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CERTIFICATE OF LIABILITY INSURANCE (4) 6 DATE IMMIDDIYYYY) gCoRo CERTIFICATE OF LIABILITY INSURANCE �� 01111/2018 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 have ADDITIONAL INSURED provisions or he.endorsed. If SU13ROGATION IS WAIVED, subject to the terms and conditions.of the policy.certain.policies may require an endorsement. A statement on this certificatedoes not confer rights to the-certificate holder.in lleu.of such endorsement(s). PRODUCER CONTACT. Shelley Bryant NAMEt Coleman Insurance Agency,.Inc PFFDFI£ (727}44'1-5911 No; (727}441=8566 1255 Belcher Read E-MAIL ADDRESS: SheEleYColemanA enc]FL.com INSURER 5 I AFFORDING COVERAGE NAIL#: Dunedin .FL 34.698 INSURER A; NIT.VERNON FIRE=INS CO INSURED INSURER H: TECHNOLOGY INS CO 42376 Clearwater For Youth Inc. INSURER c: UNITED STATES LIABILITY INSURANCE CC 1501 N Belcher Rd INSURER D.. Suite 236 INSURER E.:. Cle6rwateir FL .33765 INSURER F- COVERAGES CERTIFICATE NUMBER: REVISION.NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE L15TED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY.PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT ;'TERM'OR CONDITION OF ANY CONTRACT OFR.OTHER DOCUMENT WITH RESPECT TO WHICH.THIS CERTIFICATE=.MAY BE ISSUED OR MAY PERTAIN, THE; INSURANCE AFFORDED BY THE POLICIES. DESCRIBED HE=REIN.IS SUBJECT TO ALL THE TERMS: EXCLUSIONS AND CONDITIONS OF SUCH �P�OLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED SY PAID CLAIMS. IL,IS�R TYPE OF INSURAHC.E I TDAL SU8R POLICY EFF POLICY EXP POLICY NUMBER MMIDAIYYYY M"'ODry.Y LIMITS X COMMERCIAL GENERAL LIABILITY E,40}i OCCURRENCE t S 1,000,�OE} CLAIMS-MADEX OCCUR � 00,000 MED EXP(An one person) $ 51000 A. NPP2556717E 01115/2018 1[0111 51201 9 PERSANA[_&ADY INJURY s. Excluded �G/EEN'LAGOkEGATELIMITAPPLIESPER: € f GENERAL AGGREGATE 5 2,000,000 /•L POLICY El PROT I 71 LOC PROD UCTS-.COMPIOP AGO $ E~xcluded. ,lEC �7 3.O7HER: $ E 3 E AUTOMOBILE!_1ABILITY i COMBINED SINGLE LIMIT S. Ea accident ANY AUTO j BODILY INJURY.(Per perspn) S W OWNED. SCHEDULED 1 BODILY WJURY(Peracc dant] $ AUTOS.ONLY AUTOS HIRED JON-OWNED PROPERTY DAMAGE 5 AUTOS ONLY Ai17Q5 ONLY Per accident E FFS UMBRELLA LIAR OCCUR OCCUR EACii OCOVRRENGE SW. _._,_..V... ExCESS:LIABI ` CLAIMS=MADEF1 DED I I RETENTIONS WORKERS COMPENSATION PEft OTH- i AND.EMPLOYERS'LTAHILITY T STA?'l1rE _ER__ f ANY PEtOPRIETORlPAfRTNEPJEXEGU7IVE Y'h [ E.L.EACH ACCIDENT S 500,000 B €OFFICEPJMEMSER f_xCWDEW N� N I A� TWC363555fi OW1612011 0061201.8 E(Mandatory In.NH) E:L:DISEASE-EA EMPLOYE 5 500P000. Itzes,describe under SDSCRIPTi0I2OFOPERATIONShe,ow § E.LDISEASE-PQLICYLIMI7 S 500P000 Directors and Officers [ General aggregate $1.,000;000: C N1701054775L 11101/2017 11/01/2018 3 DESCRIPTION OF OP£RATIRNS I LOCATIONS I VEHICLES (ACORD:707,Additional Remarks Schedule,may beattached if more space is required) Certificate holder is ilsted.as:Additional Insured with respect to General Liability.. CERTIFICATE BOLDER CANCELLATION SHOULD ANY OF..THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE .THEREOF; .NOTICE WILL BE DELIVERED IN City of Clearvi+ater ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED.REP RESENTATI V E 1501 N Berber Rd. .Clearwater FL .33755 ©1988-2015 i4CORD CORPORATION. All rights reserved. ACORD 25(201ww) The.ACORN name and logo are.registered.marks-of ACORD