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ACORO® CERTIFICATE OF LIABILITY INSURANCEF5121/20MIDD19 /YYYY) 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 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 NAME: Britton Gallagher PHONE FAX One Cleveland Center, Floor 30 A/C No E t 216- 5 - 1 A/c No:2 - - E-MAIL 1375 East 9th Street ADDRESS: Cleveland OH 44114 INSURERS AFFORDING COVERAGE NAIC# INSURERA:AXiS INSURED INSURERB:EVerest Indemnity Insurance Co. 10851 Galaxy Fireworks Inc. INSURER C:EVereSt National Insurance Company 10120 204 E. Martin Luther King Blvd INSURERD: Tampa FL 33603 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1121001087 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 S. INSR TYPE OF INSURANCE ADDL SUBR POLIC F POL CY EXP LIMITS LT R INSR WVD POLICY NUMBER MM/D /YYYY MM/DD/YYYY B GENERAL LIABILITY S18ML00324-191 6/10/ 019 6/10/2020 E CH OCCURRENCE $1,000,000 X AMAGE TO RENTED COMMERCIAL GENERAL LIABILITY REMISES Ea occurrence $500,000 CLAIMS-MADE 1XI OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY PROEC� X LOC I $ C AUTOMOBILE LIABILITY S18CA00081-191 6/10/2019 6/10/2020 Ea accident $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTO S AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS Per accident $ $ A UMBRELLA LIAR X OCCUR Excess binder 6/10/2019 6/10/2020 EACH OCCURRENCE $4,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $4,000,000 DED I I RETENTION$ $ WORKERS COMPENSATION WC STATU-RY LIMITS OTH- AND EMPLOYERS'LIABILITY Y/N T ER ANY PROPRIETOR/PARTNER/EXECUTIVE❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Additional Insured extension of coverage is provided by above referenced General Liability policy where required by written agreement. Location: 5953 Gall Blvd,Zephyrhills Additional Insureds: City of Zephyrhills, Mark Ayer and all his agents, representatives and subsidiaries (Workmen Comp) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Zephyrhills THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 6907 Dairy Rd ACCORDANCE WITH THE POLICY PROVISIONS. Zephyrhills FL 33542 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26(2010/05) The ACORD name and logo are registered marks of ACORD