence) $ 300, 000 MED EXP (Any one person) $ 15,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE POLICY X LIMIT APPLIES PRO- JECT PER. LOC GENERAL AGGREGATE $2,000,000 ✓S AND PRODUCTS - COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY ANY AUTO LEGISLATIVE SRVCS DEPT COMBINED SINGLE LIMIT (Ea accident) $ OWNED AUTOS ONLY HIRED AUTOS ONLY T SCHEDULED BODILY INJURY (Per person) $ AUTOS NON -OWNED AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN 106 -45373 6/24/2016 6/24/2017 PER STATUTE X ER 0TH - OFFICER /MEMBER EXCLUDED ECUTIVE Y N/A E.L. EACH ACCIDENT $1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below 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) CFRTIFI!`ATC unI nro FAX NO. 727 - 562 -4576 CITY OF CLEARWATER 100 S. MYRTLE AVENUE #210 CLEARWATER, FL 33765 N ACORD 25 (2016/03) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN AC RDANCE WITH THE POLICY PROVISIONS. A jj ORIZED REPRESEN TIVE ARA IVANY © 1988 -2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Produced using Forms Boss Plus software. www.FormsBoss.com: Impressive Publishing 800 - 208 -1977