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CERTIFICATE OF LIABILITY INSURANCE (465)A� /2C CERTIFICATE OF LIABILITY INSURANCE DATE 9/2200 4YYY) 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 USA CONTACT NAME: (HONE ) (866) 283 -7122 (800) 363 -0105 ac. No. Ext): I FAX No.): E-MAIL ADDRESS: INSURERS) AFFORDING COVERAGE NAIC If INSURED Verizon Communications and its Subsidiaries and Affiliated Co., c/o verizon Lease Administration 7701 E. Telecom Parkway Mail Code: FLTDSB1W Temple Terrace FL 33637 USA INSURER A: National Union Fire Ins Co of Pittsburgh 19445 INSURER B: New Hampshire Ins Co 23841 INSURER C: Illinois National Insurance Co 23817 INSURER D: $1,000,000 INSURER E: INSURER F: DAMAGE TO RENTED PREMISES CERTIFICA1 • 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 HP, E BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested INSR LTR TYPE OF INSURANCE ADDL N IN -SUBR WVD POLICY NUMBER �-^ , i FF * +F pV� MID LIMITS A X COMMERCIAL GENERAL LIABILITY GL7266932 , `° - � a i 1 - ;; y �,� /3 /201 � EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES — S2,000,000 — (Ea occurrence) MED EXP (Any one person) PERSONAL 8 ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY OTHER: JECT PRO- LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP /OP AGG 52,000,000 A A A AUTOMOBILE LIABILITY CA 350 -06 -58 AOS CA 350 -06 -59 MA CA 350 -06 -60 VA 06/30/201406/30 06/30/2014 06/30/2014 /2015 06/30/2015 06/30/2015 COMBINED SINGLE LIMIT /Ea accident) S1,000,000 .-- X — __ — ANY AUTO BODILY INJURY ( Per person) ALL OWNED AUTOS HIRED AUTOS — — — SCHEDULED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) A X UMBRELLALIAB EXCESS LIAB X OCCUR CLAIMS -MADE 49131372 06/30/2014 06/30/2015 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 DED I X !RETENTION $10 000 B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YNN NIA WCO26035004 WCO26035006 KY NC NH UT VT 06/30/2014 06/30/2014 06/30/2015 06/30/2015 X PEATUTE I OTH- ER OFFICER/MEMBER EXUDED ?EXECUTIVE (Mandatory in NH) If Es, describe under E. L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 D DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 i DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached N more space is required) • ■ • • CERTIFICATE HOLDER CITY OF CLEARWATER FLORIDA SPEED CODE 3180 100 SOUTH MYRTLE AVENUE CLEARWATER FL 33755 USA CANCELLATION 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 Le� %�r ✓LLL1Ad V /� e! �!Q ACORD 25 (2014/01) 01988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Holder Identifier : Certificate No : 570054201836 .44C-C3002/f) ADDITIONAL REM AGENCY CUSTOMER ID: 570000027366 LOC #: of AGENCY Aon Risk Services Northeast, Inc. NAMED INSURED .. verizon Communications POLICY NUMBER See Certificate Number: 570054201836 CARRIER See Certificate Number: 570054201836 NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LTR TYPE OF INSURANCE - ADDL INSD SUER wVD POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YYYY) POLICY EXPIRATION DATE ( MM/DD/YYYY) LIMITS WORKERS COMPENSATION B N/A WCO26035008 NJ PA 06/30/2014 06/30/2015 B N/A WCO26035007 AZ GA VA 06/30/2014 06/30/2015 A N/A wc026035005 CA 06/30/2014 06/30/2015 B N/A wc026035012 MA,ND,OH,WA,WI,WY 06/30/2014 06/30/2015 B N/A wc026035011 MN 06/30/2014 06/30/2015 C N/A WCO26035009 FL 06/30/2014 06/30/2015 B N/A wc026035010 ME 06/30/2014 06/30/2015 ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved.