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CERTIFICATE OF LIABILITY INSURANCE (4)ACORQ® CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD /YYYY) 12/12/2014 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 BWD Group LLC 45 Executive Drive Plainview NY 11803 INSURED Bright House Networks, LLC. 700 Carillon Parkway (Suite 6) St. Petersburg FL 33716 CONTACT NAME RISK MANAGEMENT DEPT PHONE 516-327-2700 (A/C, No. Ext) AE-MaIL E riskcerts@bwd.us DDRSS ....__ ...............______ FAX 516-327-2800 INSURERS) AFFORDING COVERAGE NAIL # INSURER A: National Union Fire Ins Co Pittsbur 19445 INSURER B St. Paul Fire & Marine Insurance Co 24767 INSURER. New Hampshire Insurance Company 23841 INSURER D : INSURER E : INSURER F : COVERAGES :2094204543 • THIS IS TO CERTIFY THAT THE POLICIES INDICATED. NOTWITHSTANDING ANY REQUIREMENT. CERTIFICATE MAY BE ISSUED OR MAY EXCLUSIONS AND CONDITIONS OF SUCH .......... INSR LTR i TYPE OF INSURANCE OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TERM OR CONDITION OF ANY CONTRACT PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY ADDL',SUBR) POLICY EFF INSD''I WVD i POLICY NUMBER (MM /DD!YYYY) THE INSURED NAMED ABOVE FOR THE POLICY PERIOD OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, PAID CLAIMS. ...POLICY EXP ,... _....._.._ - ......_.._._. ._......__._. ......... .___ -- ..___. (MM /DD/YYYY) I LIMITS A �( I COMMERCIAL GENERAL LIABILITY ! CLAIMS MADE ' X OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: X "', POLICY 1 !PRO- I ... LOC JECT J OTHER: 2362789 1/1/2015 ' 1/1/2016 EACH OCCURRENCE DAMAGE TO RENTED , ..PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY I GENERAL AGGREGATE PRODUCTS COMP /OP AGG I Per Loc/Project Agg $2,000,000 $1,000,000 $EXCLUDED $2.000,000 $20,000,000 $2,000,000 $4,000,000 A 1 AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED AUTOS X 'HIRED AUTOS }( SCHEDULED AUTOS NON -OWNED AUTOS 13814948 1/1/2015 i 1/1/2016 tEO aBcidentSINGLE LIMIT 1 $2,000,000 I BODILY INJURY (Per person) $ I BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ (per accident) .........._ $ B X UMBRELLA LIAB X OCCUR . EXCESS LIAB I CLAIMS -MADE DED X RETENTION$$10,000 ZUP12P7706915NF 1/1/2015 1/1/2016 ! EACH OCCURRENCE $5,000,000 ' AGGREGATE $5,000,000 $ C WORKERS COMPENSATION A AND EMPLOYERS' LIABILITY C ; ANYPROPRIETOR /PARTNERJEXECUTIVE C OFFICER/MEMBER EXCLUDED? C (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS YIN ', N ! Al A 1 011953024 (AOS) 1/1/2015 011953025 (CA) 1/1/2015 011953026 (FL) 1/1/2015 011953027 (GA/VA) 1/1/2015 011953028 (IL /NC) 1/1/2015 1/1/2016 x PER OTH 1/1/2016 '- STATUTE ER ......... . 1/1/2016 1 E.L. EACH ACCIDENT $1,000,000 1/1/2016 1/1/2016 ,E L DISEASE - EA EMPLOYEE $1,000,000 I E.L. DISEASE - POLICY LIMIT $1,000,000 N below DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) 3030 N. Rocky Pointe Drive W., Tampa, FL 33607 Certificate holder is included as additional insured as per written contract or agreement. CERTIFICATE HOLDER CANCELLATION City of Clearwater P.O. Box 4748 Clearwater FL 33758 -0000 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 G ACORD 25 (2014/01) O 1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 12/17/2013 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 BWD Group LLC 45 Executive Drive Plainview NY 11803 CONTACT NAME: RISK MANAGEMENT DEPT ((A/CC, PHONE . E:a:516- 327 -2700 ADDRESS:nSkcertsl @bwd. us FAX No):516- 327 -2800 INSURER(S) AFFORDING COVERAGE NAIC N INSURED Bright House Networks, LLC. 700 Carillon Parkway (Suite 6) St. Petersburg FL 33716 INSURER A: National Union Fire Ins Co Pittsbur 19445 INSURER B :New Hampshire Insurance Company 23841 INSURER C :St. Paul Fire & Marine Insurance Co 24767 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE 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 ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A GENERAL X UABILITY COMMERCIAL GENERAL LIABILITY 6819509 1/1/2014 1/1/2015 EACH OCCURRENCE $2,000,000 PREMISES (Ea occurrence) $1,000,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $EXCLUDED PERSONAL & ADV INJURY $2,000,000 GENERAL AGGREGATE $20,000,000 GEN'L AGGREGATE X POLICY LIMIT APPLIES PRO- JECT PER: LOC PRODUCTS - COMP /OP AGG $2,000,000 Per Loc/Project Agg $4,000,000 A AUTOMOBILE X X UABIUTY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS 7062788 1/1/2014 1/1/2015 COMBINED accident) BI INLE-OMIT $2,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident ( ) $ PROPERTY DAMAGE (Per accident) $ $ C X UMBRELLAUAB EXCESS LIAB X OCCUR CLAIMS -MADE ZUP12P7706914NF 1/1/2014 1/1/2015 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 DED X RETENTON$10,000 $ B A B B B 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 N/A 043409026 043409027 043409028 043409029 043409030 1/1/2014 1/1/2014 1/1/2014 1/1/2014 1/1/2014 1/1/2015 1/1/2015 1/1/2015 1/1/2015 1/1/2015 X WCSTATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) 2530 Drew Street, Clearwater, FL 34625 Certificate holder is included as additional insured as per written contract or agreement. CERTIFICATE HOLDER City of Clearwater 112 South Oscala Ave. Clearwater FL 34616 -0000 i 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) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD