181 - Metropolitan Systems Inc. Etal3A19 � DAT AC" CERTIFICATE OF LIABILITY INSURANCE E(MM /DD/YYYY)
2/15/2013
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT Certificate Department
Commercial Lines - (813) 639 -3000 PHONE 813- 639 -3000 I FAX 813- 639 -7180
INC, No Ext);. (A/C, No):
Wells Fargo Insurance Services USA, Inc. E-MAIL .ere uest wesar
ADDRESS: clwcrt llfo.com
_: q @ g
2502 N. Rocky Point Drive, Suite 400 INSURER(S) AFFORDING COVERAGE NAIL #
Tampa, FL 33607_ INSURER A: Auto - Owners Insurance Co. 18988
INSURED INSURER B: Zenith Insurance Company 13269
Metropolitan Systems Inc. Etal INSURER C :
3014 Horatio Street
INSURER D
INSURER E :
Tampa FL 33609 INSURER F:
COVERAGES CERTIFICATE NUMBER: 5600481 RFVISION NIIMRFR, moo f,ol.,u
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 I TYPE OF INSURANCE ADDL SUBR - - POLICY EFF' POLICY EXP LIMITS
LTR POLICY NUMBER MM /DD/YYYY MM /DD /YYYY
A
GENERAL LIABILITY
SANFORD FL 32711
12015300
7/1/2012
7/1/2013
$ 1.000,000
X
DAMAGE ETORENTE
DAMAGE TO RENTED
COMMERCIAL GENERAL LIABILITY
_X
;
PREMISES (Ea occurrence)
$ 150,000
CLAIMS l OCCUR
-MADE
j
j
MED EXP (Any one person)
$ 10,000
PERSONAL d ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP /OP AGG
$ 2,000,000
POLICY PRO LOC
$
A
AUTOMOBILE LIABILITY
4922645100
7/1/2012
7/1/2013
COMBINED SINGLE LIMIT
1,000,000
(Ea accident)
$
X ANY AUTO
BODILY INJURY (Per person)
$
ALL OWNED SCHEDULED
BODILY INJURY Per
$
AUTOS _ AUTOS
accident
( )
NON -OWNED
PROPERTY
$
HIRED AUTOS AUTOS
tPer accident) AMAGE -
A
X UMBRELLALIAB X_ OCCUR
12015300
7/1/2012
7/1/2013
EACH OCCURRENCE
__...
$ 4,000,000
_
EXCESS LIAB CLAIMS -MADE
AGGREGATE
$ 4,000,000
DED I X I RETENTION $ 10,000
$
WORKERS COMPENSATION
X I WC STATU- OTH-
B
AND EMPLOYERS' LIABILITY
2831250620
3/3/2013
3/3/2014
TgRY.LIMITS ER
Y / N
ANY PROPRIETOR /PARTNER /EXECUTIVE
_-
E.L. EACH ACCIDENT
1,000,000
$
OFFICER/MEMBER EXCLUDED?
N/A
(Mandatory in NH)
l
E.L. DISEASE - EA EMPLOYE
$ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
�
I
I
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
CERTIFICATE HOLDER IS ADDITIONAL INSURED AS RESPECTS GENERAL LIABILITY
CERTIFICATE HOLDER CANCFI_LATIAN
CITY OF SANFORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
ATTN: CITY CLERK
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
P.O. BOX 1778
SANFORD FL 32711
AUTHORIZED REPRESENTATIVE
00 e I he ACURD name and logo are registered marks of ACORD U 1988 -2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) 11111111111111111111 IN 11111111111111111111111111111111111111111111111111111111111111111111 CVBOtA15,o0e527,OZ,02,o , o,o,e