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CERTIFICATE OF LIABILITY INSURANCE (310)I' • LONGA ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 9/18/2013 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 USI Insurance Services, LLC 1715 N. Westshore Blvd. Suite 700 Tampa, FL 33607 CONTACT NAME: PHONE , E,t), 813 321 -7500 FAX 813 321 -7525 (A/C, No): E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Phoenix Insurance Company 25623 INSURED Long & Associates Architects /Engineers, Inc. 4525 S Manhattan Ave Tampa, FL 33611 INSURER B : XL Specialty Insurance Company 37885 INSURER C : 06/24/2014 INSURER D : $1,000,000 INSURER E $1,000,000 $10,000 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 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 OF INSURANCE ADDL ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMBS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X X 6604528L957 h c,,r^_.,— - -. J 06/24/2013 ' � 06/24/2014 EACH OCCURRENCE $1,000,000 E PREMMISESO(Ea occurrence) $1,000,000 $10,000 MED EXP (Any one person) CLAIMS -MADE X OCCUR $1,000,000 PERSONAL & ADV INJURY GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP /OP AGG $2,000,000 GEN'L AGGREGATE POLICY X LIMIT APPLIES JECT PRO PER: LOC COMBINED SINGLE LIMIT (Ea accident) $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _AUTOS SCHEDULED AUTOS NON -OWNED BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENT ON $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ B Professional Liability DPR9711710 09/15/2013 09/15/2014 $2,000,000 per claim $2,000,000 annl aggr. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Professional Liability coverage is written on a claims -made basis. CERTIFICATE HOLDER CANCELLATION City of Clearwater PO 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 ACORD 25 (2010/05) 1 of 1 #S10948429/M10920327 ©1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MRLEW This page has been left blank intentionally: USI INSURANCE SERVICES CERTIFICATE RETURN MAIL PROCESSING P.O. BOX 5007 NOVATO, CA 94948 -5007 CITY OF CLEARWATER PO BOX 4748 CLEARWATER FL 33758 -4748