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MORNINGSIDE MAIN POOL RESURFACING - 16-0035-PR-C - CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 2i27i2018 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 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 NAME: Insurance by Ken Brown, Inc. PHONE FAX 707 Pennsylvania Ave Ste 1300 A/c No Ext: 321-397-3870 A/c,No:321-397-3888 Altamonte Springs FL 32701 ADODRESS: certificates @insbykenbrown.com INSURER(S)AFFORDING COVERAGE NAIC# wsURERA:Amerisure Mutual Ins.Co 23396 INSURED POOLW-5 INSURER B:Amerisure Partners Ins Co 11050 The Pool Works of Pinellas County, Inc. INSURERC:Associated Industries Ins Co 23140 The Pool Works of Florida, Inc. American Outdoor Concepts INSURER D: 9191 130th Avenue North INSURER E: Largo FL 33773 INSURER F COVERAGES CERTIFICATE NUMBER:1662444509 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD/YYY MM/DD/YYY A X COMMERCIAL GENERAL LIABILITY GL20604741002 2/19/2018 2/19/2019 EACH OCCURRENCE $1,000,000 CLAIMS-MADE � OCCUR PREMISES TORENTED PREMISES Ea occurrence) $100,000 X Pool Pop MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 POLICY ❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $2,000,000 X JECT OTHER: $ B AUTOMOBILE LIABILITY CA20604751005 2/19/2018 2/19/2019 COMBINEDSINGLELIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident X $10,000 PIP $ A UMBRELLA LAB X OCCUR CU20950380502 2/19/2018 2/19/2019 EACH OCCURRENCE $1,000,000 X EXCESS LAB CLAIMS-MADE AGGREGATE $1,000,000 DED X RETENTION$none $ C WORKERS COMPENSATION AWC1083613 4/20/2017 4/20/2018 X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE F—] E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Project: Morningside Main Pool Resurface Project#16-0035-PR-C CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Of Clearwater Morningside ACCORDANCE WITH THE POLICY PROVISIONS. Main Pool 2400 Ham Blvd. AUTHORIZED REPRESENTATIVE Clearwater FL 33756 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD