CERTIFICATE OF LIABILITY INSURANCE (957) APR-20-9019 13:16 From: 6132376990 To:727-562-4902 Fase:1/1
►cc x� CERTIFICATE OF LIABILITY INSURANCE °04i22/2o g
THIS CgRTtFICATE kS IS$tjrn AS A MATTER OF INFORMATION ONLY ANI)CONFERS NO RIGHTS UPON THE CERTIFICATE 14OLDEM THIS
r,eRTIFiCATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
REt_OW. THIS CERTIFICATE OF INSURANCE t7DES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURMS),AUT'HORLZED
REPRESENTATIVIF OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT:'if the aartifichiWe ha iter is aA AnDITIONAL'INSURED,the policy{las)rinuet.be 06dorsed. I€' DROGATI AN 18 WAIVED,subject to
the terms and condKions of the policy,cocain poikWS may require an etWoesoment. A statement on this partifica!ta does not confer rights to the
certificate holder in lieu of%uch ondort;swIlHo•
PRODUCER .. .. rte. Gwen Oliyanti
A.Kilbride ingurolrce,InD, pN Ng !Fax
�Na X813-��-74fi7 __ IA♦c,r,a1;813949-1324__._
2438 Land O I;akes Stud -
LanO C)Lakes,FI.34839 ,n� _cI�� ra#eakilf�ride.Cpm _
INSLSRt:rys>.ri�olant�+?cpv�nAct<..,... .'. nIAIc�
INSFIRBRA:YWestern World Insurance
,Nsuaso` _...... IrdsuEizs:Granada Insurance Co _._....
CSP Plambtng Ssyry m Inc IirTiURF c r
42511 Choctaw Traci .......... .......__.._._,.,,;�_...,...,...-....,.......µ.__.,..,,•:..__Y._,....,. ,.,.,.,.._..._.�._.._.__..,;....,
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HUd3kri, FL 34$99 '.
INSURER E: _ ___ .�,. �_ _i........ ..........._....
i1ISURE
COVERAGES Cfi2TtFICATE NUMBER. REVISION NU€NBER:
TEAS'IS TO CERTIFY THAT THE PDUCIES Or jHaURANCE LISTED KLOW HAVE @EEN ISS4E6 TO THE INSURep NAMED ABOVE FOR THS P6LICY PERIOD
INDICATED. NOTW1'THSTANDING ANY REQUIREMENT,TERM OR CQNDITION Cir'ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO WHICH TMIS
CERTIFICATE MAY BE 15stiEo OR MAY PERTAIN, THE Ihf5URANCE AFFORDED BY THE POLICIES DESCRIBED t1&-REIN tS Suo4SCT TO ALL THE TERMS.
FXCLUSIONS AND CONDITIONS Or SUCH POLICIES.LIMITS$H OWN MAY HAVE 9EEN REMJGED BY PAID CI-AIMs.
1 ,.......,...... ,�-- L1Z`'Y 6FP� �IMkTB
L I IYrE OF NtSS]A.AN.f. , PL1I,ICY #tlER
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3 I 'DAA'f�4GE
COMME904&L QtiNERAL LIAetL4TY
cLn>�+s-raArae IM ,j aCcuR x I#IPP85fi1543 10/25/18 ! 14/25/19 M.px!'[aaneer � d
P£fleONAL A ACV INJURY 3 11=000
GFOERAL Ai�GRWAI'F_...- ><,....'.__. 2,000,0114
fL1Fr,ML AGGREGATE UMIT APPLIES PER. `•PRoncicrs•onaip+DF'r,�GG I s .. - 2,000,000
POIXY
Om AU110100IRLIN LIABILITY ;.F:crdeni L 1 QD,(1Q0
{!?O LY INJURY(P&p6 M) 15
I ALL Ow'ur ED1 ANY AUTO
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ANY PR{]PRIETDRIPARTNFRlEXECUTIVE N f A E i I E.L;EACH ACCIPS f
t]fftC.ERlMEhif+.ER E7CCLS}C3k]U7 ..
IMAntlR#Pry 1n I j c.L.e75rA.SE-�A&AFFLpTE6'`9
if aA.ddxcripp under ! I SI £.L iSiSL?«
"T"' IPTION OF OPERA7>SkJ:�
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DE5CRIrTlON OF OPERATIONS r LOCATIONS 1 V0810LEA IAmvu4 ACWP icn,AddWvna}Rem fu tcfiacd .H mora sgxo I:nqu}rrd]
Certificate holder is also an additional insured under Cenerat liability and Auto coverage, as per written
contract. Waiver of subrogation also included under General liability coverage, as per written contract.
Certified Plumbing Contractor#CFC1426960
CERTIFICATE HOLDER CANCELLATION
Clearwater Gas System SHOULDANY OF THE AWVE t}88 A$BEDPOUq"0!E CANCELLED KFQRE
400 North Myrtle Ave THE 90MATION DATE THEREOF, NCMCs MLL N OgiAVERED IN
Clearwater,FL 33755 ACCORDA NC F WITH THE POLICY FROW41DNS.
Fax; (727)562-4$02
auTr+OeatRa laet»lesErrrATIYE?
{d11988.2010 ACORD CORP9R 1014, All rights riot erWed-
ACORO 25 1407{100 The ACORD name and Ingo are ragistarad marmi of ACORD
JIMMY PATRONIS
CHIEF-FINANICAL OFFICER STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF WORKERS'COMPENSATION
CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW
CONSTRUCTION INDUSTRY EXEMPTION
This certifies that the individual listed below has elected to be exempt from Florida Workers'Compensation law.
EFFECTIVE DATE: 7/1012018 EXPIRATION DATE: 719/2020
PERSON: CRAIG ISABELLA EMAIL: SABRINACSPINC@YAHOO.COM
FEIN: 825254863
BUSINESS NAME AND ADDRESS:
CSP PLUMBING SERVICES INC
12511 CHOCTAW TRAIL
HUDSON, FL 34669
SCOPE OF BUSINESS OR TRADE:
Plumbing NOC and Drivers
IMPORTANT:Pursuant to Chapter 440-05(14),F-S_,an officer of a corporation who elects exemption from this chapter by filing a certificate of election under
this section may not recover benefits or compensation under this chapter.Pursuant to Chapter 440.05(12),F.S.,certificates of election to be exempt...apply
only within the scope of the business or trade listed on the notice of election to be exempt.Pursuant to Chapter 440.05(13),F-S.,Notices of election to be
exempt and certificates of election to be exempt shall be subject to revocation if,at any time after the filing of the notice or the issuance of the certificate,the
person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a
certificate at any time for failure of the person named on the certificate to meet the requirements of this section.
DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609