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CERTIFICATE OF LIABILITY INSURANCE� �� A� oR°' � CERTIFICATE OF LIABILITY INSURANCE DATE�MM/DD/YYYY) 7/t/2o15 1/9/2015 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 COVERACaE 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 certi8cate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Lockton Companies Three City Place Dnve, Suite 900 St. Louis MO 63141-7081 (314) 432-0500 INSURED Corrpro Companies, Inc. 1319367 2069A Lake Industrial Court Conyers GA 30013 Indian Fire Insurance COVERAGES CORC002 CERTIFICATE NUMBER: 13299906 REVISION NUMBER: XXXXXXX 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. �LT R ADDL SUBR POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE � POLICY NUMBER / A X COMMERCIALGENERALLIABILITY y rJ CGE7409323 7/1/2014 7/1/ZO1S EACHOCCURRENCE Z OOO OOO CLAIMS-MADE a OCCUR DAM GE O RENTED 1 OOO OOO PREMISE Ea occurrence A X P�100_000 SLR XCU / BROAD FORM PD MED EXP An one erson 10 ��� PERSONAL 8 ADV INJURY $ 2 OOO OOO GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4 OOO OOO POLICY� jE � � LOC PRODUCTS - COMP/OP AGG $ 4 OOO OOO OTHER $ B AUTOMOBILE LIABILITY y N AS2641004218024 7/1/2�14 7/1/201$ Ea socltleDtS NGLE LIMIT $ 2 QQQ o00 X ANY AUTO BODILY INJURY (Per person) S XXi�XXX AUTOS NED qUTOSULED BODILY INJURY (Per accident $ XXXXXXX HIRED AUTOS A�T SWNED PROPER DAMAGE g XXXXXXX Per accident $ XXXXXXX UMBRELLA LIAB OCCUR EACH OCCURRENCE $ XXXXXXX EXCESS LIAB CLAIMS-MADE NOT APPLICABLE AGGREGATE $ XXXXXXX DED RETENTION $ $ WORKERSCOMPENSATION WA764D009004444 7/1/2014 7/1/201$ X STATUTE OTH- C AND EMPLOYERS' LIABILITY N WC7641004218014 WI i/1/2�14 7/1/2015 C ANY PROPRIETORlPARTNER/EXECUTIVE Y� N � � E.L. EACH ACCIDENT $ I OOO OOO C OPFICER/MEMBER EXCLUDED? N❑ N� A �EXCLUDING MONOPOLISTI 1 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE 1 OOO OOO DESCRIPTI N OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 OOO OOO D Professionat /Contractors y N CE0742002402 7/1/2014 7/1/2015 pRb�FESS ONA�LL PE I�CLAIM/AGG p Pollution Liability (PROF-CLAIMS MADE) $lOM COMBINED POLICY AGG LIM DESCRIPTION OF OPERATIONS / LOCATIONS ! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is requfred) CORRPRO JOB N[JMBER: 340201248 - RFP NO. 36-14. CITY OF CLEARWATER ARE ADDITIONAL INSUREDS IJNDER GENERAL LIABILITY r1ND AUTOMOBILE LIABILITY ON A PRIMARY AND NON-CONTRIBUTORY BASIS WHERE APPLICABLE BY WRITTEN CONTRACT, BUT ONLY WITH RESPECT TO LIABILITY ARISING OUT OF THE NAMED INSURED'S OPERATIONS; AND ARE ADDITIONAL INSUREDS UNDER CONTRACTOR'S POLLUTION LIABILITY WHEN REQUIRED BY WRITTEN CONTRACT OR AGREEMENT ON A PRIMARY AND NON-CONTRIBUTORY BASIS AND SOLELY FOR "COVERED OPERATIONS° PERFORMED BY OR ON BEFIALF OF THE NAMED INSURED. *'SEE ATTACHED ENDORSEMENTS'• CERTIFICATE HOLDER CANCELLATION See Attachment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 13299906 AUTHORIZED REPRESENTATIVE CITY OF CLEARWATER ATTN: CLEARWATER GAS SERVICES -ALYCE BENGE PO BOX 4748 CLEARWATER FL 33758-4748 .�. er.nRn �� r�n�ain�� 01988- RD O RA N. All rights reserved The ACORD name and logo are registered marks of ACORD r � � �A.! i"l�.l[;;, IFt � I�`i� This endarsemeni, �fiecfive an July 1, 2014, at 12:01 A.M. s#and�rd time, forms a part af Policy Na. CG�74Q93�3 af fhe XL Ir�surance America, Inc. issued tc► Gt3RR�R0 C{}Mf'ANIES, lNC. THIS ENQt�RSEMEhtT CFiANGES THE PC?LIGY. PLEASE READ IT CAREF�}L�Y. AGiDiTiQNAL tNSURER — t'�WNERS, LESSEE� tJR C+C}NTRACTQRS — SC�lEDUl�EQ R�RSQN C}R f?R�ANtZ�4TiC?N This endorsement mcadifies insuran�e p�cavided �rnder the foilowing: COM�1IERCIAL GEtJEi�AL LIABILtTY �UVERAGE F'ART hiame of Pe�son or Qr+�aniza#ic�n: Any person or arganizatic�n with whom yau have ag�eed, #h�rcaugh written contract, agreement ar permit, executed pri�r tv loss. (if no entry apRears abave; information required ta cc�mplete this endc�rsement wili be s�ovvn in the Declaratinns as appiicabie ta this endorsement.} A. Section 11— Who Is An fnsured is amended ta include as an insured the persan of organizatir�n shown in #he S�h�dul�, but aniy with respect to li�bility arising r�ut of yvur r�ngoing operations performed fcar #hat insured. B. With respect to ihe insurarrce afford�d �o th�se additi�nal insur�ds, #he fa(i�+w�r�g exc#u�ion is added: 2. �xclusions Th�s in�uranc� do�s nc�t apply to "k�odiiy injury,. c�r "pr€�perty damage"' c�ccurfing after: (1} A!I work, inc(udir�g materia[s, parts ar equi�ament fiurnished ir� cpnnec#ic�n with SuCh wOfk, 4n the prOjeCt {c�ther than SBt�iGe, maintenance car r8pairS) to be perft�rmed by or on b�1��lfi af the additional insured(s} at #he site af the cavered op�:ratie�ns has been cc�mpleted; o� (2j 1"hat pc�rtion of "yaur wark" out c�f wh�ch the injury ar �amage ar"sses has been pcat ta its intended use by any pers�n t�r or�ani�zati�n o#h�er than �n�ther cor�tractc�r or subcontractar engaged �n pe�forrning� operations for a principal as a p�rt of the �ame proj�ct: .. All ather ierrns and conditic�ns remain unchanged. �lutt�or�zed R.epres�ntative MANUS �U ��14 X.L. America, Iric. A!! Rights Reserved. �fay not be copied without permissic�n. � EhIC}OR��MEN7 Th�s endorsement, effective on ,1uly 1, 2014, at 12.t}1 A.M, st�ndar�i time, forms a part ofi Policy No. CGE?�09323 of the XL Insurance America, (nc. issued ta �+�RI�PRa C�MPANIES, 4NC. TH'1S Ef�t�flRSEMEt�T CNAN'GES THE POLiCY: PLEASE REAb iT CAF2EFULLY. ADfllTIQNAI. INSURE� — C}WNERS, LESSEES i}R Ct?NfiRACTORS — CC?MPLETED +OPERA7'I�NS This �ncio�sement mc�difies insur�nce pravided under tfie following: �CC}MMEF�GIAL GENERAk� LIA�ILIi''Y Ct�VERAGE �'AR7 Aiamett of Person ac fJrganizatian: Any p�rsan or organizatipn with whom you have agreed, through written cant�act, �greement or permit, ex�ecutt�d pritar to lass. Lvcat�on And l�escription c�f Campl�ted Operations: V�rious as fequired per written contract Additi�naE Prerr�ium: $ #ncluded �If no entry a�pe�rs above, infarmatian required to cc�mplete this endorsement wiH be shawn in the Declaratipns as �pplicabie to thi� enriorsement.} Sectic�n IM — Wha Is An insured is amended io inciude as an insured th� person or arganrzation shown in the Sche�tiule, but anly with respect #c� liabiliiy arising out of "your wc�rk" at the Ic�catian designat�d and described in the schedule af #�is endorsement performed farthat insured and irtctuded in the "products- cc�mplete�# r��erati�ns h�zard". Alt c�ti�er terms ar�d co�+dition� �err�ain unchanged. �� � ��" '� Autho�ized Repre�ent�ative ^� �R�1�� �J 20'I 1 X.L. Am�rica, Inc. All Rights Reserved. May n�t be copied without permission. ENDORSEMENT This endorsement, effective 12:01 a.m., July 1, 2014, forms a part of Policy No. CGE7409323 by XL Insurance America, Inc. issued to CORRPRO COMPANIES, INC. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY INSURANCE CLAUSE ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS COVERAGE PART It is agreed that to the extent that insurance is afforded to any Additional Insured under this policy, this insurance shall apply as primary and not contributing with any insurance carried by such Additional Insured, as required by written contract. All other terms and conditions of this policy remain unchanged. XIL 424 0605 O, 2005, XL America, Inc. ENDORSEMENT This endorsement, effective 12:01 a.m., July 1, 2014, forms a part of Policy No. CGE7409323 issued to CORRPRO COMPANIES, INC. by XL Insurance America, Inc. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT In the event coverage is cancelled for any statutorily permitted reason, other than nonpayment of premium, advanced written notice will be mailed or delivered to person(s) or entity(ies) according to the notification schedule shown below: Number of Days Name of Person(s) or Entity(ies) Mailing Address: Advanced Notice of Cancellation: Per schedule on File with the Com an 90 All other terms and conditions of the Policy remain unchanged. IXI 405 0910 O 2010 X.L. America, Inc. All Rights Reserved. May not be copied without permission. � POLICY NUMBER: AS2-641-004218-024 CONN�RCIAL AUTU CA 20 481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTQS LIABILITY COVERAGE This endorsement modi�es insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form �apply unless modfied by the endorsement. This endorsement identifies person{s) or organization(s) who are "insureds" for Covered Autas Liability Coverage under the 1Nho Is An Insured provision of the Coverage Form. 7his endorsement does not alter coverage provided in the Coverage Form. SCHEDUL.E Name Of Person(s) Or Any person or organization whom you have agreed in writting to add as an additional insured, but only to cover the minimum limits of insurance required by the written a�reement, and in no event to exceed either the scope of coverage or the limits of insurance provided in this policy. For designated insured added this policy, and where a written agreement requires the insured to provide liability insurance on a primary, excess, contingent, or any other basis, this policy will apply soley on the basis of such written agreement. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualfies as an "insured" under the Who Is An Insured provision contained in Paragraph A.'I. of Section I! - Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I- Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 4810 '13 � Insurance Services Office, Inc., 2011 Page 1 of 1 Policy Number: AS2-641-004218-024 15sued By: Liberty Mutual Fire Insurance Co. THIS ENDOR5EMENT CHANGES 7HE POLICY. PLEASE RE,4D IT CAREFULLY. N0710E O� CANCELLATION TO iHIRD PARTIES This endorsement mod'�ies insurance provided under tl�e following: SUSINESS AUTO COVERAGE PART MOTOR CARRIER COVERAGE PART GARAGE COVERAGE PART TRUCKERS COVERAGE PART EXCESS AUTOM081LE LIABILITY INDEMNITY COVERAGE PART SELF-INSURED TRUCKER EXCESS LIABILITY COVERAGE PART COMMERCIAL GEfVERAL LIABILITY COVERAGE PART EXCESS COMMERCIAL GENERAL UABILITY COVERAGE PART PRODUCTSICOMPLETEn OPERATIONS LIABILITY COVERAGE PART LIQUOR I.IABILITY COVERAGE PART Schedule Name of Other Person(s)/ Emall Address or mailing [Vumber Organ[zatton(s): address: Days Notice: Per schedule on file wi.th 60 the company A. If we cancel this policy for any reason other than nonpayment of premium, we will notrfy the persons or organizations shown in the Schedule above. We will send notice to the email or maiting address listed above at least 10 days, or the number of days listed above, if any, before the cancellation becomes effective. In no event does ihe notice to the third party exceed the notice to the first named insured. B. This advance no�cation of a pending cancellation of coverage is intended as a courtesy only. Our failure to provide such advance notfication will not extend the policy cancellation date nor nsgate cancellation of the policy. All other terms and conditions of this policy remain unchanged. LIM 99 01 0511 m 201 i, l.iberty Mutual Group of Companies. All rights reserved. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc. with its permission. THIS ENDORSEMENT CHANGES THE FOLICY. PLEASE READ IT CAREFULLY. NOTiCE OF CANCELLATION TO THIRD PARTIES A. If we cancel this poiicy for any reason other than nonpayment of premium, we will notify the persons or organizations shown in the Schedule below. We wifl send notice to the email or mailing address listed below at least 10 days, or the number of days listed beiow, if any, before cancellation becomes efFective. In no event does the nofice to the third party exceed the notice to the first named insured. B. This advance notifcation of a pending canceflation of coverage is intended as a courEesy onfy. Dur failure to provide such advance notificatian will not extend the policy cancellation date nor negate cancelfation of the policy. Name of Other Person(s} 1 Organization(s): Per schedule on file with company SCHEDULE Emaif AdBress or mailing address: Number Days Notice: All other terms and conditions of this policy remain unchanged. Issued by Liberty Insurance Corporation .� For attachment to Policy No. WA7-64D-009004-444 Effective Date 07/01/2014 Premium $ Issued to WM 8018 Q611 O 2d11 Libe�ty Mutual Group of Companies Ed. 06/01/2011 AI) Rights Reserved Page 1 of 1 ♦ @ , f � . ' . • , . R . .e � � . , ` ^ °,�* . ., . .. 4 ` '� w ' . � ` • • i���( T.. .,y� }y�+ • $ t ",:F ". .. , �17VCJ�����E�i i MVUV � T�'s� er�dt��serrber�t�, effe�tive �2:E}1 a.m�,July �, 20�a frarms � pa� t�f 4�aliGy f�Ic�.CE0742002402 issuE*d t4 Cc�rrpt'fl �c�t�#��t�ies, ��rC. b� Iridi�n Narbor lnsur�nc� �ornpa�sy. T`H� i EhiDC)� a�MENT �NANG�S THE i�GLICY. P��f�S� I��tiC7 Ii CAREFl1LLY, MANUSGF�{�*T ENCit3FtS�MEMT - CAN�ELLATIC?N NOiiFlCATtQI+! Ti'� C)THEi�S� ENDt?RSEMENT Tt�is endarsement motiifi�s insuran�e p�`ov"rd�d ur�der the faliowing: f�A1�E F�1us: �rafessic�r��i 6�cti�ritiesl�r�rnplete Exe�uti+�n + Pollutian PRt?FES�(f)NAL 8� �t}L.L:�iit)ht LIABl�.[TY F+�R �C?NSTRUGi'1t7N Ct�NTFtAGTCiRS APID �C�N�'CFtUGTIC1t� �UPPCiR°i �E�YlCES P�t�V1�ERS in rorasid�r�ti�n caf the pr�mi+�m charged, tl�e Mamed Insured ar�d the Company agree to the f�xlowing �'oiicy c�ange{sj: In the everrt covera��; is c�ncetEed for ar�y �tatutor�iy permi�fed re�son, other than ncanpaymerrt cs# �remiun�, advanc�d �,tritten n�atic� +rrii! be m�iPe�# t�r d�li�r�d t�s p�rson�s} ar �ntrty(ie�� acccrrding t� th� n�tr���ti�rn schedute �F�own below: �.___.._�.�__� _�.w....__w_.�_ .._._..._d...__W_w__�..�.�____, _ �.� �..�wti.........�_ �lumb�r crf t��ys ; �dvanc�d ; Nam� of Persc�n�s} or Enti#y(ies) , Maii�r�g Addr�ss: Natice of ; �vith ihe ,All �afh�r �erms, ct�nditit�ns �nd �xclusions af this paiicy r�main un�hanged. . t� ��.D 4i70 t�113 {�7 2�713 X.L. Amer'rt�a, Inc, Pag� 1 oi 1 A!! Ri�hts F2eserved. M�y nc�t b� copied withaut permiss6on, !' _ ,�� �- e� �,��� 03l o _ ��� - � ' 8'c���. ��l�l i� ��.� ; �--eS .` l �o �2�/ � vse.� t� . , . �`�'� ��-�ed� �� �,���� s_ � ��� � c���'� ��ed��� �s�� �� � ► ��-c o: `� C�,4s ���e� �. � Z� �5� � �( ����s � cz����c� U S� �.' �Q�,r- 2. ca�L,,� �. z,, -f- vf- � CC-�� Cv���'� �ro-(��'� �-�' l�,-t. , 3 �lZ�l��-ig ; � s �� � �� ��� � �'r/I `v � ���� � �/�� ( � �s� �- �����c�,z� �� � . � ����- -� �.� ���- � �� `�-� �� ��s ���� ��� �, . ' � 4��v, � °1