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AID�® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYI) 616t2019 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 ERIC TREEND NAME: ACRISURE LLC PHON o . (800)607-4711 AJC X No 1375 EAST 9TH STREET,30TH FLOOR,SUITE 3000 E-MAIL ADDRES ERIC.TREEND@BRITTONGALLAGHER.COM S: INSURER( AFFORDING COVERAGE NAIC# CLEVELAND OH 44114 INSURERA: FWCJUA INSURED INSURER 8 GALAXY FIREWORKS INC INSURER C: __J_ 204 E MARTIN LUTHER KING BLVD INSURERD: — - — - TAMPA FL 33603 INSURERE: k FEIN:593092878 INSURERF: i COVERAGES CERTIFICATE NUMBER: 1906060016 REVISION NUMBER, THIS IS TO CERTIFY THAT-THE-POLICIES-OF INSURANCE MISTED 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. P-- ---CLAIMS.____._ tNSR' �� ADDL?SUBR! � P6LtCY£fF i POLtGY EXP j LTR TYPE OF INSURANCE , POLICY NUMBER ! MMIDD/YYYY i MMIDDIYYYY , LIMITS COMMERCIAL GENERAL LIABILITY i i ` { 'I EACH OCCURRENCE ! S DAMAGE TO-RENTED CLAIMS-MADE i�OCCUR ' I PREMISES Ea occurrence ,.I S MED EXP(Any one person) S PERSONAL&ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: ( GENERAL AGGREGATE I S POLICY I�PRO- JECT O #LOC I { iI I PRODUCTS-COMP/OP AGG !S OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT I S (Ea accident ANY AUTO { I BODILY INJURY(Per person) S OWNED ^l SCHEDULED + I j ! AUTOS ONLY AUTOS ( i ILY WJURY(Per accident) S HIRED �- NON-OWNED j i �110D PROPERTYDAMAGE -- AUTOS ONLY i_AUTOS ONLY i I Per accident S I I Is UMBRELLA LIAS I I OCCUR f EACH OCCURRENCE S EXCESS LIAB _17 CLAIMS-MADE AGGREGATE !S DED RETENTION S WORKERS COMPENSATION i I X i SPER TATUTE ' OTH- { AND EMPLOYERS'LIABILITY YIN I I �- i ER .ANY PROPRIETORIPARTNERIEXECUTIVE i 1 E.L.EACH ACCIDENT ,S 5d�>��•�0 A OFFICERIMEMBEREXCLUDED? NIAi i 2E637021 } 1/19/2019 , 1/19/2020 --- -- (Mandatory in NH) i i EI L.DISEASE-EA EMPLOYEE S 500,000.00 If yes,describe under 500,000.00 DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT Is l I I I } DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION City of Zephyrhills SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 5335 8th Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Zephyrhills FL 33542 AUTHORIZED REPRESENTATIVE Phone Number: (813)780-0000 � t Q 1988-2015 ACORD CORPORATION. All rights reserved.