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CERTIFICATE OF LIABILITY INSURANCE (902)A, CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 5/7/2018 THIS CERTIFICATEIS 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 SIHLE INSURANCE GROUP INC/PHS 225280 P: (866) 467-8730 F: (888) 443-6112 PO BOX 29611 CHARLOTTE NC 28229 CONTACT NAME oicc,m,Ext): (866) 467-8730 (a ,No): (888) 443-6112 gDESS: INSURER(S) AFFORDING COVERAGE NAICN NsuRERA: Hartford Casualty Ins Co INSURED INTERIOR FUSION 7261 BRYAN DAIRY RD SEMINOLE FL 33777 INSURER B : LIABILITY INSURER C: INSURERD: SBA R53988 - F ' e�. �� ( INSURER E: 06/01/2019 INSURERF: $2,000,000 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 LTR TYPE OF INSURANCE ADDL INSR SUER WV!) POLICY NUMBER POLICY EFF (M41/DD/YYYY) POLICY EXP MM/DD/PYY17 LIMITS A COMMERCIAL GENERAL -MADE Liab LIABILITY 21 SBA R53988 - F ' e�. �� ( 06/01/2018 ' '!, 3 - " 4I i , s".. , 06/01/2019 EACH OCCURRENCE $2,000,000 CLAIMS X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $300,000 3 0 0 0 0 0 X General X MEDEXP(Anyoneperson) $10, 000 PERSONAL&ADVINJURY s2, 000,00 0 GENT. AGGREGATE LIMIT PRO- JECT� APPLIES PER: GENERAL AGGREGATE $4,000,00 0 POLICY X LOC PRODUCTS -COMP/OP AGG sExcluded OTHER_ S A AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY SCHEDULED AUTOS NON -OWNED AUTOS ONLY 21 S ;� s6 ,+� �I I�`�I ��, LEG'Si nTI�jY_' 11f1I1{._ -6�l14 / g (- lM�,-� 1` /\{�jl 6J SRVCS DEP DEPT. 06/01/2019 COMBINED SINGLE LIMIT (Ea accident)rr $2000000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X x PROPERTY DAMAGE (Per accident) $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEC RETENTION $ $ WORKERS COMPENSATION ANDEAfPLOrLRSLIgg1LnT ANY PROPRIETOR/PARTNER/EXECUTIVB'/N OFFICERJMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS N/w PER OTN- STATUTE ER E.L. EACH ACCIDENT $ EL DISEASE- EA EMPLOYEE below E.L. DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS /LOCATIONS I VEHIOPEZORD 101 Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. Certificate holder is an additional insured per the Business Liability Coverage Form SS0008 and the Hired Auto and Non Owned Auto Endorsement SS0438, attached to this policy. CERTIFICATE HOLDER CANCELLATION The City of Clearwater 112 S OSCEOLA AVE CLEARWATER, FL 33756 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE _f" ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD "�,CERTIFICATE OF LIABILITY INSURANCE DATE 5/7/2018( THIS CERTIFICATE'S 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 714E 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 SIHLE INSURANCE GROUP INC/PHS 225280 P:(866) 467-8730 F: (888) 443-6112: PO BOX 29611 CHARLOTTE NC 28229 CONTACT NAME: ox.mr,Ext: (866) 467-8730 wc.No): (888) 443-6112 o�sss INSURER(S) AFFORDING COVERAGE NAICK INSURER A: Hartford Casualty Ins Co INSURED INTERIOR FUSION 7261 BRYAN DAIRY RD SEMINOLE FL 33777 INSURER B LIABILITY INSURER C INSURERD: t i j' - INSURERE: EACH OCCURRENCE INSURERF: MBER: 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. ]NSR Int TYPE OE INSURANCE ADDL IN.ss SITBR WVD FOLIC YNUMBER POLI6YEFF (MM/DD/YYYT% POLICY EXP (M'MIOD/rYYfl LIMITS A COMMERCIAL GENERAL Liab LIABILITY 21 SEA RS? Bt&} -.1,V//Q(IS18 t i j' - 06/01/2019 EACH OCCURRENCE $2,000,000 CLAIMS -MADE X OCCUR DAMAGE TO PREMISES (aENTED occurrence) $300,000 X General MED EXP (Any one person) $10,000 PERSONAL &ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT JECT PRO- APPLIES PER: GENERAL AGGREGATE $4, 000,000 POLICY X1 LOC PRODUCTS-COMP/OPAGG sExciuded OTHER: $ A AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY SCHEDULED AUTOS NON -OWNED AUTOS ONLY L r; G��F�(_.I�L i� 1EGjSLAil('E 21 SEA RS3988 ECO,r� D.s ANDCOMBINED .� Jf�L SRVCS DEPT, 06/01/2018 06/01/2019 SINGLE LIMIT (Ea accident) $2,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X , x PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE 5 AGGREGATE $ $ DEC RETENTION $ DECOMPENSATION 9ND�PLOYF.DS LIA.8ILL7G[TY ANEMPLOYERS' ANY PROPRIETOR/PARTNER/EXECUTIVEY/N OFFICER/MEMBER EXCLUDED?r (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS 11 ,yA PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE- EA EMPLOYEE $ below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS / VEHICII S)RD 101 Additional Remarks Schedule. may be attached if more space is required) Those usual to the Insured's Operations. -------------- Ucic I IrIt,M 1c AOtr,crc The City of Clearwater 112 S OS CEO LA AVEu�„ CLEARWATER, FL 33756 —...----- _____ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE L �` r A .....r.n ~singes^ es ATIP1W All .41..1.11.c ...cm,' ACORD 25 (2016/03) l"J IDOD- . The ACORD name and logo are registered marks of ACORD