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CERTIFICATE OF LIABILITY INSURANCE (806) --�"1 KRUTSIN OP ID: CR2 CERTIFICATE OF LIABILITY INSURANCE 710/18/2016 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 Robert D. Reynolds Morris&Reynolds Inc. PHONE 305-238-1000 FAX 305-255-9643 14821 South Dixie Highway A C No Ext: A/c,No Miami, FL 33176 E-MAIL Robert D.Reynolds ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:United States Fire Insurance 21113 INSURED Krutsinger Services, Inc. INSURER B:RetailFirst Insurance Company 10700 Mr.Steven Krutsinger 4511 North 56 Street INSURER C: Tampa, FL 33610-7109 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSR TYPE OF INSURANCE DDL UBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY X 5068844838 03/24/2016 03/24/2017 DAMAGE TO RENTED 100 000 PREMISES Ea occurrence $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 POLICY JECT LOC Emp Ben. $ 1,000,000 AUTOMOBILE LIABILITY COMEa BINED accident S INGLE LIMIT $ 1,000,000 A X ANY AUTO X 5068844838 03/24/2016 03/24/2017 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS PER ACCIDENT UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY TORY LIMITS IER B ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 52040787 09/08/2016 09/08/2017 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 A Garagekeeper's 5068844838 03/24/2016 03/24/2017 CSL 1,000,000 Legal Liability Hired Lia 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Clearwater Gas Systems and The City of Clearwater are named as additional insured as per written contract in regard to the General Liability and Auto. CERTIFICATE HOLDER CANCELLATION CLEAWAT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Clearwater Gas Systems ACCORDANCE WITH THE POLICY PROVISIONS. The City of Clearwater 100 S. Mytle Avenue AUTHORIZED REPRESENTATIVE Clearwater, FL 33756 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD rAtE�MWDD�YYYY!I AC"RO a ILI CERTIFICATE OF LIABT I U Y NSF;LANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF tNIFORMATION 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. IMPORIANT; If the Certificate holder Is an ADUHIONAL INSURED,the policy(los)miust be endorsed, if SUBROGATION IS WAIVED, subject to the terms and concliflons of the policy,certain pollicios may require an endorsement, A statement On this cortlficaW does not corifair rights to the cerfifIcate holder in lieu of such endorsement(s), PRODUCER 'ANAL: CT Morris&Reynolds Inc (305i 238-1000 (305 255-9643 PHONE F11 Wc,Nq C ------- '148,21 South Dixie Highway E-MA[L ADDRESE:....... ......... ..... ............................. Mian-t FL 33176 MSVRERJ�) ............. NAIC N ........... WSURERA: 21113 INSURED NNSURrR B Ra�aIl Firsi hisiurance Cornpany 1070U Krucinger Services,Inc rN Mr.S1PvPn KnAsOng Pr' MURES D 45 11 North 56 Street INSURER E Tarnpa FL 33610-7109 INS URER F COVERAGES CERTIFICATE INUMBER: REVISION NUMBER; THi$IS TO CERTiFY 7 r1H AT THE POLICIES ".)IF INStjRANCIE LIST-ED BELOW HAVE BEEN ICSUED TO THE INSURED NAtorm AROVE FOR THE POLICY Pl IND C� ATIED. NOTWITHSTANDING ANY REOUIRIE'�,104T, TErVA OR CONDITI01`4 OF ANY CON7 RAc"r oF4 071 IER DOCUMENT fflTH RESPECT TO WHICH THIS CERT11FICATE MAY BE ISSUED OR MAY PERTAIN,, THE INSURANCE AFFORDED BY THE POLICrES DESCRIBED HEREIN 0S SUBJECT' TO ALL THE TERMS, EXCLUSIONS AND"ONDITIONS OF SUCH POLICIES,UNMTS SH0.7VO4 MAY HAVE BEEN REDUCED BY PAID CLAR4S, 1 P Or:�C V EFF PO 1-1 C Y E X P LIR i TYPr OF INSURANCE POLICY NUMBER IMWDDfYYM WM(DDfYYYY11 GENERAL"ABILI"" EACH OCCURRENC' $aAAG L v I I ..........— X GLNERAL PRDVISES 100,00 0 CLAWSIAIADE OCCUR 5,000 A 506B844835 03124x2016 1 03(24/2017 PERSONAL 8 ADVI NJURY -2-,000,00() GENERAL AGW�EGA7E PROCUCTS-CONIP�OP Ar3G i S 2,000 ODG 1,00n,ODO i X Emp,BeneN Uab. AUTOMOBILE UABILITY OMNNED SflNGLE WAIT [X';My A I SCD L'(INJURY(Pu,pees Sri A AlA.QVOEO 5��H F D1 A El D 5068844838 0124/2016 D3/24/2017 INJURY�Por a,,.x,d,w,Q $ i AUTOS AUTOS �ioN-6rvw?rmE,.Ll HIRED AQT0$ AUTO$ S, 1per Am(000L.............. ..... $ UM6RFLLALJAB EALH OCCURRENCE $ I occuq, EKCESS LINK I CLAWS4AADE� AGGREGATE a ........................ ..... UE"U RL R tN MIN WOR KE R5 COMP EN 3 ATION ,7G1 r9f1 WC S1 ATU- QTH AND EMiPLOYERS'LIABIL17Y Y/N IQRYLINI[I$-� , .................. F3 ANy1k1AW*flE7QRfPAR FNXEQI)TIVE EL HAT.HA CIDEW Is OFF GEAWAEMLEA EXCLODED", ��NIA, 620407B7 09,(08/20161 09/09/2017,t- IMmIdatory Ill NH) EL DISEASE r EA $ 500,D00 H as.degalbo undev D SCRIP,rm OFOPERA1 IONS bbl l E L DISEASE 1POL CYLJMIT S 500,000 i Garagekeeper's 5068844838 03/24/2016 0312C2017 CSL S 1,000,000 1 A Legal Uabffit� IlIred Lilb $ 1,0000)() DESCRrPTIIONOFOPERATIONSrLOCATrONS)VEEilCLES 1 Dealer Plate Business Auto Policy provides$10,00O Limit xn PlP cover,F,1ge Garage LiaNlIty Included under the Genw,ial Liabdily Poficy CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Oeamater Gas SyS[eIrJ1 THE EKPIPATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 100 S.Myrtle Avenue ACCORDANCE VVITH THE POLICY PROVISION's, Ctearwater FL 33756 AUTHORIZEC REPRESENTATIVE Robert D.Reyr*Ns ACORD 25(201010,5) Z)1988-201 0 ACORD CORPORATION. All rights reserved. The ACORD name an:dl logo are registered marks of ACORD