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CERTIFICATE OF LIABILITY INSURANCE (996)AR d CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/VYYY) 2/04/2019 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 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 Poppell Insurance Inc. 503 W. Dr. M. L. King Blvd. Plant City FL 33563-5217INSURERA: CONTACT Patty Lyons NAME: PHONE (813) 752-4155 FAX (813) 752-7681 (A/C, No, Ext): (A/C, No): E-MAIL Patty@poppellinsurance.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # Continential Casualty Co. 20443 INSURED Wetherington Tractor Service IncINSURER PO Box 4199 Plant City FL 33564 ValleyF INSURER B :or Forge 20508 C : Continential Insurance 35289 INSURER D $ 1,000,000 INSURER E : INSURER F : X COVERAGES CERTIFICATE NUMBER: CL1912407966 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUER- WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MMIDD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY - _ _ 4 6079528689 i . _ _.... _ 12/01/2019 .. .. 12/01/2020 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR` DAMAGE TO RENIED PREM SES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'LAGGREGATE POLICY OTHER: X LIMIT APPLIES PRO JECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG 2000,000 $, $ B AUTOMOBILE _ X — — LIABILITY' ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY — _ SCHEDULED AUTOS NON -OWNED AUTOS ONLY _. 6079528692 ' _ 12/01/2019 12/01/2020 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ Uninsured motorist $ 1,000,000 C XX UMBRELLALIAB EXCESSLIAB OCCUR CLAIMS -MADE 6079528708 12/01/2019 12/01/2020 H EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,000 DED X RETENTION $10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y 1 N N/A 10TH I SPTER I R E.L EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A Inland Marine 6079528689 12/01/2019 12/01/2020 Leased or Rented Equipment $500,000 Limit 2% Deductible DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION City of Clearwater 112 S Osceola Ave Clearwater ACORD 25 (2016/03) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE FL 33756 © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD