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CERTIFICATE OF LIABILITY INSURANCE (804) =TIE DDIYYW) CERTIFICATE OF LIABILITY INSURANCE 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 CONTACT Diane Brier Grieves Insurance PHONE (813)876-4166 C AX (813)870 0170 Lippincott SA Nxa,Nnxdlb B (A r 3617 Henderson Blvd. �IWL dianel @b sins com — ........ .... ..-INSURER(S)AFFORDING COVERAGE NAIC p Tampa FL 33609 INSURERA:Ohio Securitv Insurance 24082 ....... ... ... .... ..�- ... �. .ee ----- ........ 1- ........_ ..... INSURED INSIIRFR R Ohio Casualtv Insurance 24074 INSURER,;w,w,. ...,., ........,.. _. .._— ... ....... ............ Encore Broadcast Equipment Sales CRetailFirat 1. ..... ...... 2104 W Kennedy Blvd INSURER.E ._...... ............__ .......... _.. . Tampa FL 33606 INSURER F COVERAGES CERTIFICATE NUMBER:CL1681613237 REVISION NUMBER: 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. I rw TYPE OF INSURANCE ui L u vn ......POLICY NUMBER „PO, Y . .f .�.... ................. . INSR 11121 Y EFF' PO#NC'Y EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A _ CLAIMS-MADE X OCCUR pRLMISES.(Ep�4 16f1afr1 �4Y $ 300,000 00-- 1 DAMAGE I"O RE NCV D _� -- BKS57000412 11/10/2015 11/10/2016 MED EXP(Anv one person) $ 15,000 — .... -- PERSONAL&ADV INJURY IS 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY El iprn FI LOC P — X,. RODUCTS COMP/OPAGG $ 2,000,000 ' OTHER: Experience Mad Factor 1 $ AUTOMOBILE LIABILITY COMS114ED SINGLE UMG°1 $ 1,000,000 A ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BKS57000412 11/10/2015 11/10/2016 B AUTOS — AUTOS BODILY -_INJURY(Per accident) $ — X HIRED AUTOS X P9OPER T f DA1v1At NON OWNED _ AUTOS Qi'y! 9If#1NR1,,,,........... ....... $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1 0.00."...000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1.000.000 B ......................................................... ...... DEC RETENTION ES056457143 11/10/2015 11/10/2016 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY crnTi irF FR ANY PROPRIETOR/PARTNER/EXECUTIVE E .EACH ACCIDENT $ 1 000.000 OFRCER/MEMBER EXCLUDED' N/A -- C IMandastory In NH) 520-22521 9/1/2016 9/1/2017 E.L,DISEASE EA EMPLOYE $ 1 000 000 If yes,describe under .. ......" DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ 1 000.000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) The City of Clearwater is listed as additional insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Clearwater THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 100 S. Myrtle Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Clearwater, FL 33758 AUTHORIZED REPRESENTATIVE Brier Grieves/NANCY ©1988-2014 ACORD CORPORATION. All rights reserved, ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS02519n1lan+i