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I <br />I <br />f <br />q A ROC O <br />E <br />i <br />CERTIFICATE OF LIABILITY IMIRGNrFP <br />aAre IRRICV(YtY) <br />i,,A,<U 5 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY ANO CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES <br />NOT AFFIR MATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />THIS CERTIFICATE OF <br />INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(Sh AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE <br />CERTIFICATE HOLDER <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy QPS) must be endorsed. If SUBROGATION IS WAIVED, <br />subject to the terms and <br />conditions of the policy, certain policies may require an endmament. A statement on this does <br />certificate not confer rights to the CerUSGate holder In Ieu of such <br />endorsemen s <br />PRODUCER <br />uUMS <br />wee..ca t- SOlm -16'tl t4800 µ R3 r7 -797-07N <br />FRANKCRUM INSURANCE AGENCY, INC. <br />"Au <br />1DD S. MISSOURI AVE. <br />IJJSURE S AFFORDING COVERAGE <br />RUC{ <br />CLEARVLATER FL 33756 <br />I.SORHRA: FRANK WINSTON CRUM INSURANCE 00. <br />Ilwo <br />VLF <br />INSURED <br />wsmm P <br />wS E C: <br />eAµA MRDRED <br />FrankGum 1- 800- ZT7 -1620 <br />wsIJ uaEaa <br />100 S MISSOURI AVENUE <br />w,SURER B <br />CLEARWATER FL 33756 <br />mSURER F. <br />COVERAGES ..�.........�......� <br />._____ <br />HtvIADN NUMBER: <br />THISKTOTE NGTNAT THE POLICIES TERM INSURANCE LISTED VAL HAVESEENISSUEDTOTHEIN3UR ®H UAEDABOVEFORTHE CERPERIODIMAYBE IS <br />PERTAIN, I MU ANYE AFFORDED B TERM OA CIES DESC DESCRIBED ANf CONTRACT OR DRIER DOCUNENTRIN RESPECT i AND C DRI NS OF U(>1 MAY BE ISSUED S SAY <br />PERTAIN, THE wSURAJJCE AFFORDED aV THE POLICIES DESCW SED HE(R[0N IS SUBJECT TO ALL 1HE TERN9, EXCLUSIONS AND CONOIDONS OF SUCH POLICIES. ORBS SNONI: <br />MAY HAVE SFFJJ REDUCED BY PUD 0.AL•0S. <br />6UM110E <br />AM <br />I.R <br />3UBR <br />NYe <br />g RUYaaR <br />P EFF <br />(uw w n <br />mucr cv <br />ryStTIXRYy) <br />uUMS <br />EACH l . <br />5 <br />VLF <br />eAµA MRDRED <br />E Ooaza <br />K7�E= <br />oFAIeARAmwtraAm <br />PPm YEt <br />m o cTs. <br />S <br />r vxn <br />Aloaawese, <br />Iuanrtt <br />ceu sanlx oast <br />eomrsum 6a Pe'� <br />$ <br />urrwra <br />,JLOARRO <br />se <br />eoecr PUmw..=ee.y <br />tyros os <br />es <br />N 't'.MD <br />'Otm AUTO] as <br />PIE#RR]WADE <br />vtlW <br />5 <br />5 <br />�UA9 <br />PAO+omre <br />S <br />4cEUliu <br />tlISJSIVUE <br />cAm <br />S <br />IPJ FE1EiIpVi <br />5 <br />A <br />Ase <br />no.st,�YCRr <br />NCX114J0000 <br />1/12014 <br />IJ12DI5 <br />I <br />I <br />RUB <br />AW Pn.'Uit�TOILEXaLMFXt1tr`R <br />X <br />�wu. <br />Fa <br />e-41 v10 FXmLCE ➢t ILJI <br />NIA <br />EL VGI ICOk7rt <br />.LI Om ppD <br />V •WW hMe <br />Joe <br />OW. 'Eno du <br />a¢QePIxYR OF a4RATWNe.L. <br />FI PSFA�.FA ReleYEe <br />' <br />51.W3 U'IJ <br />El osc.RSE -PUJCy UW <br />51.]00 <br />oFSC�nm oFeeDUnDXS ilb.Aisu¢ /URattFS tRe.a,ACOrm Rm ,AAamrlem,rt.swylmw..yatr.Rd,.�y <br />EFFECTS 171018011, COVERAGE IS FOR IODYP OF THE EMPLOYEES OF FRANKCRUM LEASED TO CRAIG A SMITH & ASSOCIATES, INC. (CLIENT) FOR WHOM <br />THE CLIENT IS REPORTING HOURS TO FRANKCRUM- COVERAGE IS NOT EXTENDED TO STATUTORY EMPLOYEES. <br />CETRMFICATE HOLDER CANCp.LATON <br />SHOULD ANY OF THE= ABOVE I ESCRIDEO POLICIES SE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE MI. SE DELIVERED IN <br />Proof Of Insurance <br />ACCORDANCE WITH THE POLICY PROMS IONS <br />AVmmtllID RpREtFX.ARR <br />ACVRD 25 (20mf0S) <br />The ACORD ue mx And Iogo me rag,,,rao Qm s e( ACORD <br />0196 2DIDACORDCORPORATION. AlldghlAresmwd. <br />Craig A. Smith & Associates, Inc. <br />RFQ No. 14 -07 -02 <br />Page 9 <br />