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CERTIFICATE OF LIABILITY INSURANCE (915) " L;tK I II-IUA It Ut LIAbILI I Y INbUKAN4t T/z9/zo18 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 REPRESENTAT€VE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: H the certificate holder Is an ADDITIONAL INSURED,the policy(les)must he endorsed. If SUBROGATION IS WAIVED,sub*t 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 NAME, C7essica Belvitch Ben Brown Insurance Agency PHONE~ [941]487--3502 FAX {941 365-3143 3731 S Tuttle Ave ESL _ ADD s:certificates@benbrownins.com. INSURER(S) AFFGRDING COVERAGE NAiC g Sarasota FL 34239-6410 ....... INSURERA:©nit:ed $ ecialt Ins Co 12537 INSURER INSURERS Autd--Owners Insurance Co 1S9$$ 3 1E+1 Barris Contractors, Inc. INsuR3�Rc:Evanstpn Ins Co 35378 344$ Crystal Springs Rd. E"!RER.D:_TraV lt3 s Property_.Casuals Cq of 25474 _...._� _ ._ ......._5..._................._...... INSURER E Zephryhills FL 33544 INSURER F: COVERAGES CERTIFICATE NUMBER:IS/GL,Exs, 17/BArSxs 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. NOTWUHSTANDING 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, E XGLUS{ONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 3NSR . ..._......_......._.... .... W.... . J4rSfii [3a`R..........._..�. ...._.._...... ............_........... _........._.:_.. _....._...m.... LTR TYPE r7F INSURANCE ? POLICY NUMBER POLECY EFF PMW E7CP LIMITS X COMMERCIAL GENEPAL LIABILITY I ERCH OCCURRENCE g 1,000,000 A CLAIMS-MADE C OCCUR TQ RENTED PRFJAI ESTER Qr,�c�,rrence S IQO,000 I X LIG0617900 8/2/2618 8/2/2919 MED EkP Any ane person S 5,1300 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMrr APPLIES PER: ! GENERAL AGGREGATE $ 2,000,000 POLICY I I PRO- LOC PRODUCTS-CO3MPIOPAGG g 2,004,000 OTHER: f AUTOMOBILE UABUTY I OMBI, PILE ANY AUTO B i I BODILY INJURY(Per person)ALL $ AUTOS E3J SCHEDULED AUTOS X j 5142469400 110/1/2017 10/1/2010 BODILY INJURY(Persoddent) $ NON-CWNED I HIRED AUTOS AUTOS E PROPERTY DAMAGE f {PeraF�€den9................W.._.:._... g 7C PIP'30,00.0 S UMafiELLALiAi3 7C E OCCUR EACHi CCURRENCE S R 000 000 �( EKCESSLIAR CLAIMSMADE AGGREGATE S 4 Ufl0 9©t3 C _....._... .. ........._,.._..._....._....R r DEb RETENTION$ NKLV2EUL102685 8/2/2618 812/207.9 S WORKERS COMPEH$ATION [ PER TH AND EMPLOYERS'UABftnY YIN f[ 1 STATUTE ER ANY PROPRtETORIPARTNERIE%ECUT[V OFE.L EACH ACCIDENT $ FPGERIINEMSER EJCCLUDO? N7A� m......_.. ..,.._..._..._.......__..�...................W... It EL DISEASE-EA EMPLOYE I! es,�rn6e under I $ b SCRIPTtON OF OPERATIONS Wow F-L DISEASE-POLICY LIMIT $ D Excess Liability (Auto) ! SUP15T9846k17NF 110/1/2017 10111201H Ar agate 1,000,000 3 � I DESCRIPTION OF OPERATIONS 1 LOCATIONS 1VEHICLES(ACORD 101,Additional komAds Schedule,maybe aUacAad If mcre lapse*Is requlredl Motile Welding and Underground Installation- - The City of Clearwater is an additional insured with regard to general liability including products and completed operations and auto liability. CERTIFICATE HOLDER CANCELLATION (727)552-4902 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Ci..ty of Clearwater Administrative THE EXPIRATION DATE THEREOF, NOTICE WELL BE DELIVERED IN Offices and South Area Service Center ACCORDANCE WITH THE POLICY PROVISIONS. 440 North myrtle Ave Clearwater, rL 33755 AUTHOR=REPIIESENTATtVE Evan Brown/ANGELA A ®798&2014 ACORD CORPORATION. All rights reserved. ACORD 25(2414101) The ACORD name and Toga are registered marks of ACORD INS025(muoi)