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CERTIFICATE OF LIABILITY INSURANCE (745)A� QR r16 L..-----"-- D CERTIFICATE OF LIABILITY INSURANCE DATE (M M/DD/YYYY) 6 /30/20I6 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 Phone: (813)251 -4900 Fax: (813)253 -2676 Professional Insurance Center, Inc. 2003 West Kennedy Blvd Tampa, Florida 33606 .... ._ _ CONTACT Professional Insurance Center Inc NAME: PHONE FAX IA /C. No. Ext): (A/C No): ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER -: Ascendant Commercial Insurance, Inc. 13683 INSURED AZTECA TAXI SERVICE LLC 103 WAVERLY WAY CLEARWATER, FL 33756 INSURER B : INSURER C : _ INSURER D $ INSURER E : INSURER F : OCCUR COVERAGES CERTIFICATE NUMBER: 1479 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSU• RED 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 (MMIDDIYYYY) POLICY EXP (MMIDD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ GENL MED EXP (Any one person) $ PERSONAL & ADV INJURY $ AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT PER: LOC GENERAL AGGREGATE $ PRODUCTS - COMP /OP AGO $ $ A AUTOMOBILELIABILITY ANY AUTO A D AUTOS HIRED AUTOS ONLY ✓ AUTOSULED NON -OWNED AUTOS ONLY ✓ N FH- 8779 -0 - 6/10/2016 6/10/2017 - Fa =SINGLE LIMIT $ BODILY INJURY (Per person) $ 125,000 BODILY INJURY (Per accident) $ 300 000 PROPERTY DAMAGE Per accident) $ 100 000 UMBRELLA LIAB EXCESS LIAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N - N/A { t - PER 0TH - STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER IS LISTED AS ADDITIONAL INSURED - SCHEDULED VEHICLES- ._ .. 2008 - HONDA - ODYSSEY - SF■RL38738B023044 CERTIFICATE HOLDER CANCELLATION Holder's Nature of Interest : Additional Insured CITY OF CLEARWATER 100 SOUTH MYRTLE AVE CLEARWATER FL 34697 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CCORDANCE WITH THE POLICY PROVISIONS. AUT ORIZED REPRES VE /// ACORD 25 (2016/03) ©1k88 -2015 ACOR ORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD