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DATE(MM/DD/YYYY) AFRO® � CERTIFICATE OF LIABILITY INSURANCE 05/31/2018 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 endorsements. PRODUCER CONTACT NAME: ACRISURE LLC DBA BRITTON PHONE FAX 1 CLEVELAND CENTER BUILDING AIC,No,Ext): (A/C,No: 1375 E 9TH ST 30TH FL STE 3000 E-MAIL ADDRESS: CLEVELAND OH 44114 79HJC INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:FLORIDA W.C. JUA INSURED INSURER B: GALAXY FIREWORKS INCORPORATED INSURERC: 204 E MARTIN LUTHER KING BLVD TAMPA FL 33603 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDIYYYY MM/DDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED 41 CLAIMS-MADE ❑OCCUR PREMISES Ea occurrence $ MED EXP(Any oneperson) $ PERSONAL&ADV INJURY $ RGEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑PROJECT LOC PRODUCTS—COMP/OPAGG $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY Perperson) $ OWNED AUTOS SCHEDULED BODILY INJURY Per accident $ ONLY AUTOS PROPERTY DAMAGE HIRED AUTOS NON-OWNED Per accident $ ONLY AUTOS ONLY UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ IDED1 IRETENTION $ $ WORKERS COMPENSATION PER OTH- A AND EMPLOYERS'LIABILITY (6FR 13UB-2E63702-1-1 8) 01-19-18 01-19-19 X STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? Y/N E.L.EACH ACCIDENT $ 500,000 (Mandatory In NH) NIA N Y E.L.DISEASE—EA EMPLOYEE$ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE—POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) 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. CITY OF ZEPHYRHILLS AUTHORIZED REPRESENTATIVE 5335 8TH STREET ZEPHYRHILLS FL 33542 ©1988-2016 ACORD CORPORATION.All rights reserved. ACORD 26(2016/03) The ACORD name and logo are registered marks of ACORD