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CERTIFICATE OF LIABILITY INSURANCE (1019) ,acoRDgCERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDlYYYY) 6/15/2020 THIS CERTIFICATE IS ISSUED ASA 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(les)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 HONo Ext: (727)461-3704 FAX NO: (727)441-3298 510 Druid Rd Suite C ADDRESS:Maryann@lancins.cam P 0 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCEINSR VtVr) POLICY NUMBER_.(M /DD=) MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE T5 RENTED PREMISES Ea occurrence $ 50,000 A CLAIMS-MADE OCCUR X 0514096 6ji2/2020 J12/2021 MED EXP(Any one person) $ 5,000 0514046 6/12/2019 /12/2020 PERSONAL&ADV INJURY $ 1,000,000 0514046 6/12/2018 6/12/2019 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO LOC $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) $ 1,000,000 X ANYAUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED 95433339800 1/21/2019 1/21/2020 BODILY INJURY(Per accident $ AUTOS X AUTOS X ) HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION S $ B WORKERS COMPENSATIONX WC STATU- I IOTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETORIPARTNER/EXECUTIVE 20331705 /1/2020 /1/2021 OFFICERlMEMBEREXCLUDED? a N/A E.L.EACH ACCIDENT $ 500,000 (Mandatory in NH) 0331705 /1/2019 /1/2018 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 0331705 /1/2018 /1/2017 DESCRIPTION OF OPERATIONS below r E.L.DISEASE-POLICY LIMIT $ 500,000 C Professional Liability HCC1967146 1/21/2019 1/21/2020 perclaim 1,000,000 peraggregate 1,000,000 DESCRIPTION OF OPERATIONS t LOCATIONS/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. e-mail Tonymagganas@clearwatergas.com 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 (�.G�+v ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).01 The ACORD name and logo are reaistered marks of ACORD