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CERTIFICATE OF LIABILITY INSURANCE (735)ACORO® CERTIFICATE OF LIABILITY INSURANCE 4..../' DATE(MM/DD/YYYY) 7/8/2016 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 Vermost & Associates, LLC 1120 Belcher Rd S Suite 1 Largo FL 33771 CONTACT NAME: N8ncy Roberts NC.N .Ext): (727) 748 -2886 FAX No): (727)577 -4991 E -MAIL ADDRESS: nroberts @vermost.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :Southern Owners Insurance Company 10190 INSURED Douglas Taylor Air Conditioning & Refrigeration Inc. 6560 116Th Ave Largo FL 33773 -3725 INSURERB:Owners Insurance Company 32700 INSURERCAuto- Owners Insurance Company 18988 INSURER D: INSURER E : CLAIMS -MADE INSURER F: DAMAGE TO RENTED PREMISES (Ea occurrence) COVERAGES CERTIFICATE NUMBER•CL167604850 • 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 INCn SUBR WVD POLICY NUMBER POLICY EFF IMM /DIYYYYY) POLICY EXP (MM /DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY ii ,"�°, -' 2063814taC s' ��"a► ! t A i t ) L) .O 5 a 7/24/2016 - 7/24/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X j OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 50 000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE POLICY OTHER: X LIMIT APPLIES MI PER: j LOC GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP /OP AGG $ 3,000,000 Premises/Operations P $ B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X X SCHEDULED AUTOS NON -OWNED AUTOS !! t� p�`` iCIl� Cp �✓'�.{�i �y1�'�(��'t" `,tV►.?I-� `1 t 4458745202 �{ VI? 7/24/2016 7/24/2017 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ Medical payments $ 2,000 C X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 4458745201 7/24/2016 7/24/2017 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 $ DED X RETENTION$ 5,000 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 PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A Crime /Employee Dishonesty Incl 3rd Party Fidelity 20740847 2/27/2016 2/27/2017 Blanket Form $100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Heating /Air Conditioning, Refrigeration, Installation, Service & Repair. CERTIFICATE HOLDER CANCELL CITY OF CLEARWATER FL 100 S MYRTLE AVE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. CLEARWATER, FL 33756 AUTHORIZED REPRESENTATIVE Sue Lockett /HARVFE c 4; 2 ACORD 25 (2014/01) INS025 (201401) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD