CERTIFICATE OF LIABILITY INSURANCE (938) ' ►' CERTIFICATE OF LIABILITY INSURANCE DATEIMMIDDIYYYY)
11/20/2018
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(les)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain pollcles ma require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in Ileu of such e IT do rsement(s).
PRODUCER NAME:AUT
Brendan McAuley _--_
Killingsworth Agency PHONE (352)796-1451 FAx t3sx:sn�-sseb
AAC No Exth AOC No:
1.5259 Cortez Blvd. " r �' E-MAIL
ADDRESS:
P. D. Box 1754 rJ �7tts.
INSURER(S)AFFORDING COVERAGE MAIC#
Brooksville FL 34645-1750
INSURERA:Ohio securit:x ins„ CO. 24082
INSURED] INSURER B..
CDC Plumbing & Gas Contractor LLC INSURERC:
1247 S Pinellas Ave INSURER
Suite A-1
INSURER E:.
Tarpon Springs FL 34689 MNSURERF:
COVERAGES CERTIFICATE NUMBER.18-19 REVISION NUMBER.:
THIS MS 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
CY EXP
LTR TYPE OF IN SURANCE POLICYNUMBER IDD3AYYYY- LIMITS
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,'000
A CLAIMS-MADE X OCCUR - ,..., . 300,000
PREMISES (Ea occurrence 8
SLS584961,61 12/29/2018 12,/29/2019 MED EXP(Any one Person) s 15,000
PERSONAL&ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE. $ 2,000,000
PRO
POLICY JE:CT LOC PRODUCTS-OOJu9Plt7PAG'G $ 2,000,000
OTHER: Experience Mod Pacior 4
AUTOMOWILE.LIABILITY COM.01RE591NGLE LI I $
Ea acrideni
ANY AUTO BODILY INJURY(Pen person) s
ALL.OWNED SCHEDULED
AUTOS AUTOS BODILY INJURY(Per accident) $
HIREOAUTOS NOWOWNED
AUTOS ROr PYOAMAGE
s
s
UMBRELLA UAB OCCUR
EACH OCCURRENCE. $
EXCESS LIAR CLAIMS-MADE
AGGREGATE
DED RETENTION S S
WORKERS COMPENSATION _ P pH-
AND EMPLOYERS'LIABILITY Y 1 N STAT TE _.. ER
ANY PRO PRIETORIPARTNERIEXECUTWE. E.L.EACH ACCIDENT S `
OFFICERIMEMBEREXCLUDE07 NAA
(Mandatory in NHl E.L.DISEASE-EA EMPLOYEE $
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE POLICY LIMIT 5
DESCRIPTION OF OPERATIONS I LOCATIONS i VEHICLES IACORD 704.,Additional Remarks Schedute,maybe attached if more space Is required)
Limits shown are those in effect at policy inception date.
CERTIFICATE.HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Clearwater Gas THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
400 N. Myrtle: Avenue ACCORDANCE WITH THE POLICY PROVISIONS.
Clearwater, FL 33755
AUTHORIZED REPRESENTATIVE
Brendan McAuley/CLARE )
1988-2014 ACORD CORPORATION, All rights reserved.
ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD
INS026(201404)