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CERTIFICATE OF LIABILITY INSURANCE (572)_._---,��.-_ � �� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) ACORD osnorzo�a �....•�" 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 CONTACT MalSh USA, II1C. NAME: PHONE FAX 1166 Avenue of the Americas �uc No : New York, NY 10036 E•MAIL Attn: Walmart.certreauest(a�Marsh.com ADDRESS: J48574-G A-WG1415 6420 ALARM INSURED WAL-MART STORES, INC. Its Subsidiaries and Its Affiliates 702 Southwest 8th Street Bentonville, AR 72716 INSURER S AFFORDING COVERAGE 1 iNSURER a: NaGonal Union Fire Ins. Co. of Pittsburgh, PA 19445 c: f� COVERAGES CERTIFICATE NUMBER: NYC-00582820420 REVIStON NUMBER: t THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTIMTHSTANDING 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 TYPE OF INSURANCE ADDL SUBR pOLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS LTR A CENERAL LIABILITY 2047439 09/15/2014 09/15/2015 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY S2,O00,000 Self-Insured Reten6on PREM SES�EaEoccu ence $ �,�O,OOO CLAIMS-MADE D OCCUR MED EXP (My one person) g NIL PERSONAL & ADV INJURY $ �,�O,OOO GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 3,000,000 X POLICY PR� LOC $ :.UY<iMiiBI�E Lii�i3iLiTY COMBWED SINGLE LIMIT _N Ea accident ANY AUTO BODILY INJURY (Per person) $ ALl OWNED SCHEDULED BODILY INJURY (Per accideM) $ AUTOS AUTOS PROPERTY DAMAGE $ NON-OWNED Per accident HIRED AUTOS AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS' LIABILITY Worker's Compensation 1,000,000 ANY PROPR�ETOR/PARTNER/EXECUTIVE Y� N E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? � N� A See Attached 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Addidonal Remarks Schedule, if more space is required) ALARM DIVISION 05-8749, 702 SW 8TH STREET, BENTONVILLE, AR 72716 EVIDENCE OF INSURANCE FOR ALARM CENTRAL FOR WAL-MART STORE #16420 - 2575 GULF-TO-BAY BLVD. CLEARWATER, FL 33765 CITY OF CLEARWATER 100 SOUTH MYRTLE AVENUE CLEARWATER, FL 33756 ACORD 25 (2010/05) 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 of Marsh USA Inc. Laura Quackenbush �su�.a oluo�.�xin�[k� �O 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD � a3za-o,-oo-0000szs-000z-000,os2 ACORO� `..►.i� AGENCY Marsh USA, Inc. POLICY NUMBER CARRIER AGENCY CUSTOMER ID: J48574 LOC #: New York ADDITIONAL REMARKS SCHEDULE NAIC CODE NAMEDINSURED WAL-MART STORES, INC. Its Subsidiaries and Its Affiliates 702 Southwest Sth Street Benlonville, AR 72716 EFFECTIVE DATE: Page 2 of 2 ACORD 101 (2008/01) O 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD � ` `-' - � � �J\O S (��n �� c�'_�`�.�-� . � . i� Z- � � � _�� _ �. — _ — - _ _ — — _ - — — — — — .� EN C.-,�� ce.,�, c-� 7 8'��r�-d :�l`�!�'� .��• o�t�� 2- �C� �`�� , < ��` S`` � ; � -�-o �- —�-c �-� c �--�p �; � � -� '�'J `C� `� � Cs� �-( �.�3 {' � vc� :-�cc�S =.� _-�v�--� �- �—R�— \�,�, ��= 5/IWio p �� /3V�5 , � �- � C� `�� - �3 . C�-� �.�-,� ��M� =7 � (�-� y�'"1�� Q� �3 � ��.x('�� 3/ 1/�V� � \� "✓ � ' C.J �� \ w a �� ` � . � 1.J �� G ��!— � _ �� ' '�� /�� • 3 3l /1 � /, �J�- `�o°(`'( -�- 9 e �. �-� �� P � . � � : � � ��2�� . . ��,�� . � `�� C�- `�� Q �-�C`1 �P'� v� �-�° cM�° � f��c_ i9'� �.� ' l /�l/ I • ��s � � �� <<r�r�- ��s �� .-� � �� z�� 0324-01-00-0000326-0003-0001093 �s �_{ �\��-, C �� z� s� �� s,-�t �o�� ,� Ms? �Je C. �a., c� � �� `� .�� .� �,� � �;e,-�e �.� , � �� ,,, -�.� � ��, �.-,- ..�. �- �--__ �.-- .. � � ;�� r� �� - �� .� � �, � ��;��'��`