CERTIFICATE OF LIABILITY INSURANCE (903) Artex Risk Solutions, Inc. FL275
8840 E Chaparral Rd Suite 275
Scottsdale,AZ 85250 RECE'1wu,,,
MAY 2 1 2018
GAS ADMIN
4620 1 AB O405
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CITY OF CLEARWATER 14-4620
400 N MYRTLE AVE
CLEARWATER, FL 33755-4433
AC"RV CERTIFICATE OF LIABILITY INSURANCE DA05/1512018Y]
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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 HOLDEN.
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 CONTAOT
NAME:
Andrew Atsaves PHONEFAX
iAt
clD Artex Risk Solutions,Inc. C No ExgI (4K)951-41.77 {AIC,No� (480]951-4266
. .. .... .... .. .... ....
ED RRL SDL.BSD.Cer[irlcates@ar[extisk.com
8840 E.Chaparral Rd.;Suite 275 ApDnEss:. .
Scottsdale,AZ 85250 INSURER(S)AFFORDING COVERAGE MAIC 0
INSURER A:.Aitierican I_uricli Insurance Company 40142
............ ....... _ ._-. ... .
INSURED INSURER B:
A-1 HR a clivlsiun of Oasis Outsourcing,Inc Alt.Emp:Scotto Plumbing Service Inc.
3829 Coconut Palm Dr INSURER C;
Tampa,FL 33619 INSURER D
INSURER E
INSURFR F:
COVERAGES CERTIFICATE NUMBER:18FL276899889 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATE[), 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 $Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR:........... . .......... .... ��LIClEFF.,....FOLIGY EXP...,.........
LTR TYPE OF INSURANCE POLICY NUMBER MMIDDrYYYV MIDDIYYYY : LIMITS
COMM ERC IAL GENE RAL LIABILITY : EACH OCCURRENCE � S
. : DANTAEiE'rC]RMFCt•U... ..-. .. .
CLAIMS-MADE OCCUR
PRE M15ES JEa occurrence]..-.-;.8.....
MED EXP(Any one pgrsan) 5
PERSONAL&ADV INJURY +$
GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE +s
JPRO-
POLICY LOC PRODUCTS-COMPIOP AGG '5
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OTH F R:
AUTOMOBILE LIABILITY e S
bMBINEU SINGLE Lth11'i
...{En
ANY AUTO BODILY INJURY{Per Wsony 5
I
OWNED : SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY(Per accident). 5
HIRED NON-OWNEb
PROPERTY
.. .;
AUTOS ONLY AUTOS ONLY pAIi1AGE L
r
LPei.accident}.
UhA[3RELLA LI AS
OCCUR EACH OCCURRENCE E
EXCESS LIAB CLAIMS-MADE. AGGREGATE
DED RETENTIONS E
WORK£IRS COMP ENSATIONPFR ❑TH-
:AND EMPLOYERS'UASILITY YIN i x.:.STAT...UTE.TE.i .... ... .-.... .. ...... .
£R
ANYPROPRIETOR1PAR7t4ERIEXECUTIVE E L EACH ACCIDENT : 5 11000,000
A OFFICERIMEMPEREXCLUDE D7 NIA; WC 02-79-166.03 0610112018 ;[1610112019 t ... .......
(Mandatory in NH} E-L.DISEASE-EA EMPLOYEE: t 1,004,040
I!My ,de5LLlbe under .. .. ..-... .. ... .
:llESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT: 3 11004,000
Location Coverage Period: 46101/2098 :06/0112019' Client# 40.1218-FL
DESCRIPTION OF OPERATIONS 1 LOCATIONS VEHICLES (AGORD tpt,Additional Remarks Schedule,may be attached if mare space is required)
Coverage is provided for Scotto Plumbing Service Inc.
Only those co-employees 1761 Camegie Avenue
Or but not subcontract M Clearwater, FL 33756
to,
CERTIFICATE HOLDER CANCELLATION
City of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
400 N Myrtle Avenue THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Clearwater, FL 33755 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
C,9988.2075 ACORD CORPORATION. All rights reserved.
ACORD 25(2016103) The ACORD name and Joao are registered marks of ACORD