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CERTIFICATE OF LIABILITY INSURANCE (1066),4c�Ro� CERTIFICATE OF LIABILITY INSURANCE DATESMMfDDfYYYYj CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 3/2412021 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 CONTACT Morris & Reynolds Inc. PHONE FAx 14821 South Dixie Highway [AiE Na. Ext): 30 238 1006 - IAIc, Nal: 305-25 9643 Miami FL 33176 ADDRlESS: INSURERS) AFFORDING COVERAGE MAIC ill PREMISES Ea occurrence 1NSURERA: United States Fire Insurance 21113 iNSURED KRUTSER-01 INSURER 6: RetailFlrst Insurance CO- 10700 Krutsinger Services, Inc. 4511 North 56 Street INSURERC: -- Tampa FL 33610-7109 INSURER D $ 5,004 INSURER E . INSURER F : COVERAGES CERTIFICATE NUMBER: 1394180602 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_ INSR AD6L SUBR POLICY EFF POLICY .F_XP TYPE OF IN LTR POLICY NUMBER MMIDDIYYYYI (MMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY X I Y 506-901113-1 3/24/2021 3124/2022 LACH OCCURRENCE [iA1v,I,AGETO-RENTED $ 1,000,000 J CLAIMS -MADE OCCUR PREMISES Ea occurrence $ 300,000 MED EXP [Any one person) _ - $ 5,004 PERSONAL& ACV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER_ PRO - X 1 POLICY F JECT F-1 LOC j j GENERAL AGGREGATE $ 2,000,000 $2,000,000 PRODUCTS - COMPIOPAGG OTHER: $ A AUTOMOBILE LIABILITY X ; ANYAUTO Y 506-901113-1 3/24/2021 3/24/2022 COMBINED SINGLE LIMIT [Ea accidenty . SOD]LY INJURY (Per person) $ 1,000,000 _ $ 1 OWNED SCHEDULED AUTOS ONLY AUTOS{ BODILY INJURY Par acpden; ) $ x i HIREDx NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ UMBRELLA L1AB OCCUR l EAC FIOCC URRENCE $ EXCESS LiAB CLAIMS -MADE _ E AGGREGATE $ I DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN 552040787 91W020 91512021OTH- ANYPRO PRI ETOFiII 'AHTNE HIEXE C UTIVE OFrICEHIMEMBEREXCLUDED? ❑ NIA E.L. EACH ACCIDENT ---••••-- $ 500,000 --. E -L- DISEASE - EA EMPLOYEP $ 500,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E -L. DISEASE -POLICY LIMIT $ 500,000 A Garagakeepers Legal Liability 506-9011131 3/24/2021 3/24/2022 CumpIC0114sorr 150,OOfl DESCRIPTFON OF OPERATIONS 1 LOCATIONS 1 VEHICLES [ACORD 101. Additional Remarks Schedule, may be attached if more space is required] Sale of new trucks, parts and repairAesting (tune ups, warrarrrty work, etc) as related t0 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 - CERTIFICATE HOLDER 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 100 S- Mytle Avenue AUTHORIZED REPRESENTATIVE Clearwater FL 33756 USA ©1988-2015 ACORD CORPORATION. Ali rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD