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CERTIFICATE OF LIABILITY INSURANCE (905) Ben Brown Insurance Agency Fax To: City of Clearwater Fax: 7275824902 From: Jessica Phone: (941)487.3502 Email: Jessica@BenSrownlns.com Date: 5/2512018 3:43 PM Subject: Electro Mechanical South renewal insurance certificate Memo: Good afternoon, This is the renewal certificate of insurance on behalf of Gemini Enterprises, Inc. dha Electro Mechanical South for your records. If you have any questions,or need revisions, please respond directly to me and INCLUDE a copy of this certificate(so that I [snow which company you represent)and I will be happy to assist you. Thank you and have a wonderful weekend. Jessica Ben Brown insurance Agency DATE(MM[ODIYYYYI A R0 CERTIFICATE OF LIABILITY INSURANCE 5/25/2018 THIS CERTIFICATE IS ISSUED AS A NATTER 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) roust 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 suets endorsementts). PRODUCER CONTACT E: Angela Powers Ben Brown Insurance Agency PHONE (941 366-9373 'rix {e411 365-3143 3731 8 Tuttle Ave ADDRE S:cartifieates@benbrowmi.ns.com INSURER(S) AFFORDR40 COVERAGE ?WC @ Sarasota FL 34239-6410 INSURF-RA:Southern Owners Insurance Co 10190 ......._......._....................._......._..__......_........_......_......_...... ...._......_......_.........................-......_.....__....._....._......_............_......_......-...... _... INSURE] IN8uRER.a-Auto-Owners Insurance Cc 18988 Gemini Enterprises, Inc., INSURERC: DBA: Electro Mechanical South INSURER D: ...._._ W._..__...._....... 1575 Cattlemen Rd INSURER E Sarasota FL 34232 INSURER F: COVERAGES CERTIFICATE NUMBER;18/GL,BA,UME 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 SEEN REDUCED BY PAID CLAIMS. _.....—..._..... .......__..,....,.... ...—..._....._.....__.......�...,.__......... _...,.__�,..._..__... ..._.. ..._..... ..._....._................._...._............. ...._......_....__..........._...._.............._...._....._.. ...._...._,.._.._...m,............_....... SR EAVOL'$[I Rr POLICY EFF PWDDr Fare LIMITS LTR TYPE OF INSURANCE I I POLICYNUMBER t X COMMERCIAL GENERAL LIABILITY � EACH OCCURRENCE $ 1,000,000 A .._ ..... CLAIMS-MADE C OCCUR _?i? ! R SZ $._. .m... .....300,000.. I 20292104 6/14/2018 6/14/2019 MED EXP jLnX one pemm S 10,000 PERSONAL&ADV INJURY $ 1,000,000 3 GEN'L AGGREGATE LIMIT APPLIES PER: j I GENERA!AGGREGATE $ 2,0Q0,000 PON LICY[:]JECQT- CDC PRODUCTS-COMPiOP AGG $ 2,000,000 DTIER: I $ AUTOMOBILE LARLITY 0 BINEDSINGLELIMrr $ 1_�.000,000 $ Lra.-.... ..._...._.... ._..... ......_..... ..._..._... .........._.............. _. XANY AUTO I BODILY INJURY(Par persm) $ ALL OWNED SCHEDULED ' AUTOS AUTOS i 4510180542 6/14/2019 611412019 BODILY INJURY(Paracc�dentl S NON-OWNED E I PROPERTY DANKM X HIRED AUTOS XAUTOS ,...._....._......... .... $..._...._..m............._......_............. _. X PIP 10.000 1 S X UMBRELLA LFAs X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS[IAB CLAIM"ADE AGGEiEGgTE $ 7 400 029.. A —.._ _. _................... .._..._.......-......-............_........._....._......-....._...._r r 1)ED x IRETENTIONE 0 4SID190503 5/14/2010 5/14/3019 $ WORKERS COMPENSATION !PER AND EMPLOYERS'UABSUTY Y I NI STATUTE ER ANY PROPRIETOWPARTNERIEXECUTWE sl E.L.EACH ACCIDENT $ OFFICERMEMBER EXCLUDED? NIA _ ............_. .. ...._..._..._..._......._....m... ....m.. ............. ...._......m (PAarWatnry In NH) E.L.DISEASE-EA EMPLOYEE $ If gas,deswibe Under I DESCRIPTION OF OPERATIONS blow ! E.L.DISEASE-POLICY LIMIT S i A Bailess 20292104 611412918 611412019 Uma 250.400 � � I DESCRIPTION OF OPERATIBNS I LOCAMONS I VEHICLES(ACORD 101,Addiilornal Remarks Schedule,Wray be attached H mor*space Is required) Repair industrial electric motors, Bumps and controls. CERTIFICATE HOLDER CANCELLATION (727)562-4902 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Clearwater THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1900 Grand Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Clearwater, FL 33765 AUTHORIZED REPRESENTATIVE levan Browrt1ANGELA ©1988-2094 ACORN CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025(2DI401)