CERTIFICATE OF LIABILITY INSURANCE (838) Client#: 1192721 GASLOGI
DATE(MMIDOIYYYY)
ACORIDn. CERTIFICATE OF LIABILITY INSURANCE 3103/2017
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,EX'T'END 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 NA141E Select Commercial Unit
USI Insurance Services,LLC PHONE 855-874-1270 04 No
500 Columbia Drive,Ste 102 -MAN+�
AnORESS: selectcommercial @usi.COm
West Palm Beach,FL 33409-2718 .~ - INSURERIS)AFFORDING COVERAGE NAIC 0
561 693-0500 INSURERA:Arch Specialty Insurance Compan 21199
INSURED INSPIRER B
Gas Logistics,Inc.
INSURER C
dba All American Gas Services
INSURER D-
PO Box 46007
INSURER E
Tampa,FL 33647
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 CONTRACTOR 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.
USIINSR TYPE OF INSURANCE ADDL SUB POLICY EF E POLICY EXP L�h6Crs
I f INSR YVVD POLICY NUMBER MMlDDI1 YY MMIDD
A X4 COMMERCIAL GENERAL LIABILITY AGL002307102 D3/03/2(117'0310312018 EEpACH OCCURRENCE s2,000,000
i CLAIMS-MADE [9 OCCUR E PRE.398 EaE.NTEDnce s150,000
i MED EXP(Any one person) $10,000
i PERSONAL&ADV INJURY 52,000,000
GEKL AGG REGATE LIMIT APPUE 9 PER' I GENERAL AGGREGATE 82,0000{(0
I PROD UCTS-COMPIOPAGG 52,000,000
PRO-
POLICY❑JECT F
LOG
i OTHER: $
AUTOMOBILE LIA131U Y I COMBINED SINGLE LIMIT
Ea aodddent 5
ANY AUTO BODILY INJURY(Per person) Is
ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS NOUN OWNED � PROPERTY DAMAGE 5
HIRED AUTOS AUTOS RECE ED (Per accdent 5
Y Y r
UMBRELLA LIAR OCCUR I EACH OCCURRENCE $
EXCESS LIA9 CLAIMS-MADE MAR 14 2 Q 17 AGGREGATE 5
DED RETENTION$ $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS'LIABIUTY YIN ��--rr �w ��gg��yqgy U
ANY PROPRIETORIPARTNERIEXECUTNE ra AS 1-3SPIi`F.]LN E.L.EACH ACCIDENT $
OFFICEMMEMBER EXCLUDED? NIA
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE: S
Ryes,desc6be under
DESCRIPTION OF OPERATIONS below E,L.DISEASE-POLICY LIMIT Is
f
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORO 101,Additional Remarks Schedule,may be attached If more space Is required)
CERTIFICATE HOLDER CANCELLATION
CLEARWATER GAS SYSTEM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL 13E DELIVERED IN
400 N MYRTLE AVENUE ACCORDANCE WITH THE POLICY PROVISIONS.
CLEARWATER,FL 33755
AUTHORIZED REPRESENTATIVE
I
1D 1988.2014 ACORD CORPORATION.All rights reserved.
ACORD 25(2014101) 1 Of 1 The ACORD name and logo are registered marks of ACORD
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