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CERTIFICATE OF LIABILITY INSURANCE (358)ACORM, CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 8/29/2014 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 EPRESENTATIVE 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 BB &T Insurance Services, Inc. Post Office Box 13941 Durham, NC 27709 919 281- 4500 CONTACT Debbie Church PHONE 910- 772 -3720 I FAX JA/C, No, Ext): i (A/C, No): 888.746 -8761 E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Hartford Fire Insurance Company 19682 INSURED McKim and Creed Inc 1730 Varsity Dr Ste 500 y Raleigh, NC 27606 -2689 I INSURER B: Hartford Casualty Insurance Corn 29424 INSURER C: Farmington Casualty Company 41483 . INSURER D : Hartford Ins Co of the Midwest 37478 INSURER E : MED EXP (.Any one person) INSURER F : TE 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 iADDl TYPE OF INSURANCE INSR SUBR WVD POLICY NUMBER POLICY EFF (MMIDD /YYYY) 09/05/2014 09/05/2014 POLICY EXP (MMIDDIYYYY 09/05/201 09/05/201 - LIMITS A GENERAL LIABILITY I 22UUNNN0633 22UENPG9685 EACH OCCURRENCE $1,000000 $300 000 $10,000 X COMMERCIAL GENERAL. LIABILITY Ep PREMISEEs a occu D nce) CLAIMS -MADE X OCCUR MED EXP (.Any one person) PERSONAL & ADV INJURY $1 ,000,000 J GENERAL AGGREGATE $2,000,000 GENII AGGREGATE LIMIT APPLIES PER: POLICY I—I JECT I ^I LOO PRODUCTS - COMP /OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY 1 FO accdentSINGLE LIMIT $1,000,000 X X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS HIRED AUTOS X I SCHFDt.L..ED AUTOS NON -WNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accidentZ $ $ X! UMBRELLA LIAB EXCESS UAB X OCCUR 22XHUNN5410 UB4142T72514 09/05/2014 09/05/2014 09/05/201 09/05/201 EACH OCCURRENCE $10,000,000 CLAIMS -MADE I AGGREGATE $10,000,000 DED I XI RETENTION $10000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY . N ANY PROPRIETOR/PARTNER /EXECUTIVE. - -. I OFFICER/MEMBER EXCLUDED? I N i I N I A (Mandatory in NH) J I If yes, describe under O DESCRIPTION OF OPERATIONS below X ORY LIMITS IOTH- $1,000,000 E.L. EACH ACCIDENT E.L. DISEASE • EA EMPLOYEE $1 000,000 $1,000,000 E.I.. DISEASE - POLICY LIMIT i DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It more space is required) Client #0992 CERTIFICATE HOLDER CANCELLATION City of Clearwater, Engineering Dept, Ste 220 Attn: Dina Katsougrakis PO Box 4748 Clearwater, FL 33756 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 1EC19andOFR /M19on'99n ©1588 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD I A W nra• 80MCKIMCRE A CORD,. CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) x/27/2014 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(les) 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 BB &T Insurance Services, Inc. 2108 W. Laburnum Avenue, Suite 300 Richmond, VA 23227 CONTACT Jenny Fisher PHONE 804 678 -5025 FAX (A/C,No, EAU; (A/C, No): 888 -751 -3010 E-MAIL bbandt.com ADDRESS: Wisher@bbandt.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: XL Specialty Insurance Company 37885 INSURED McKim & Creed Inc. 1730 Varsity Drive #500 Raleigh, NC 27606 INSURER B : INSURER C : PREMI E TO (RENTED PAMAG ET R NTED INSURER D : INSURER E : MED EXP (Any one person) INSURER F : CO• REVISION NUMBER: V 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 INSR INSR SUER WYD POLICY NUMBER ( MMIDDY�) (MM /DDIYYYP YI LIMITS EACH OCCURRENCE S GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY I 1 OCCUR PREMI E TO (RENTED PAMAG ET R NTED S 1 CLAIMS -MADE MED EXP (Any one person) S PERSONAL & ADV INJURY S GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT RO- POLICY El JECT APPLIES — PER: LOC SCHEDULED AUTOS NON -OWNED AUTOS PRODUCTS • COMP /OP AGG $ COMBINED SINGLE LIMIT (Ea accdent) $ $ AUTOMOBILE ... LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS BODILY INJURY (Per person) $ BODILY INJURY (Per accident) S PROPERTY DAMAGE (Per accident) S S UMBRELLA LIAR EXCESS LIAB I OCCUR CLAIMS -MADE EACH OCCURRENCE S AGGREGATE S DED i RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR!PARTNER/EXECUTIVE —, OFFICER/MEMBER EXCLUDED? ` (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A I WC STATU- OTH- TORY LIMITS . ER _ E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE - POLICY LIMIT S A Professional Liability PDPR9719210 09/05/2014 09/05/2015 $5,000,000 Per Claim $7,000,000 Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION City of Clearwater Attn: City Clerk P.O. 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 #512887247/M12680010 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD TLS