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CERTIFICATE OF LIABILITY INSURANCE (733)Client#: 5359 WHALDER ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD/YYYY) 7/06/2016 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 Lanier Upshaw, Inc. 1115 US Hwy 98 South P.O. Box 468 Lakeland, FL 33802 CONTACT NAME: Renee Brown n"/c °, NE , No, 863 686 4113 F4X (A/C, No): 863 682 -6292 E-MAIL SS: Renee.Brown @LanierUpshaw.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Amerisure Insurance Company 19488 INSURED W H Alderman Plumbing & Heating Co Inc. 1755 E Gary Rd. Lakeland, FL 33801 INSURER B : Amerisure Mutual Insurance Co 23396 INSURER c INSURER D : CLAIMS -MADE INSURER E : OCCUR INSURER F : $100,000 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. 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 INSR SUBR WVD POL POLICY EFF (M /DD/YYYY) /18/2016 DEPT POLICY EXP (MM /DD/YYYY) 07/18/2017 LIMITS EACH OCCURRENCE $1,000,000 A X COMMERCIAL GENERAL LIABILITY CPP20777 JUL 3ff+y JU!' 't 3liL OFFICIAL ��' LEGISLATIVE SRVCS CLAIMS -MADE X OCCUR PREMISES (ERENTED nce) $100,000 MED EXP (Any one person) $ 5000 PERSONAL & ADV INJURY ,____f $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY I XI JECOT I LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP /OPAGG $2,000,000 $ A AUTOMOBILE X X XDrive LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS Oth Car X SCHEDULED AUTOS NON -OWNED CA2077745040 07/18/2016 07/18/2017 (Ea COMaccidBINED ent) SINGLE LIMIT $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ PIP $$10,000 B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CU2077747040 07/18/2016 07/18/2017 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 $ DED X RETENTION $O A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N N / A WC207774804 07/18/2016 07/18/2017 X PER STATUTE OTH- ER E.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) CERTIFICATE HOLDER CANCELLATION City of Clearwater 100 South Mytrle Clearwater, FL 33756 -5520 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 144,144 0. G ACORD 25 (2014/01) 1 of 1 1tS333915/MT3V19R © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MOM