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CERTIFICATE OF LIABILITY INSURANCE (904) DATE A LY® CERTIFICATE F LIABILITYINSURANCE 5/22/2018 Y) 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 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 y NAME: Maryann Fekete Lancaster Insurance Inc PHONE (727)461-3704 AX (727)441-3298 (AIC_Na Extk "A /C. No): 1210 S. Myrtle Ave. AIL ADDRESS:Maryann.fekete@ lancasterinsur.com P O BOX 2856 INSURER(S)AFFORDING COVERAGE NAIC# Clearwater FL 33757 INSURERA:Owners Insurance 32700 INSURED INSURER B:Southern-Owners Insurance 10190 Jim Kenney Electric Inc INSURERC: James Robert Kenney Lic#EC0003101 I INSURER D: 12800 Sophia Circle INSURER E: '.Largo FL 33774-2428 INSURER F; COVERAGES CERTIFICATE NUMBER:CL134304647 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE I POLICY NUMBER (MM/DD/_YY_YY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES(Eaaccurrence) $ 50,0001 A CLAIMS-MADE � OCCUR X 20514046 6/12/2018 6/12/2019 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY,` $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GGEEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMP/OP AGG $ 2,000,000 X1 POLICY nPRO- LOC $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT !Ea accident) _$---__.----------1,000_ 000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED X 95433339800 '111/21/2017 11/21/2018 BODILY INJURY(Per accident) $ _ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ _ HIRED AUTOS AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE'. AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION X I TNRY I STATU- I 0TH- 1 AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 20331705 4/1/2018 4/1/2019 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? F N/A (Mandatory in NH) F..DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS belowE.L..DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) The City of Clearwater and Clearwater Gas is listed as additional insured with respect to the general liability and commercia auto. liability insurance. Robert.Morig@myclearwater.com CERTIFICATE HOLDER CANCELLATION rosie.westerfield@ clearwat SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Clearwater ACCORDANCE WITH THE POLICY PROVISIONS. Gas Department Attn: Eryn Berg AUTHORID REPRESENTAT9V ,.._A 400 N Myrtle Ave f Clearwater, FL 33755 , i t ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005)01 The ACORD name and logo are registered marks of ACORD