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CERTIFICATE OF LIABILITY INSURANCE
Client#: 2242 RRIrSwnl lc ACORD CERTIFICATE OF LIABILITY INSURANCE DATE M/DD/YYYY) TM 122/1/16/6/2009 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION BWD Group LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE BWD Plaza P.O. Box 9050 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR , ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 113 South Service Road Jericho, NY 11753 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: National Union Fire Ins Co Pitt Bright House Networks, LLC. INSURER B: St. Paul Fire & Marine Insuranc 700 Carillon Pkwy., Suite 6 INSURER C: Illinois National Insurance Com St. Petersburg, FL 33716 INSURER D: New Hampshire Insurance Company INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE D T D/YY POLICY EXPIRATION DATE MM/DD LIMITS A GENERAL LIABILITY 7146086 01/01/10 01/01/11 EACH OCCURRENCE $2,000 ,000 X COMMERCIAL GENERAL LIABILITY.. D PREMISES (Ea 'urrenoe) AMAGE TO RENTED . $1,000,000 CLAIMS MADE N OCCUR MED EXP (Any one person) $EXCLUDED PERSONAL & ADV INJURY s2,000,000 GENERAL AGGREGATE $20 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG s2,000,000 POLICY JEC LOC Per Loc Acig $4,000,000 A AUTOMOBILE LIABILITY 6647447 01/01/10 01/01/11 X ANY AUTO R ?` CF11 /+ COMBINED SINGLE LIMIT (Ea accident) $2,000,000 ALL OWNED AUTOS V BODILY INJURY SCHEDULED AUTOS DE - 3 12 (Per person) $ X HIRED AUTOS 0 009 BODILY INJURY $ X NON-OWNED AUTOS OFF' (Per accident) CLAI RECORDS AN D PROP RTY A LEG'S4' wd1 VE JcRVCS DC V C J C E D MAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO EA ACC OTHER THAN $ AUTO ONLY, AGG $ B EXCESSIUMBRELLA LIABILITY OK06502562 01/01/10 01/01/11 EACH OCCURRENCE $rj000000 X OCCUR ? CLAIMS MADE AGGREGATE s5.000.000 2 DCDUCTI OLE $ X RETENTION $10,000 $ -A WORKERS COMPENSATION AND - 020341974 01101/10 04/01411 X WC STA7U- _ OTH- C EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE 020341975 01/01/10 01/01/11 E.L. EACH ACCIDENT $1 000,000 C OFFICERIMEMBEREXCLUDED? 020341976 01/01/10 01/01/11 E.L. DISEASE - EA EMPLOYEE $1,000,000 D If yes des S PECIAL PROVISIONS below 020341977 01/01/10 01/01/11 E.L. DISEASE - POLICY LIMIT $1,000,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS Re: 2530 Drew Street, Clearwater, FL 34625 Certificate holder is included as additional insured as per written contract or agreement. City of Clearwater 112 South Oscala Ave. Clearwater, FL 34616 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 _ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVE AGUKD Z5 (ZUU1/U5) 1 of 2 #S135846/M135052 CACAT © ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL. INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25-S (2001108) 2 of 2 #S135846/M135052