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CERTIFICATE OF LIABILITY INSURANCE (1043) AC 0R& CERTIFICATE OF LIABILITY INSURANCEDATE( DDIYYYY) 312412420 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 TITS COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE AA CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDEN. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(les)must have ADDITIONAL INSURED provisions or he 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 lie_u of such endorsement(s). PRODUCER CaRrAu NAME; Morris&Reynolds Inc, Fspne 3tb5-238-1000 Ajc�Nn:305-255.9643 14521 South Dixie Highway E-MAIL Miami FL 33175 ADDRESS: INSURERIS)AFFORDING COVER AGE NAIL# INSURER A,United States Fire Insurance 2111 INSURED KRUTSER-01 INSURER a't RetailFirst Insurance Co. 107DD Krutsinger Services, Inc. INsuRartc, 451'1 North 55 Street Tampa FL 335111-7109 INSURER INSURER E: INSURER F r COVERAGES CERTIFICATE NUMBER:727391741 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 NTH 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 CONDIT'ION'S OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS- INSR ADDLSUBR POLICY EFF POLICY EXP TYPE OF INSURANCE POLICY NUMBER MMQ LIMITS A X COMMERCIAL GENERAL LIABILITY Y 506-898752-4 312412024 312412021 EACH OCCURRENCE $1,400,000 DAMAGE TO RENTED CLAIMS-MADE �OCCUR PREMISES Esaccurrersco� $304,004 MED EXP IArLT!prsm s5,000 PERSONAL&ADV INJURY $1,440,040 Gorr.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _ $2,0K004 _I POLICYEl PRO- JECT 'L:.I LOC PRODUCTS-CCtMPII~sPAGG $2,40{1,044 fl OTHER: $ A AUTOMOBILE LIABILITY_ Y- 506-598752-4 -- - 312412024 312412021 COM BI NE D E accident 1 L X I $ ,444,400 ee X ANY AUTO DODILY INJURY(Per pemn) $ OWNED SCHEDULED BODILY INJURY(Nr e� rl) '.AUTOS ONLY AUTO'S X HIREDNON-O WNED PROPERTY DAMAGE s AUTOS ONLY AUTOS ONLY Per Iderd $ UMBRELLA.LIAR OCCUR _..__. _ EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ a WORKERS COMPENSATION 52040787 91812019 91812020 X - AND EMPLOYERS'LIABILITY Y 1 ti 57ATUTE. ER .ANYPROPRPETO1;:iPA'RTNCR�EXECL'TIVE E.L.EACH ACCIDENT $504,044 (Ma ndatary In NN)ERihIEMBEREXCLUDEO7 NSA IM�ndE.L.DISEASE-EA EMPLOYEE $500,000 IP Yes,desaabe under DESCRIPTION OF OPERATIONS bebw E.L.DISEASE-POLICY LIMIT $544,440 A Garagekeepers Legal Liability 546.698752.-4 312412420 312412021 Comp;Cdlisan 150,000 DESCRIPTION Cele OPERATIONS I LOCATIONS I VEHICLES(ACORD 1014,Additional Renwrks Schedule,may be attached If mote spssr Is required) Sale of new trucks,parts and repairltestill (tune ups,werramty work,etc}as related to energy industry trucks. Clearwater Gas Systems and The City of Clearwater are included as additional insureds as required by written contract regarding to the General Liability and Auto Liability coverages. RECEIVED CERTIFICATE HOLIER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Clearwater Gas Systems The City Of Clearwater ACCORDANCE WITH THE POLICY PROVISIONS. Bruce H.Griffin, PMP 143 S.Mytle,Avenue AUTHORIZED REPRESENTAIWE Clearwater FL 33756 USA a4__ 1988-2 015 ACORD CORPORATION. All rights reserved. ACORD,26(2016103) The ACORD name and logo are registered marks of ACORD MMDNYYY AC'C) CE TIFI T F IMA 1LIT"Y IN UISA G� OA (MC I 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,ANIS THE CERTIFICATE HOLDM 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 endorsoment(s). PRODUCER CORTAM NAME. Morris&Reynolds Inc. PPIION"� � 14821 South Dixie Highway E-MAIL305-231-1000 A1c No).305-255-9643 Miami FL 33175 ADDRESS., INSURERS)AFFORDING COVERAGE MAIC� INSURERA:United States Fire Insurance _ 21113 INSURED KRUTSER-01 INSURERS;RetailFirst Insurance CO. 10700 Krutsinger Services, Inc. 4511 North 55 Street Il�sur c Tampa FI..3M 10-7109 INSURER D: INSURER E INSURER F.: COVERAGES CERTIFICATE NUMBER:26690342 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,TERVE'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. LEXP TR TYPE OF INSURANCE A L U POLICY NUMBER M1PDYt YFYY POLICY LIMIT'S LTR A X COMMERCIAL GENERALLIABILITY Y 568-838752-4 312412010 312412021 EACH OCCURRENCEDAMAGE TO RENTED 51,000,006 CLAIMS-MADE OCCUR PREMISES eOccu ra $384,000 MED EXP(Any ane ersan) $5„000 -- PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY PRO0 LOC -- PRODUCT$-OOMPIOPAGG $2,000,000 PRO- OTHER; $ A AUTOMOBILE LIABILITY Y 50-898752-4 3t2412020 311412021 %M 11,1ND SINGLE I $1,060,000 JX ANY'AUTO BOILYINJURY(Perperson) S OWNED SCHEDULED BODILY IWURY(Per accident) $ AUTOS ONLY AUTOS HIRED X NON-OWNED EPERTY DAMAGE. S AUTOS ONLY AUTOS ONLY Psr acradanl 5 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE DED _.. - OED RETENTION B WORKERS COMPENSATI I 51040787 918J2013 902020X 0TH= AND EMPLOYERS'LIABILITY ANYPI30PRIETORiPARTMEPJEXFCUTIV'E Y� N 7 A....... E.L.EACH ACODENT I$500.004 OFFICMMEMBER EXCLUDED? (Mandatory In NN) E.L.DISEASE-EA EMPLOYE $500.000 UO3,descnba un:°cr �. . SE RiPTION OF OPERATIONS below E.L.,DISEASE-POLICY LIMIT $500,000 A Garagakeepers Legal Liability 506-8387524 312412020 312412021 COmP/WI soo 154,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 141,Additional Remarks Schedule,may be attached if mecca apaee Is mqulaed) Sale of new trucks,parts and repalr/tesltng(tune ups,warrama work,etc)as related to energy indus”trucks. Clearwater Cas Systems and The City of Clearwater are Inclu ed as additional insureds as required by written contrr fine General Liability and Auto Liability coverages. CERTIFICATE HOLDER CANCELLATION rop In — SHOULDANYOF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE (DELIVERED IN City Of Clearwater GBS System ACCORDANCE WITH THE POLICY PROVISIONS, 40 N.Myrtle Avenue - — Clearwater FL 33755 AUTHORIZED REPRESENTATIVE USA ay_/4� — Q 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25( 015f03) The ACORD name and logo are registered marks of ACORD