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CERTIFICATE OF LIABILITY INSURANCE (831) KRUTSIN OP ID:AAG ACORO DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 03/27/2017 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 NAME:CONTACT Robert D. Reynolds Morris&Reynolds Inc. PHONE 305-238-1000 FAX 305-255-9643 14821 South Dixie Highway AIC No Ext: AIC,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 INSD WVD POLICY NUMBER MMIDD/YYYY MMIDD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE 1XI OCCUR X 5068881108 03/24/2017 03/24/2018 DAMAGE TO RENTED 100 000 PREMISES Ea occurrence $ 03/24/2017 03/24/2018 MED EXP(Any one person) $ 5,000 A Garage Liability 5068881108 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 X POLICY ECT [::] LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER I Emp Ben. $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident A X ANY AUTO X 5068881108 03/24/2017 03/24/2018 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 LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN B ANY PROPRIETOR/PARTNER/EXECUTIVE 52040787 09/08/2017 09/08/2018 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? ❑NIA (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 5068881108 03/24/2017 03/24/2018 CSL 1,000,000 Legal Liability Hired Lia 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Clearwater Gas Systems and The City of Clearwater are additional insureds as required by written contract regarding to the General Liability and Auto Liability coverages. 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 Bruce H. Griffin, PMP AUTHORIZED REPRESENTATIVE 100 Clearwater,r ater, Avenue Clearwater, FL 33756 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD