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CERTIFICATE OF LIABILITY INSURANCE (750)Accuzace 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 Adcock - Adcock Insurance Agency 315 W. Fletcher Ave. Tampa FL 33612-3414 CONTACT NAME: Thalla King PHONE 813- 933 -6691 FAX (A/C de _Fat). (A /C. Nol: ADDRESS: thaliak @ adcock- insurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :Southern-Owners Insurance Co. 10190 INSURED 28860 Sitecrafters of Florida Inc 2207 W North A Street Tampa FL 33606 INSURER B:Bridgefleld Employers Ins Co 10701 INSURER C :Owners Insurance Co. 32700 INSURER D :Lloyd's of London $1,000,000 INSURER E : INSURER F : X VERAGES • • 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 (MMIDDIYYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 20857309 ti` - -- - . _ - . •S,, i., . . t' 1,, .r- 448 73804 7/21/2016 712112016 7/21/2017 7/21/2017 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $300,000 GE MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 N1 AGGREGATE POLICY OTHER: X LIMIT APPLIES r-- JECT - L PER LOC GENERAL AGGREGATE $2,000,000 PRODUCTS- COMP /OPAGG $2,000,000 COMBINED SINGLE LIMIT (Ea accident) $ $ 1,000,000 C AUTOMOBILE X LIABILITY ANY AUTO AUTOS NED HIRED AUTOS SCHEDULED NON -OWNED AUTOS BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ PIP -Basic $10,000 A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 4485730902 7/21/2016 7/21/2017 EACH OCCURRENCE $8,000,000 AGGREGATE $8,000,000 DED X RETENT ON $10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N N I A 0830 -36694 7/21/2016 7/21/2017 X STATUTE OTH- ER EL. EACH-ACCIDENT $4;000;090 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 D Pollution Liability PGIARK02095 -04 7/21/2016 7/21/2017 Each Occurrence Limit 2,000,000 Aggregate 5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION City of Clearwater 100 S Myrtle 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