CERTIFICATE OF LIABILITY INSURANCE (21) E `�'IFIC T LIABILITY I [:!213120119
EIMtMarDDYYY,,
.�IIC 1
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 CERTIFICA'T'E 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 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 TACT
NAME: CAROL WIGGIN
FULTON AGENCY INC PHONE I L(9541776-9015 c.oL (954}318-7474
1301 E Oakland Park Blvd
E-MAIL
carol fultona enc .com
Oakland Dark, FL 333.34 INSURER s AFFORDING COVERAGE, NAIc
INSURERA: COVINGTON SPECIALTY INS CO
INSURED INSURER B:
JRM SCIENCE ENTERPRISES INC
INSURER C
DBA MAD SCIENCE OF GREATER TAMPA BAY INSURER D: ww
204 37TH AVE NO#123 INSURER E;
ST PETERSBURG FL 33704 INSURER F I
COVERAGES CERTIFICATE NUMBER; REVISION NUMBER:
'HIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
'GCATED. 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 AD@LFsuakrl. POLICY'EFF POLICY EXP._ LIMITS
LTR TYPE OF INSURANCE . POLICY NUMBER MSM&QD0 MtM/DDYYY
X COMMERCIAL GENERAL LIABILITY --_ YY ,nf
EACH OCCURRENCE -- _$ -_..1,QQtl§000
CLAIFaSS-MACE (OCCUR DAMAvETO RENTE6 100(}0f1
PREMISE' tEs occurrence, Ja
MED EXE IAny one per$9ni � 5,000.
A VBA676718 00 21/412019 211412020 PERSONAL&ACV IN.IURY,,,,,..,.) $w 1 000,QC�0_._
��GEN'LAS"GREGATE LIMIT APPLIES PER: GE NE RAL AGGRL ATF...__.. $ 2,000,000
X., POLICY JE� LOC PRODUCTS c P OP AC a 000 000
OTHER:
--
AI1T 7Mf)ffILE
LIABILITY' COMBINED SINGLE-LIMIT $..
Ea a.ccidn
C ANY AUTO BODILY Ih L,RY tR r person) ..
F OWNED SCHEDULED � I ! BODILY IN uRY tiFe..�7cciner4r,
AUTOS ONLY AUTOS
HIRED NON=OWNEf RRC'Pk R't Y OA"r„wC L, _
AUTOS ONLY AUTOS ONLY jPzrr�cid r�
...} $
UMBRELLA LIA9 :OCCUR. — ._EACH OCC RRENCE -_-I.$
I EXCESS LIAR' ... .....
CLAIha4 MAGE AGGREGATE; ( $ -----_
DEO ( 1 RETENTION$
WORKERS COMPENSATION i I PER GTN-
EIS
AND,EMPLOYERS'LIABILITY STATJTF IY I N .- ..... ........
ANY PROPRI>a`ORIPARTNERfEXECUTIVENIA E L.EACH ACCIDENT ..i.$
CYFFICERIMiEMBER EXCLUDED?
(Mandatary in NN) E.L.DISEASE-EA EMPLOYEE $
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $.
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 141,Additional Remarks Schedule,may be attached if more space is required)
SAME AND TEMPORARY WORK SITES ELSEWHERE IN THE STATE OF FLORIDA.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
CLEAR'WATER PUBLIC LIBRARY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
100 N OSCEOLAAVE AUTHORIZED REPRESENTATIVE
CLEARWATER, FL 33755 )
198$ 015 AC RD IOATION. All rights reserved.
ACORD 25(20161031 TI,, AltInDrl.,4..,a4 1—
_ - _ -•- • ..