DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CANCELLATION
CERTIFICATE HOLDER Westbrook Apartment Community 4932 Eaglesmere Drive Orlando, FL 32819
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CANCELLATION
CERTIFICATE HOLDER Watkins Realty & Lakes at North Port 1015 Ohana Way North Port, FL 34289
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER Sheltair St Petersburg LLC 4860 NE 12th Ave Ft Lauderdale, FL 33334
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER Probuild 13750 US Highway 19 North Clearwater, FL 33764
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
USA Broadmoor LLC
CANCELLATION
CERTIFICATE HOLDER Internacional Realty Mangement LLC., USA Broadmoor LLC 2251 Broadway Suite 108 San Antonio, TX 78215
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER Priority Sign 837 Riverfront Drive Sheboygan, WI 53081
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CANCELLATION
CERTIFICATE HOLDER TWC 79, Westminster Apartments 200 Westminster Blvd. Oldsmar, FL 34677
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CANCELLATION
CERTIFICATE HOLDER Modera Prime 235,Bayview Apts LLC, Lincoln Apts Mgmt LP 235 3rd Ave North St. Petersburg, FL 33701
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER City of Largo 13120 Vonn Rd Largo, FL 33774
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER Wellington Apartments 2900 Drew St Clearwater, FL 33759
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
WC 90-00-818-05
N/A
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CANCELLATION
CERTIFICATE HOLDER Highlands Community Development District 12051 Corporate Blvd Orlando, FL 32817
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CANCELLATION
CERTIFICATE HOLDER Park at Ashley Place Realty LP, Watkins Realy Services LLC 4031 Vista Verde Drive New Port Richey, FL 34655
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CANCELLATION
CERTIFICATE HOLDER Imperial Point II Condo Association c/o Qualified Property Management 1301 Seminole Blvd. Ste., 110 Largo, FL 33770
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER Harbor Renovations, LLC 977 Withlacoochee St Safety Harbor, FL 34695
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
X
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
Endorsements: Waiver of Subrogation
CANCELLATION
CERTIFICATE HOLDER Front Street Facility Solutions Inc 4170 Veterans Memorial Highway Bohemia, NY 11716
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CANCELLATION
CERTIFICATE HOLDER HomeAdvisor, Inc 14023 Denver West Parkway, Bldg. 64, Suite 200 Golden, CO 80401
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CANCELLATION
CERTIFICATE HOLDER Waterford Investors DBA Waterford at Cypress Lake 4733 West Waters Ave Tampa, FL 33614
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CANCELLATION
CERTIFICATE HOLDER Kindred Healthcare Inc c/o Jones Lang LaSalle Americas Inc Attn: Strategic Sourcing 3030 Sixth Street South St. Petersburg, FL 33705
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER Allen Building Construction LLC 6520 Bayshore Blvd Tampa, FL 33611
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
WC 90-00-818-05
N/A
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CANCELLATION
CERTIFICATE HOLDER Bell Partners Inc., C/O Compliance Depot P.O. Box 115006 Carrollton, TX 75011
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER FRDGS I LLC 100 S Ashley Drive Suite 200 Tampa, FL 33602
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
WC 90-00-818-05
N/A
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CANCELLATION
CERTIFICATE HOLDER Landmark at Grayson Park Apartment Homes 15501 Bruce B Downs Blvd Tampa, FL 33647
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER MDC Construction 15397 Stony Creek Way Suite 104 Noblesville, IN 46060
TJ Tampa FL-766 Contract No 8
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER Town & Country Industries 6750 Cross Bayou Drive Largo, FL 33777
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
WC 90-00-818-05
N/A
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CANCELLATION
CERTIFICATE HOLDER Kendale Design Build General Contractor 4501 Beverly Ave Jacksonville, FL 32210
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CANCELLATION
CERTIFICATE HOLDER United Associations of Town Apartments North Inc 1900 61st Ave North St. Petersburg, FL 33714
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER Kustom US Inc 265 Hunt Park Cove Longwood, FL 32750
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CANCELLATION
CERTIFICATE HOLDER Golden Sands General Contractors, Inc 2500 NW 39th Street Miami, FL 33142
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER Jik Pinellas Park 4701 88th Ave North Pinellas Park, FL 33782
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER Windermere Apartments 9474 Windermere Lake Drive Riverview, FL 33578
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER Simon Roofing 4201 A East Columbus Drive Tampa, FL 33605
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
X
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
Vendor ID 699136
Endorsements: Waiver of Subrogation, 30 days written cancel notice (10 days for non payment of premium)
CANCELLATION
CERTIFICATE HOLDER American Management Services LLC DBA Pinnacle C/O Compliance Depot P.O. Box 115006 Carrollton, TX 75011
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER CBRE Inc/The Hertz Corp 225 Brae Blvd 3rd Floor East-3E59 Park Ridge, NJ 07656
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER C.J. Carvalho Construction Inc 728 Wesley Ave Suite 1 Tarpon Springs, FL 34689
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CANCELLATION
CERTIFICATE HOLDER Clearwater Oaks Town Homes LLC, CARPREIT Residential Mgmt LLC ETAL 1121 Druid Road E Clearwater, FL 33756
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CANCELLATION
CERTIFICATE HOLDER First Choice Association Mgmt Inc 4174 Woodlands Parkway Palm Harbor, FL 34685
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CANCELLATION
CERTIFICATE HOLDER Genesis Maintenance Corporation 299 Market Street Suite 230 Saddle Brook, NJ 07663
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER Greco International Corp 12230 SW 130th Street Miami, FL 33186
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
WC 90-00-818-05
N/A
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
Brian Catt #PA2771
CANCELLATION
CERTIFICATE HOLDER Hillsborough County Contractor Licensing 601 East Kennedy Blvd, 19th Floor P.O. Box 1110 Tampa, FL 33601
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER International Paper 6706 North 53rd Street Tampa, FL 33610
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CANCELLATION
CERTIFICATE HOLDER Jones Land LaSalle Americas Inc 570 Warbler Drive Bolingbrook, IL 60440
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER Kindred Hospital Bay Area 3030 Sixth Street South St. Petersburg, FL 33705
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER MW Hyde Park LLC 1621 West Snow Circle Tampa, FL 33606
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
Brain Catt ID014988 License LP 09050
CANCELLATION
CERTIFICATE HOLDER Pasco County Contractor Licensing 7530 Little Road Room 212 New Port Richey, FL 34654
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER PCCLB Pinellas County 12600 Belcher Rd Suite 102 Largo, FL 33773
Brian Catt C-9668
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER Sentry Management Inc 2180 West S.R. 434 Suite 5000 Longwood, FL 32779
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CANCELLATION
CERTIFICATE HOLDER Signature Flight Support Corporation 14525 Airport Parkway Clearwater, FL 33762
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER 1st Choice Facilities Services 1941 Whitfield Park Loop Sarasota, FL 34243
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CANCELLATION
CERTIFICATE HOLDER WRH Realty Services Inc C/O Compliance Depot P.O. Box 115006 Carrollton, TX 75011
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER The Wilson Company 655 N Franklin Street Suite 2200 Tampa, FL 33602
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER Sentry Management Inc 7625 Little Road Suite 200A New Port Richey, FL 34654
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER North Florida Field Services Inc 9210 Cypress Green Drive Jacksonville, FL 32256
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER Jones Sign Company Inc 1711 Scheuring Road De Pere, WI 54115
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CANCELLATION
CERTIFICATE HOLDER Providence Home Renovations Inc 3614 W Lykes Ave Tampa, FL 33609
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER Kam Services 11207 SR 33 Groveland, FL 34736
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER Ardent Mills 110 S Nebraska Ave Tampa, FL 33602
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER Wyngate Apartments 390 112th Ave North St. Petersburg, FL 33716
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
X
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
Waiver of Subrogation in Favor of NRP Parnters C/O Notivus ., NRP Holdings LLC., NRP Investments its subsidiaries and affiliated entities, their respective directors, officers, employees and agents. Work being performed in Florida.
Endorsements: Waiver of Subrogation
CERTIFICATE HOLDER NRP Partners C/O Notivus 5174 McGinnis Ferry Road Suite 133 Alpharetta, GA 30005
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER Weston Oaks Aparments 1251 Weston Oak Drive Holiday, FL 34691
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER Westminster Apartments 200 Westminster Blvd Oldsmar, FL 34677
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER Lakeview Apartments 14201 Cyber Place Tampa, FL 33613
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER National Coating Solutions 1715 Princess Circle Naperville, IL 60564
Work being performed in Florida.
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
MacDill Air Force Base Florida
CANCELLATION
CERTIFICATE HOLDER Homeland Security Constrcution Corp 2501 51st Ave Hyattsville, MD 20781
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
Endorsements: 30 days written cancel notice (10 days for non payment of premium)
CERTIFICATE HOLDER Little Manatee Springs 4337 Hamlin Way Wimauma, FL 33598
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE
12/18/2015
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). CONTACT NAME: PHONE (A/C, No, Ext): E-MAIL ADDRESS:
PRODUCER
Bouchard Insurance for WBS P.O.Box 6090 Clearwater, FL 33758-6090
FAX (A/C, No):
(866) 293-3600 ext. 623 INSURER(S) AFFORDING COVERAGE
INSURER A : INSURED
NAIC #
American Zurich Insurance Company
40142
INSURER B :
Workforce Business Services, Inc. Alt. Emp: American Painters Inc 1401 Manatee Ave. West Ste 600 Bradenton, FL 34205-6708
INSURER C : INSURER D : INSURER E : INSURER F :
CERTIFICATE NUMBER: 15FL079857731
COVERAGES
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 LTR
ADDL SUBR INSD WVD
TYPE OF INSURANCE
POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)
POLICY NUMBER
COMMERCIAL GENERAL LIABILITY CLAIMS-MADE
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER: PROLOC POLICY JECT
LIMITS
EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence)
$
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
COMBINED SINGLE LIMIT (Ea accident)
$
BODILY INJURY (Per person)
$
$
OTHER: AUTOMOBILE LIABILITY
ANY AUTO ALL OWNED AUTOS
SCHEDULED AUTOS NON-OWNED AUTOS
HIRED AUTOS
BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident)
$
$
A
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
EXCESS LIAB
CLAIMS-MADE
AGGREGATE
$
DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below
$
X Y/N
N/A
WC 90-00-818-05
12/31/2015 12/31/2016
PER STATUTE
OTHER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT
Location Coverage Period:
12/31/2015
12/31/2016
$
1,000,000 1,000,000 1,000,000
Client# 054138
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Coverage is provided for only those co-employees of, but not subcontractors to:
American Painters Inc 12024 Steppingstone Blvd Tampa, FL 33635
CERTIFICATE HOLDER Westfield Brandon 459 Brandon Town Center Brandon, FL 33511
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. AUTHORIZED REPRESENTATIVE
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD