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CERTIFICATE OF LIABILITY INSURANCE (743)KEMPS -1 OP ID: BR ,acoRO~ CERTIFICATE OF LIABILITY INSURANCE `---� DATE (MM /DD/YYYY) 07/15/2016 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 Brown & Brown of Florida, Inc Suite 400 1401 Forum Way West Palm Beach, FL 33401 Nicholas DiBattisto NAME: ACT Nicholas DiBattisto (A/C.NN , Ext) :561- 686 -2266 FAX No): 561 - 686 -2313 E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: National Trust Insurance Co 20141 INSURED Kemp Signs & Service, Inc. and Kemp Signs Inc Attn: Stephen Kemp 1740 Hill Avenue West Palm Beach, FL 33407 INSURER B : FCCI Insurance Company GL001697502 ,- .. ; i ) INSURER C : FFVA Mutual Insurance Co 10385 INSURER D: Federal Insurance Company $ 1,000,000 INSURER E : INSURER F : X 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 INSD -SUBR WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY X GL001697502 ,- .. ; i ) 07/16/2016 07/16/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR PAMAGE S (RENTED PREMISES (Ea occurrence) 100,000 $ � XCU MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GE 'L AGGREGATE POLICY OTHER: x LIMIT APPLIES PE O PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 Emp Ben. $ 1,000,000 B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS E . '' L CA0027 ,, .r , 1:07-Fik. I .J , r +� I ,r IF#1412016 f 07/16/2017 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ PIP $ 10,000 A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE UMB001937202 07/16/2016 07/16/2017 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DED X RETENTION $ 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE Y OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below / N N / A WC84000306112016A 07/16/2016 07/16/2017 X STATUTE ER H E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 D Equipment Floater 45467894 07/16/2016 07/16/2017 Leased & 100,000 Rented DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Sign Manufacturing & Installation CERTIFICATE HOLDER CANCELLATION City of Clearwater tY 100 S Myrtle Ave RM 210 Clearwater, FL 33756 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