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CERTIFICATE OF LIABILITY INSURANCE (6)OP ID: KR CERTIFICATE OF LIABILITY INSURANCE Dar Yrr) 01/07/11 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 407-644-5722 NA IT CT Kristin ROdri uez Lykes Insurance, Inc. - WP 407-628-1363 P No Ext:407-478-4979 A No): 407-626-1363 P. O. Box 2703 _ E-MAIL DRE83:-krod ue ke31ns1iPafYGS?OnY°? --? ---- 'nter-Park-,-FL 3279G PR Du KINGEA CUSTOMER ID Mark E. Jackson A129051 INSURERS AFFORDING COVERAGE NAIC # INSURED King Engineering Associates INSURER A:CNA Insurance Companies 4921 Memorial Highway #300 INSURER B: Tampa, FL 33654 INSURER C : INSURER 0: 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 I Ht F'ULICY I'EItIUu 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF (MM/DP /YYYY POLICY EXF MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ CLAIMS-MADE F-IOCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO- LOC lapoft $ AUT OMOBILE LIABILITY Kitt-, COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS ? /? ?0?? JAN BODILY INJURY (Per accident) $ SCHEDULED AUTOS L H'\ ?j f'1 PROPERTY DAMAGE G ' (Per accident) $ NON-OWNED AUTOS OV F OAL RECORDS ) , LEGISLA7IVVE SRVCS ER $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LWB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION ' WC S T A M TAN EMPLOYERS LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE - • E.L. EACH ACCIDENT $ ? OFFICER/MEMBER EXCLUDED? N/A EA-EMPLOY If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ A Professional EH113805181 01101/11 01101/12 Per Claim 2,000,000 Aggregate 4,000,000, DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Blanket Waiver of Subrogation is included when required by contract CITY474 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 Clearwater Attn: City Clerk P.O. Box 4748 FL 33758-4748 Clearwater AUTHORIZED REPRESENTATIVE , ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 26 (2009/09) The ACORD name and logo are registered marks of ACORD