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CERTIFICATE OF LIABILITY INSURANCE (726)ACORD 4,....----- O CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 6/28/2016 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 Brier Grieves Insurance 3617 Henderson Blvd. Tampa FL 33609 CONTACT Diane Lippincott PHHCON Exn: (813) 876 -4166 FAX No): (813)870 -0170 DORESS:dianel @bgains.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERANationwide Insurance 25453 INSURED FORCE ELECTRIC INC 8910 N DALE MABRY HWY STE 35 TAMPA FL 33614 -1500 INSURER B Hartford ACPGLZ05 97 3758 41 6yg ��1j\ g$�� lyl S1 t� @ate INSURER C:Amtrust 7/3/2017 INSURERD: $ 1,000,000 INSURER E : INSURERF: X COVERAGES CERTIFICATE NUMBER:CL1662813001 • 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 POLI CIES. LIMITS SHOWN MAY HAVE BEEN REDU CED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE -ADDL INSD SUBR WVD POUCY NUMBER POUCY EFF (MM/DD/YYYY) POLICY EXP (MMIDD/YYYY) UMITS A X COMMERCIAL GENERAL UABILITY ACPGLZ05 97 3758 41 6yg ��1j\ g$�� lyl S1 t� @ate 7/3/2016 j 7/3/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100 , 000 GEN'LAGGREGATE X MEDEXP(Anyoneperson) $ 5,000 RY 1,000,000 POLICY OTHER: LIMIT APPLIES JECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OPAGG $ 2,000,000 $ B AUTOMOBILE X LIABIUTY ANY AUTO AUTOS HIRED AUTOS X X AUTOSULED AUTOS AUTOS JIJt- i (Z £U L p p� Cy�y 21UECVl7 �7�iyIQC�I/p9LIi/ECORr/V^C2p��3y2r��5 LEGISLATIVE SRVCS U p �� DEPT ' 12/5/2016 COMBINED SINGLE LIMIT (Ea accident) $ 500,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY rraccidentDAMAGE $ PIP -Basic $ 10,000 UMBRELLA LIAB EXCESS UAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR /PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A AWC1054549 10/1/2015 10/1/2016 TUTE 0T X STATUTE H E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1 000 , 000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 B Automobile Deductibles 21UECVN7575 • 12/5/2015 12/5/2016 Comprehensive . $500 Collision $1,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION City of Clearwater 100 S. Myrtle Avenue 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 Brier Grieves /NANCY ACORD 25 (2014/01) INS025 (7014011 © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD