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CERTIFICATE OF LIABILITY INSURANCE (1034)
ACORD® �, CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 07/20/2020 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 Coleman Insurance Agency, Inc 4831 Ruen Dr Suite 200 Palm Harbor FL 34685 CONTNAME: ACT Shelley Nevins (A/c. PHONE Ext): (727) 441-9911 (AIC No): (727) 441-9566 E-MAIL ADDRESS: Y@ 9 YColemanA enc Shelle FL.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: HERITAGE INSURANCE 14407 INSURED Outdoor Living Solutions, LLC P.O. BOX 2392 Dunedin FL 34697 INSURER B : FLORIDA CITRUS BUSINESS AND INDUSTRIES F 15764 INSURER C : X INSURER D : DAMAGE TO RENTED PREMISES (Ea occurrence) INSURER E : INSURER F : MED EXP (Any one person) COVERAGES CERTIFICATE 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER HCR001760 RECEIVED �teV� 030 AUGV GVLt1 O POLICY EFF (MM/DD/YYYY) /30/2020 POLICY EXP (MM/DD/YYYY) 06/30/2021 LIMITS EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 1 OO,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENII X AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY SCHEDULED AUTOS NON -OWNED AUTOS ONLY OFFICIAL RECORDS LEGISLATIVE SRVCS AND DEPT. COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENT ON $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY OFFICER/MEMBER EXCLUDED? PROPRIETOR/PARTNER/EXECUTIVE [] (Mandatory in NH) I T I If yes, describe under DESCRIPTION OF OPERATIONS below N / A 10656999-2020 08/20/2020 08/20/2021 V, X PER STATUTE ETH E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Aluminum & Vinyl Repair and Construction (Pool Cages, Screen Enclosures, Soffit, Fascia, Gutters, Vinyl Fence andllieiTi6E11 hatllcCluskey License # SCC131151568. 'JUL 2 3 2020 GAS A.D1,1„, CERTIFICATE HOLDER CANCELLATION City of Clearwater 400 N. Myrtle Avenue Clearwater FL 33755 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 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD