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Aco® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/21/2016 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 ELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED EPRESENTATIVE 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 BetsyCrawford NAME: Lassiter-Ware Insurance of Jacksonville IAfC N Exu: (800)845-8437 FAX No: (888)883-8680 8659 Baypine Rd aDpRess:Betsyc@lassiter-ware.com Suite 100 INSURER(S)AFFORDING COVERAGE NAIC 8 Jacksonville FL 32256 INSURERA:Amerisure Insurance Company 19488 INSURED INSURERB:Amerisure Partners Insurance 11050 Air Mechanical & Service Corp. INSURERC: 2700 Ave of The Americas INSURERD: INSURER E: Englewood FL 34244 INSURER F: COVERAGES CERTIFICATE NUMBER:17/18 Master 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MMIDD/YYYY) (MM/DD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 300,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ A CLAIMS-MADE n OCCUR X CPP2095042 1/1/2017 1/1/2018 MED EXP(Any one person) $ 10,000 X Contractural Liability PERSONAL BADV INJURY $ 1,000,000 X XCU Included GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 -I POLICY 51 Tei Ti LOC - ,_ $ 0 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ X ALL OWNED SCHEDULED X CA2095041 1/1/2017 1/1/2018 BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS x AUTO WNED PROPERTY(Per accident)DAMAGE $ X $10,000 PIP UNisured Motorists $ 20,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE CU2095043 1/1/2017 1/1/2018 AGGREGATE $ 5,000,000 _ DED X RETENTION$ 10,000 $ WORKERS COMPENSATIONWC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N X TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 A OFFICER/MEMBER EXCLUDED? N/A 12/31/2016 12/31/2017 WC2095044 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) • CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION ATE THEREOF, NOTIC InformationACCORDANCE WITH THE POLICY PROVIS ONSE WILL BE DELIVERED IN 11111 AUTHORIZED REPRESENTATIVE only _ Kirk Bramlett/BETSYC — — ` ELS ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).01 The ACORD name and logo are registered marks of ACORD