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CERTIFICATE OF LIABILITY INSURANCE (787)SOUTPOW -01 BUSTAI '9� —K" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 8/24/2016 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 Mulling Insurance Agency, Inc. P.O. Box 308 Auburndale, FL 33823 CONTACT NAME: PHONE 863 967 -4454 Fax 863 967 -7592 tac, No, Ext): ( ) (ac, No): ( ) E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC U INSURER A:Old Dominion Insurance Co 40231 INSURED Southern Power & Electric Co. Gulf Power & Electrical Services of Central Fla Inc. 2663 34th St. SW Winter Haven, FL 33881 INSURER B :Auto-Owners Ins. Co. 18988 INSURER C : Bridgefield Employers Ins. Co. 10701 INSURER D D. $ 1,000,000 INSURER E : INSURER F : X CERTIFICATE NUMBE • 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 POLIC ES 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 n YY) POLICY EXP (MM /DD/YYYI() LIMITS A X COMMERCIAL GENERAL LIABILITY MPG65559 09/24/2016 09/24/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR P DREMISES (AMAGE TO Ea RENTED occurre nce) $ 500 000 , MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 $ B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS ^ SCHEDULED AUTOS NON -OWNED AUTOS 4297953900 09/04/2016 09/04/2017 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 $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) Dyes, describe under DESCRIPTION OF OPERATIONS below - / N N /A 0830 -31662 03/23/2016 03/23/2017 X PER STATUTE X OTH- ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) RECEIVED AUG 2 i 2015 OFFICIAL RECORDS AND r.-a -' -• r- ERTIFICATE HOLDER CANCELLATION City of Clearwater /Development & Neighborhood Svcs. Dept. P.O. Box 4748 Clearwater, FL 33758 -4748 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