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QUALROO-02 BJONES ACORO® DATE CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)8/14/2019 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 CONTNAMEACT ASSOCIATES AGENCY,INC. AHO"N E ,($13)988-1234 FAX No:(813)988-0989 11470 N 53rd St Temple Terrace,FL 33617 E-MAIL .certs@associatesins.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Southern Owners Insurance Co 10190 INSURED INSURER B:Owners Insurance CO 32700 Quality Roofing,Inc. INSURER C:Westchester Surplus Lines Ins.Co. 1905 N 40th St INSURER D: Tampa,FL 33605 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPITR LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS-MADE F_X]OCCUR 20209725 9/1/2019 9/1/2020 DAMAGE TO RENTED S 300,000 MED EXP(Any one person S 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000 POLICY[XI JPER e T LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER: S B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 500,000 X ANY AUTO 4893827001 9/1/2019 9/1/2020 BODILY INJURY Per person) S OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident S X HIRED X NON-AWNED PeOracEcidentDAMAGE S AUTOS ONLY AUTOS ONLY PIP S 10,000 A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE 4893827002 9/1/2019 9/1/2020 AGGREGATE S 5,000'000 DED I I RETENTIONS S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N ISTATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACHACCIDENT S FFI dE oMFin NH)EXCLUDED? ( ry E.L.DISEASE-EA EMPLOYEE S If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Pollution Policy G70966244 001 9/1/2019 9/1/2020 Occ$2,00,000 AGG 2,000,000 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 City of Ze h chills THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN tY p Y ACCORDANCE WITH THE POLICY PROVISIONS. 5335 8th Street Zephyrhills,FL 33542 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD