CERTIFICATE OF LIABILITY INSURANCE (1078)DATE (MMIDDIYYYY)
ACC CERTIFICATE OF LIABILITY INSURANCE 8112,2021
MATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
THIS CERTIFICATE i5 ISSUED AS A MATTER OF INFOR
LY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVE
E
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURR(5), 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 ri hts to the certificate holder in lieu of such enAdorsement(CT s].
PRODUCERNAME:
Morris & Reynolds Inc. A Division of World Insurance Associates LLC PHONN • 305.238-1000 FAX Ho : 305-255-9643
14821 South Dixie Highway E-MAIL
Miami FL 33175 ADQRESS:
INSURERS AFFORDING COVERAGE MAIC #
��nrQ o • United States Fire Insurance 21113
INSURED
Krutsinger Services, Inc.
4511 North 56 Street
Tampa FL 33510-7109
DVERAGES CERTIFICATE NUM13ER:825690675 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.
enni anRR _ POLICY EFF . POUCY EXP LIMITS _
0. TYPE OF INSURANCE INSP I WVD I Poi
TR
A
_"ME Y 506-901113.1
CLAIMS -MADE Fil OCCUR
GE"L AGGREGATE LIMIT APPLIES PER:
PRO•
X
❑ LOC
POLICY JECT
OTHER:
$
A AUTOMOBILE LIABILITY
Y 506-901113-1
X ANY AUTO
g
OWNED
SCHEDULED
AUTOS ONLY
AUTOS
HIRX X
EOs
AU ONLY
AUTOS O LDY
UMBRELLA LIAB � OCCUR
EXCESS LIAB I—i CLAIMS
B WORKERS COMPENSATION 52040787
AND EMPLOYERS LIABILITY Y I N
ANYPROPRIETORIPARTNERIEXECUIIVE N I A
OFF IC ERIM E MB ER EXCLU DED7
(Mandator In NMI
A Garagekeepers Legal Liability ' ` 566.901113.1
3/24/2021 1 3124/2022
3/24/2021 1 3/24/2022
EXP
ADV
S
COMBINED SINGLE LIMIT
$ 1,000,000
Ea accldenl
BODILY INJURY {Per persaaj
$
BODILY INJURY (Per accident)
S
PROPERTY DAMAGE
g
Per accident
S
WOCCURRENCEURRENCE
E $
$9/6/2021 3124/2022 TE ERACCIDENT $ 500,000SE - EA EMPLOYEE $ 500,000SE - POLICY LIMIT $ 500,0003/24/2021 3/2412022 an 150,000
DESCRIPTION OF OPERATIC NS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
Sale Of new trucks, parts and repairiiesting {tune ups, warramty 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 regaiRc) LDEt IUE� General Liability and
Auto liability coverages. �� [[ ::
AUG z U 2021
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Cityy of Clearwater Gas System
4D0 N. Myrtle Avenue
Clearwater FL 33755 AUTHORl2EDREPRESENTATIVE
USA
1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD