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CERTIFICATE OF LIABILITY INSURANCE (159)ACOR[). CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD /YYYY) 07/01/2013 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 Aon Risk Services Northeast, Inc. New York NY Office 199 Water Street New York, NY 10038 -3551 CONTACT NAME: Risk Management Department PHONE FAX (A/C, No, Ext): (866) 443 -8489 (A/C, No): (800) 889 -0021 E-MAIL ADDRESS: work.comp @trinet.com INSURER(S) AFFORDING COVERAGE NAIC # INSURED TriNet HR Corporation and all its affiliates and subsidiaries* Florida Sign Company Inc (Endorsed as alternate employer) 9000 Town Center Parkway Bradenton, FL 34202 INSURER A: Commerce & Industry Ins Co 19410 INSURER B: Illinois National Ins Co 23817 INSURER C: Ins Co State of Penn 19429 INSURER D: Nat'l Union Fire Ins Co 19445 INSURER E: New Hampshire Ins Co 23841 INSURER F: DAMAGE TO RENTED PREMISES (Ea occurrence) 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 POL CIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS GENERAL LIABILITY COIvIIMERCIAL GENERAL LIABILITY I CLAIMS -MADE CCUR r ; .. = s i c':::".....7,..,.... .. Y ' j M,, ) 3 1 ..i EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN L AGGREGATE LIMIT APPLIES PER: POLICY PROJECT LOC PRODUCTS - COMP /OP AGG $ COMBINED SINGLE LIMIT (Each accident) $ AUTOMOBILE _ LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ SCHEDULED AUTOS NON OWNED AUTOS C7, 7 :a BODILY INJURY (Per person) $ BODILY INJURY (Per accident $ PROPERTY DAMAGE (Per accident $ _UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE AGGREGATE $ DED RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y / N ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 039401238 FL 07-01-2013 07 -01 -2014 WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $2,000,000 E.L.DISEASE- EA EMPLOYEE $2,000,000 E.L. DISEASE- POLICY LIMIT $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required): 930H / 9F3 * TriNet HR II, Inc. and TriNet HR V, Inc. CERTIFICATE HOLDER CANCELLATION City of Clearwater PO Box 4748 Clearwater, FL 33758 -4748 IIIIIIIIIIII1Irrrll11111111 "111IIII111111 +111111"1111'I1'IIII SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE . . J rso a �/I.sl rite ✓yea A04864 ACORD 25 12010105) The ACORD name and logo are registered marks of ACORD © 1988.2010 ACORD CORPORATION. All rights reserved.