CERTIFICATE OF LIABILITY INSURANCE (748)'4 °i CERTIFICATE OF LIABILITY INSURANCE
I DATE 07 /19/D/YYYY)
07/19/2016
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 POUCIES 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
FEDERATED MUTUAL INSURANCE COMPANY
HOME OFFICE: P.O. BOX 328
OWATONNA, MN 55060
CONTACT
NAME: CLIENT CONTACT CENTER
PHONE
(A/C, No, Ext): 888 - 333 -4949 FAX No): 507- 446 -4664
ADDRESS: CLIENTCONTACTCENTER aFEDINS.COM
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: FEDERATED MUTUAL INSURANCE COMPANY
13935
INSURED 270 -977 -2
REGER ELECTRIC SERVICE
PO BOX 700965
ST CLOUD, FL 34770 -0965
INSURER B:
,.,
�, ^ -
_
9928963
INSURER C:
08/25/2017
INSURER D:
$1,000,000
INSURER E:
INSURER F:
X
COVERAGES
CERTIFICATE NUMBER: 48
REVISION NUMBER: 0
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
SUER
WVD
POLICY NUMBER
POLICY EFF
(MMIDD /YYYY)
POLICY EXP
(MM /DD /YYYY)
LIMITS
A
COMMERCIAL GENERAL LIABILITY
N
N
,.,
�, ^ -
_
9928963
,;.
-� • -
3 _ : �,
08/25/2016
08/25/2017
EACH OCCURRENCE
$1,000,000
CLAIMS -MADE
X
OCCUR
DAMAGE TO RENTED
PREMISES (Ea occurrence)
$100,000
X
BUSINESS OWNER'S LIABILITY
MED EXP (My one person)
PERSONAL s ADV INJURY
$1,000,000
GENERAL AGGREGATE
$2,000,000
GEN'L AGGREGATE
X POLICY
OTHER:
LIMIT APPLIES
RO-
JECT
PER:
LOC
PRODUCTS - COMP /OP AGG
$2,000,000
A
AUTOMOBILE
-
X
X
LIABILITY
ANY AUTO
ALL
AUTOS
HIRED AUTOS
SEE BELOW - 4A
-
_
X
AUTOSULED
NON -OWNED
AUTOS
N
N
i '-•''-
2
S ��
9928964
-- , ...
08/25/2016
..
..:, !
08/25/2017
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
PROPERTY DAMAGE
(Per accident)
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
AGGREGATE
DED
RETENTION
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR /PARTNER /EXECUTIVE
OFFICER /MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
D
DESCRIPTION OF OPERATIONS below
Y / N
N / A
N
9062335
08/25/2016
08/25/2017
X
PER STATUTE
OTH-
ER
E.L. EACH ACCIDENT
$100,000
E.L. DISEASE - EA EMPLOYEE
$100,000
E.L DISEASE - POLICY LIMIT
$500,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
SYMBOL 4A: AUTOMOBILE LIABILITY INCLUDES OWNED AUTOS OTHER THAN PRIVATE PASSENGER AUTOS ONLY.
CERTIFICATE HOLDER
CANCELLATION
270 -977 -2 48 0
CITY OF CLEARWATER
PO BOX 4748
CLEARWATER, FL 33758 -4748
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
O 1988 -2014 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
FEDERATED
INSURANCE��
To Whom It May Concern,
RE: REGER ELECTRIC SERVICE
Enclosed is a certificate of insurance that has been renewed for a new policy term. If a copy
of an additional insured or policy endorsement was requested, the document will be sent in a
separate envelope.
If you have any questions regarding this please contact: the Federated Insurance Client
Contact Center at:
Phone: 1- 888 - 333 -4949
Fax: 507 - 446 -4664
E -mail: clientcontactcenter @fedins.com
Thank you,
Client Contact Center
Federated Insurance Companies
Enclosed:
Certificate of Insurance
MISC -0974 (04 -13)