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ACOOR"® CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DDmyY) . 1 1/1112 0 1 9 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 Susan Kern,AAI CIC CPIW NAME: Stahl&Associates Insurance Inc. PM No Ext: (813)818-5300 FA( No): (813)818-5396 3939 Tampa Road E-MAIL susan.kern@stahlinsurance.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Oldsmar FL 34677 INSURER A: Amerisure Insurance Co 19488 INSURED INSURER B: Ammerisure Mutual Insurance Company 23396 Rapp Operations LLC,DBA:Precision Garage Door Service INSURER C: 13737 Automobile Blvd INSURER D: INSURER E: Clearwater FL 33762 INSURER F: COVERAGES CERTIFICATE NUMBER: 2019 w/o Forms REVISION NUMBER: THIS IS TO CERTIFYTHATTHE 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 POLICY EFF POLICY EXP LTR INSD WVD POLICYNUMBER MMIDD MMIDD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 �/ DAMAGE TO RENTffff- 100,000 CLAIMS-MADE X OCCUR PREMISES Ea cccurrence $ MED EXP(Any one person) $ 5,000 A CPP21104320 11/15/2019 11/15/2020 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANYAUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED CA21104300 11/15/2019 11/15/2020 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 4,000,000 B EXCESS LIAR CLAIMS-MADE CU21104310 11/15/2019 11/15/2020 AGGREGATE $ 4,000,000 DED RETENTION S $ WORKERS COMPENSATION X STATUTE 10 ERH AND EMPLOYERS'LIABILITY Y/N 1,000,000 A ANY PROPRIETOR/PARTNER/EXECUTIVEFN] NIA WC21104290 11/15/2019 11/15/2020 E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? 1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I 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 City of Zephyrhills ACCORDANCE WITH THE POLICY PROVISIONS. 5335 8th Street AUTHORIZED REPRESENTATIVE Zephyrhills FL 33542 � ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD