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ACC)I CERTIFICS--, il'E OF LIABILITY INSUR ai CE DATE(MM/DD/YYYY) �.� 4/28/2020 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 Britton Gallagher PHONE FAX One Cleveland Center, Floor 30 (A/c o Ext 216-658-7100 Alc.No):216-658-7101 1375 East 9th Street A DRIESS: Cleveland OH 44114 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Axis Surplus Ins Company INSURED INSURER B:Everest Indemnity Insurance Co. 10851 Gal204 E. amen rut Luther INSURERC:Everest Denali Insurance Company 204 E. Martin Luther King Blvd Tampa FL 33603 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 1306735935 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 PAVEDAUIMS, ILTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM DDPOLICY/YYYY ,POLICY MM D EXP LIMITS B GENERAL LIABILITY S18ML00324-201 6/10/2020 6/16/2021 ACH OCCURRENCE $1.000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE (RENTED PREMISESS Ea occurrence) $500,000 CLAIMS-MADE Fx_] 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 PERO X LOC $ C AUTOMOBILE LIABILITY SIBCA00081-201 6/10/2020 6/10/2021 COMBINED SINGLE LIMIT Ea accident $1 000 000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ IAUTOS Per accident A UMBRELLA LIAB X JOCCUR P-001-000142177-02 6/10/2020 6/10/2021 EACH OCCURRENCE $4,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE *$4,000,000 DED I I RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (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 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Zephyrhills 6907 Dairy Rd AUTHORIZED REPRESENTATIVE Zephyrhills FL 33542 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD