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CERTIFICATE OF LIABILITY INSURANCE (988) , 6..R ® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIVYYY) �._.--� 11/22/2019 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(ies)must 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 CONTACT Maryann Fekete NAME: Lancaster Insurance Inc PHONE (727)461-3704 FAX (727)441-3298 AIC No Ezt: AIC No): 510 Druid Rd Suite C h-MAIL s:Maryann@lancins.com ADDRE P O BOX 2856 INSURERS AFFORDING COVERAGE NAIC# Clearwater FL 33757 INSURERA:Owners Insurance 32700 INSURED INSURER B;Southern-Owners Insurance 10190 Jim Kenney Electric Inc INSURER c:Houston Casualty 42374 James Robert Kenney Lic#EC0003101 INSURER D: 12800 Sophia Circle INSURER E: Largo FL 33774-2428 INSURER F: COVERAGES CERTIFICATE NUMBER:CL134304647 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE T RENTED PREMISES Ea occurrence S 50,000 A CLAIMS-MADE FOOCCUR X 20514046 /12/2019 /12/2020 MED EXP(Any one person) S 5,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 2,000,000 X POLICY PRO- LOC $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident _ S 1,000,000 X ANYAUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED X 5433339800 1/21/2019 1/21/2020 AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE S AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN 'RY - ANY PROPRIETOR/PARTNER/EXECUTIVE 0331705 /1/2019 /1/2020 OFFICER/MEMBER EXCLUDED? � NIA E.L.EACH ACCIDENT $ 500,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 C Professional Liability CC1967146 1/21/2019 1/21/2020 per claim 1,000,000 per aggregate 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) The City of Clearwater and Clearwater Gas is listed as additional insured with respect to the general liability and commercia auto. liability insurance. CERTIFICATE HOLDER CANCELLATION Eryn.Berg@MyClearwater.com SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Clearwater Gas Department ACCORDANCE WITH THE POLICY PROVISIONS. 400 N Myrtle Ave Clearwater, FL 33755 AUTHORIZED REPRESENTATIVE Maryann Fekete/MAF I ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).0' The ACORD name and loan are regi-,tered mark-, of ArOPn