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CERTIFICATE OF LIABILITY INSURANCE (749)- ACQRO® �,� CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 7/14/2016 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. 2600 Lake Lucien Drive Suite 330 Maitland FL 32751 CONTACT NAME: mei&EXtl: (407)660 -8282 FAX (Am, 1407) 660-2012 E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC 8 INSURERA:Gemini Insurance Company 10833 INSURED J.A. Croson, LLC Sorrento Downtown Properties South, LLC Sorrento Downtown Properties North, LLC 31550 CR 437 Sorrento FL 32776 INSURERB:Amerisure Insurance Company 19488 INSURERCAmerican Guarantee Liab Ins Co 26247 INSURER DAmerisure Mutual Insurance Co 23396 INSURERE: INSURER F : X COVERAGES CERTIFICATE NUMBER:CL1671407497 R 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 Iran SUBR wvn POLICY NUMBER POLICY EFF IMMIDD/YYYY) POLICY EXP IMM /DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY VGGP002181 !r tY [ I ` y, 8/3/2016 ' ; 8/3/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 50,000 X GE Contractual per GL Form MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 'L AGGREGATE POLICY OTHER: X LIMIT APPLIES 120. PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 Ded-BI&PD $ 10,000 B AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS x _AUTOS SCHEDULED AUTOS NON -OWNED -\, r , r c-,:1 r a, s CA202321M,31t° r )t �• f �"`8•%2r016 - ,,.. n 8/3/2017 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ C - x UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE SXS0199378 -00 8/3/2016 8/3/2017 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED X RETENTION$ 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY `if/ N ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? I N (Mardatcry In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WC20222431501 FL,AL, GA, SC,NC, TN 8/3/2016 8/3/2017 X PER 0TH - STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE 5 1,000,000 $ 1,000,000 E.L. DISEASE - POLICY LIMIT D Rented Equipment Special CovPer Form 1120835940502 8/3/2016 8/3/2017 Per Om $ 160,000 Ded -ACV $ 1,000 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 Myrtle Ave #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 T D'Avanzo, CPCU, CPA ACORD 25 (2014/01) INS025 (201401) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD