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Scott's Quality Cleaning, 07/22/2016 - 07/22/2017 v_ 112 =►r -2 OP ID: MB AC^ORO DATE(MMIDDINNY) ��- CERTIFICATE OF LIABILITY INSURANCE 1010712015 -- THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON T C ERTIFICATE HOLDER. THIS a_ CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE . ORDED BY THE POLICIES).-1 BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISS lLL INSUR AUTHORIZED'-- REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. cf,I `j `V IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBR GPyTION S IVED, subje�,c,/t�he\ the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certifica does no Confer rights Y°�yie certificate holder in lieu of such endorsement(s). L)'/ PRODUCER CONTACTNAME: ISU Lawrence Insurance Agency PHONE Heath Lawrence PO Box 549 (Arc No Ext):863467-0600 (A/C,No): -5142 Okeechobee, FL 34973 E-MAIL Heath Lawrence ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC I INSURER A:American States Insurance Co 19704 INSURED Scotts Quality Cleaning, LIc INSURER B: 2344 SR 70 West INSURER C: Okeechobee, FL 34972 — INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. NSR 'ADDC SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDDIYVYY) (MMJDDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE I Xl OCCUR X 01CI81352320 07/22/2016 07/22/2017 DAMAGE TORENre6 PREMISES(Ea occurrence) $ 200,000 MED EXP(Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEM_AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JE4 LOC PRODUCTS-COMP/OP AGG $ 1,000,000 OTHER: $ AUTOMOBIELIABILnY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $_ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS — AUTOS (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y J N STATUTE ER ANY PROPRIETCR/PARTNERJEXECUI1VE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L DISEASE-EA EMPLOYEE $ If DESCRIPTION Ss,describe under DEE.L.DISEASE-POLICY LIMIT $ SCRIPTION OFOPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) JANITORIAL SERVICES City of Okeechobee is included as an additional insured with respect the General Liability under form CG8674 CERTIFICATE HOLDER CANCELLATION CTYOKEE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Okeechobee 55 S.E.3rd Avenue Okeechobee, FL 34974 AUTHORIZE D(REPRESENTATIVE i L� `-�2!li��r3r-�----•--- ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD