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Client#: 1405231 131 UNIVEENG
<br /> ACORD,,, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br /> 1/09/2019
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br /> BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
<br /> REPRESENTATIVE OR .
<br /> PRODUCER,,AND THE CERTIFICATE HOLDER.
<br /> ............... ..-......_................... ......._......_..._..._....................._....................._.....__......................... . . -- ._.
<br /> --.................._..........._....--- ...._..._ _........-.........._..._...................._..........................--.._............. ...................
<br /> TAW
<br /> :If the_ ce_..rtificate holder Is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
<br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on
<br /> this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER :CONTACT
<br /> NAME:
<br /> McGriff Insurance Services PHONE ................._.._.._-.----.._.—........__......__—_r _......__--
<br /> (Arc,No,E,,t):407 691-9600 IA/C,Nap 888-635-4183
<br /> PO Box 4927 E-MAIL ) _ _`..__......w..
<br /> Orlando, FL 32802-4927 AgogEss_—___.._..--__.............._ _.-.-------..... ..-.-.___--
<br /> ' INSURER(S)AFFORDING COVERAGE NAIC i1
<br /> 407 691-9600 --- ----................__.._._..-----._.._..._......_..__....—.__.._._.._...-----
<br /> INSURERA:Valley Forge Insurance Company €20508
<br /> INSURED INSURER B:Continental Insurance Company 35289
<br /> Universal Engineering Sciences Inc
<br /> INSURER C;National Fire Insurance of Hartford i 20478
<br /> 3532 Maggie Blvd. ---.........._........_._..---_---_............_...... -------- .. .. -_....................-
<br /> INSURER D:Various Carriers-See Description
<br /> Orlando,FL 32811 _._. .._....._.........................---- --....._._......................_—_...... --
<br /> INSURER E
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: #5 19120 Municipal REVISION NUMBER:
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> INSR ADDUSUBR POLICY EFF POLICY EXP
<br /> LTR..... TYPE OF INSURANCE __POLICYNUMBER MMIDDIYYYY)_(MMIDDIYYYY)__i___ LIMITS
<br /> A �( COMMERCIAL GENERAL LIABILITY * * 16075841134 1/01/2019:01/01/2020 EACH OCCURRENCE 1$1 000,000
<br /> CLAIMS-MADE i X.00CUR P Et11M Eaorcuence IS100,000
<br /> X Incl X,C,U MED EXP(Any one person) $15,000
<br /> PERSONAL&ADV INJURY $1,000,000 —
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE i S2,000 OOO
<br /> -- ---,PRO _, !
<br /> ....__..,-.;POLICY_XI JECT .._�....._. LOC I PRODUCTS-COMP/OPAGG I S2,000i-----...A...._..OOO
<br /> ......-'-'DUCTS--'_'__....._... .---.._.._.._..._
<br /> s OTHER: I S
<br /> ...: ......................_._..........._..............................._..........._.._..........._................._...._.__._._......_.....__......._._...._._......_.._... ......_._.. __._..__...._.................... _._...._._.... — --.—._._....__.._... _:--- —
<br /> j AUTOMOBILE LIABILITY * * I COMBINED SINGLE LIMIT I
<br /> C 16075841120 1101/2019 01/01/202 Ea accident) 1S1,000,000
<br /> X ANY AUTO € BODILY INJURY(Per person) S
<br /> W'OWNED SCHEDULED ....... ._...._..,_(.. ._ ... ..... __
<br /> BODILY INJURY Per accident) $
<br /> 'AUTOS ONLY .AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY i { _(Per.acc:ident}
<br /> _..._...._...— I .....---._.....
<br /> ... ...__..._.._.._....... —._..-----..................._.— ...._...-'---`-- --..... . .... ...............__.......................__..i.._.................._.........
<br /> D UMBRELLA LIAB I X ?OCCUR ` See Description 1/011201901/01/202O.EACHOCCURReNCE i sSee Descript
<br /> X.EXCESS B ESS LIA ( ' `
<br /> { _ ';CLAIMS-MADE for EXCESS Llab AGGREGATE
<br /> DED RETENTIONS _ Information —_— _ _ S
<br /> WORKERS COMPENSATION + i PER OTH-
<br /> B ! 6075841151 1/01I201901/0112020 X (STATUTE_...._:. _.ER..I_. _......._......... _.
<br /> !AND EMPLOYERS'LIABILITY ANY PROPRtETOR/PARTNER/EXECUTIVEY/NN E.L.EACH ACCIDENT I NIA; __.._.___ 1000OOO____ __OFF h _
<br /> .(Mandatory in NH) ""' ' i .E.L.DISEASE-FA EMPLOYEE:SI,000,OOO-
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below__._......._....,__,._._,�___—.___ .............._..._....,....................................... E.L.DISEASE-POLICY LIMIT I S1 OOO OOO
<br /> . ....... .. ..... ........._ ._ _. ............. ............--
<br /> ......._. ............ ......._ ............. ......--- ---.....Y LIMIT.....-----.......
<br /> 3
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> RE:Olympus Pools,Various Lots.*Additional Insured status is granted with respect to General Liability if
<br /> required by written contract per"Blanket Additional Insured-Owners,Lessees or Contractors-with Products
<br /> Completed Operations Coverage Endorsement'Form#CNA75079XX 10/16. Primary and Non-Contributory status is
<br /> granted with respects to General Liability if required by written contract per"Architects,Engineers and
<br /> Surveyors General Liability Extension Endorsement'Form#CNA74858 01115.
<br /> (See Attached Descriptions)
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> Pasco County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Building Department ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 8731 Citizens Drive Ste 230
<br /> New Port Richey, FL 34654 AUTHORIZED REPRESENTATIVE
<br /> I
<br /> ©1988-2015 ACORD CORPORATION.All rights reserved.
<br /> ACORD 25(2016/03) 1 of 3 The ACORD name and logo are registered marks of ACORD
<br /> #S227228241M22586184 PSBE
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