CERTIFICATE OF LIABILITY INSURANCE (997) Act& CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDMM
1212012019
THIS CERT)FiCATE IIS ISSUER AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELYAMEND,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 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 endarsement(s).
PRODUCER CONTACT Debbie Qullas
NAME
Stahl&Associates Insurance Inc, PHONE (813)818-5300A (813)818-5395
JAS No Qdl� I AfC.No
3939 Tampa RoadAoDRELss: debble.quiles®stahlinsurance.com
INSURER(S)AFFORDING COVERAGE MAIC 0
Oldsmar FL 34677 INSURERA: Evanston Insurance Company
C INSURED
INSURER 9:
Paws for Friendship Inc INSURER C;
PO Box 341378 INSURER D:
INSURER E:
Tampa FL 33694 1 INSURER F:
COVERAGES CERTIFICATE NUMBER- 19120 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, N07IMTHSTANDING 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 1S SUBJECT MALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
EXP
LTR TYPE OF INSURANCE i Sp POLICYNUMBER (MWDDlYYYY POLICY
M DDZYYYY LIMITS
X.COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $
1,000,000
RERTEtf__
CLAIMS-MADE ®OCCUR PREMISES Eo oauriunce S 100,000
MED ECP(Any one parson) $ 5.000
A 3AA375118 12720!2019 12120/2020 PERSONALS ADV INJURY S 1,040,000
GEN"LAGGREGATE UMITAPPLIES PEP.; GENERAL AGGREGATE S 2,000.000
POLICY E JE' r7 LOC PRODUCTS-COMPIOPAGG s induded
OTHER. Animal Coverage Endt s 100,000
AUTOMOBILE LIABILITY COM31NED SINGLE LIMIT S
Eo accldonG
ANYAUTO BODILY INJURY(Por person) S
OWNED OS OULEO
AUT
AUTOS ONLY AUTOS BODILY INJURY(Pet acddont) S
A
HIRED NCNWNED PROPERIYDAI.tAGE
AUTOS ONLY AUTOS ONLY Per axklent S
s
EDED �
_.[dOCCUR EACH OCCURRFNCE 5
CLAIMS-MADE AGGREG+s--: S
NTION S S
WORKERS COMPENSATION PGR7H-
AND EMPLOYERS'LIABILITY YIN STATUTE I ER
ANY PRO PRIETORMARTNEWEXECUTNE
OFFICER/MEMBER EXCLUDED? NIA E.L.EACH ACCIDENT 5
(Mandatory Vas.deacnpe Under andatory In E.L.DISEASE-EA EMPLOYEE S
Under
DESCRIPTION OF CPERATIONS belay E.L.DISEASE-POLICY 1.1hirr 5
DESCRIPTION Of OPERATIONS I LOCATIONS I VEHICLES IACORD 101,Addldonal Remarks Schedule,may be attached If more spike*Is required)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
FOR INFORMATIONAL PURPOSES ONLY ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
4&%r Z, sra&
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