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CERTIFICATE OF LIABILITY INSURANCE (294)Client #: 1048517 MCCARASS ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD /YYYY) 03/06/2014 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 USI Insurance Services, LLC, 1715 N. Westshore Blvd. Suite 700 Tampa, FL 33607 CONTACT NAME: PHONE 813 321 -7500 FAX 813 321 -7525 (A/C, No, Ext): (A/C, No): ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: MSA Insurance Company 11066 INSURED McCarthy & Associates, Inc. 2555 Nursery Road, Suite 101 Clearwater, FL 33764 INSURER B : Travelers Casualty & Surety Co 31194 INSURER C : Phoenix Insurance Company 25623 INSURER D $1,000,000 $ 500,000 $5,000 INSURER E : INSURER F : CLAIMS -MADE X 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 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 ADDLSUBR INSR WVD "9 POLL LICY EFF /DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X BPG95782 ' ` I`jtyky (y C.77 Ci "d. krr.CL .; F d � : i' C /26/2014 e.) ANT L•4 J EYT j 04/26/2015 EACH OCCURRENCE $1,000,000 $ 500,000 $5,000 PREMISES (Ea occur ante) CLAIMS -MADE X OCCUR MED EXP (Any one person) PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GE 'L AGGREGATE POLICY X LIMIT APPLIES JEa PER: LOC - PRODUCTS - COMP /OP AGG $2,000,000 $ C AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS X BA3E074776 03/09/2014 03/09/2015 OM(ECBINED SINGLE LIMIT a accident) $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) It yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A X UB5848Y553 05/01/2014 05/01/2015 X WORVTUMirs Er - E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE $500,000 E.L. DISEASE - POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Clearwater is an Additional Insured w'th respect to General Liability and Automobile Liability where required by a written contract prior to a loss per policy terms and conditions. A thirty (30) day, written notice of cancellation or modification of coverage applies. CERTIFICATE HOLDER CANCELLATION City of Clearwater Attn: City Clerk P.O. Box 4748 Clearwater, FL 33758 -4748 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 op ACORD 25 (2010/05) 1 of 1 #S11789212/M11789199 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD KEBEW USI INSURANCE SERVICES CERTIFICATE RETURN MAIL PROCESSING P.O. BOX 5007 NOVATO, CA 94948 -5007 CITY OF CLEARWATER ATTN: CITY CLERK PO BOX 4748 CLEARWATER FL 33758 -4748