CERTIFICATE OF LIABILITY INSURANCE (1012) � bDTpl3 �TIFI T F LIABILITY I r� 0 YY)
THIS CER IFICATE 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 INSURERS), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT:It the certificate holder Is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL.INSURED provisions or be endorsed.It
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($).
PRODUCER NCAICT
sc+
Alan Risk Services Central, inc 1-1 283 7122 {8f)p) 363_®las
St. Louis ono office [Arc,NOs Ealt); tAt c.Na.g;
4220 Duncan Avenue2
E-MAIL o
Suite 401 ADDRESS;
5t Louis mo 63110 USA
INSURER(S)AFFORDING COVERAGE NAIL#
INSURED INSURER A; old Republic insurance Company 24147
Pulte Group, affiliates and subsidiaries INSURER B:
2662 S. Falkenburg Rd.
Riverview FL 33578 USA INSURER C.
INSURER D.
INSURER E:
INSURER F..
COVERAGES CERTIFICATE NUMBER:570080919708 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 POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested
POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICYNUMBERf YWOO�'YYYY /trgf�YY'YY LIMkTS
X COMME'.RCIAL GEf4ERAL LIABILITY MWZY i - EACH OCCURRENCE $5,000,000
CLAIMS-MADE L OCCUR DAMAGE TO RTEDPREMISES ca.'occursence $5,00 t1,(}40
MED EXP(Any and person) $5,000
PERSONAL&ADV INJURY $5,000,000
GENLAGGREGATELIMITAPPL.IESPER- GE:NERALAGGREGATE $5,000,000
POLICY % PRO-
LOC PRODUCTS-COMRP 0P'AGG $57,'Uoo,000 m
OTHER:
mwTTg 3146OS-20 04/01/2020 04/01/2021 COMBINED SINGLE LIMIT `a'
A
AUTOMOBILE LIABILITY S2,000,000
E e.�acl:lderttv.
BODILY INJURY(Per person)
ANYAIUTC3'XI _.
OWNED SCHEDULED BODILY INJURY(Per accident) tla
AUTOS ONLY AUTOS
HIREDAUTOS NON-OWNED PR�3PERTY T3Af�AAtGE
ONLY AUTOS ONLY18
{Per accr`dent.
UMBRELLA LIAR HOCCUR EACH OCCURRENCE
EXCESS LIAR CLAIMS MADE. AGGREGATE
DED RETENTION
A WORKERS COMPENSATION AND MC314. 4 01/2.020 04/01/201T K PER STATUTE EOR
EMPLOYERV LIABILITY
ANY PROPRIETOR r PARTNER t EXECUTIVE YIN N E.L.EACH ACC[DENT $2,000,000
�OFFICERWEM13ER CXCLUOED? N INIA
(Mandatory tat NH) E,.L.DISEASE-EA EMPLOYEE 12'000,000
II es,alesxiie under - —
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $2,000,000
DESCRIPTION OF OPERATIONS 1 LOCATIONS I'VEHICLES(ACORD 101,Addiftiai Remarks Saedule,may W attacftett If more Space IS required) RIFiCEd
VED
s
CERTIFICATE HOLDER CANCELLATION AMIN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE. THE
EXPIRATION DATE THEREOF, NDTICE'. WILL BE DELIVERED IN ACCORDANCE WITH THE rte,
POLICY PROV43IONS.
Clearwater [ray AUTHORIZED REPRESENTATIVE
400 N. myrtle Ave,
Clearwater FL 33755 USA
019M2015-2015 ACCORD CORPORATION.All rights reserved.
ACCORD 25(2016103) The ACORD name and logo are registered marls of ACORD