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CERTIFICATE OF LIABILITY INSURANCE (770)
A o CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 8/1/2016 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 Wallace Welch & Willingham, Inc. 300 1st Ave. So., 5th Floor Saint Petersburg FL 33701 CONTACT NAME: PHONE Ei2 727 - 522 -7777 I 727- 521 -2902 ( ) Ljn/n c. No): A' ADDRESS: certificates @w3ins.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :Continental Insurance Co. /CNA 35289 INSURED DUNCSEA -01 Duncan Seawall Dock & Boat Lift, LLC Lift, LLC 1714 Independence Blvd. Sarasota FL 34234 INSURER B :Nat'l Fire Ins Co of Hartford 20478 INSURER C : 8/1/2017 INSURER D: $1,000,000 INSURER E : INSURER F : X COVERAGES •1062094976 • 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 Y Y ML9780704 - .... - 8/1/2016 8/1/2017 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $250,000 MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE POLICY OTHER: X LIMIT APPLIES JEr PER: LOC GENERAL AGGREGATE $2,000,000 PRODUCTS-COMP/OP AGO $2,000,000 $ B AUTOMOBILE X X _ LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X _AUTOS SCHEDULED AUTOS NON -OWNED 6043010654 8/1/2016 8/1/2017 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PRRPERTY DAMAGE (Per accident) $ A UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE EX121943 8/1/2016 8/1/2017 EACH OCCURRENCE $5,000,000 AGGREGATE $ $ DED X RETENTION $25,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER /EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A Protection & Indemnity Y Y H876587 8/1/2016 8/1/2017 Per Occurence 1,000,000 CSL 1,000,000 Deductible Per Occ 2,500 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Mark Parsons CGC1517864 Certificate holder is named as Additional Insured regarding General Liability coverage. CERTIFICATE HOLDER CANCELLATION City of Clearwater 100 S. Myrtle Ave Ste 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