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CERTIFICATE OF LIABILITY INSURANCE (661):,:�� DATE (MM/DD/YYYY) .�CORD� CERTIFICATE OF LIABILITY INSURANCE 09/14/2015 �...-�" THIS C�RTIFICATE 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 gELOW. 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 Marsh USA, InC. NAME: 1166 Avenue of the Americas PHONE Fnx AIC No : New York, NY 10036 E-MAIL Attn: Walmart.certrequest@Marsh.com ADDRESS: INSURER S AFFORDING COVERAGE NAIC # J48574-G A-WC-15-16 6420 ALARM iNSUReR n: National Union Fire Ins. Co. of Pittsburgh, PA 19445 INSURED INSURER B : WAL-MART STORES, INC. Ils Subsidiaries and Its Affiliates INSURER C: 702 Southwest 8th Street INSURER D: Bentonville, AR 72716 COVERAGES CERTIFICATE NUMBER: NYC-007157453-22 REVISION NUMBER:1 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN �SSUED 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. L�MITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 7ypE OF INSURANCE ADDL SUBR pOLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS LTR A X COMMERCIAL GENERAL LIABILITY 3333242 09/15/2015 09/15/2016 EACH OCCURRENCE $ 1,000,00� CLAIMS-MADE � OCCUR $z,000,000 Self-Insured Reten6on PREM SES Ea occTu ence S 1,000,000 MED EXP (Any one person) g NIL PERSONAL & ADV INJURY $ 'I,OOO,OOO GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY ❑ PR� � LOC PRODUCTS - COMP/OP AGG $ 3,000,000 JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ 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 PER OTH- AND EMPLOYERS' LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTNE Y� N� A Worker's CompensaGon E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCIUDED? See Attached (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ 1,000,000 K yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 107, Addklonal Remarks Schedule, may be attached if more space la requlred) ALARM DIVISION 05-8749, 702 SW 8TH STREET, BENTONVILLE, AR 72716 EVIDENCE OF INSUR,4NCE FORALARM CENTRAL FOR �;EC�-�VEf) ,ry,.' "';,,;�:,,,i;f: WAL-MART STORE #6420 - 2575 GULF-TO-BAY BLVD. CLEARWATER, FL 33765 ' C' �" ""'"' `� '� "� .. . �. _ , . CERTIFICATE HOLDER CITY OF CLEARWATER 100 SOUTH MYRTLE AVENUE CLEARWATER, FL 33756 ACORD 25 (2014/01) TION 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. Ann-Marie Fleming �1- t...ip...t,�-t �'�p�r'u�t,f�- �O 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD • AC� � ��. 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 8th Street Bentonville, 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 .�acoR � CERTIFICATE OF LIABILITY INSURANCE DOJI142O15D/YYYY) 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�, AUTHORI2ED 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 dces not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Marsh USA, Inc. 1 i66 Avenue of ihe Americas New YoAc, NY 10036 Attn: Walmart.certrequest@Marsh.com J48574-G A-WC-15-16 6420 ALARM INSURED WAL-MART STORES, INC. Its Subsidiaries and Its Affiliates �02 so�mw�� am saeec Bentonville, AR 72716 A: Natlonal Union Fire Ins. Co. of Pittsburgh, PA D: E: 19445 COVERAGES CERTIFICATE NUMBER: NYC-00715745&22 REVISION NUMBER:1 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POL.ICY PERIOD INDICATED. N0TIMTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUEO 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. ____ ADOL UBR POLICY EFF POLICY EXP �N� TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY 3333242 09115I2O15 09115/2016 EACH OCCURRENCE $ _ 1,000,000 X� s2,000,000 Self-Insured Retention DAMA E T RENTED CLAIMS-MADE OCCUR PREMISE Eaoccurcence $ 1,��,�� MED EXP (Any one person) $ NIL PERSONAL & ADV INJURY $ 1,000,000 --�� - --__--.. GEN'L AGGREGATE UMIT APPLIES PER: GENERAI AGGREGATE _ $ ,.__ 3,000_OOO X POLICY ❑ PR� � LOC PRODUCTS - COMPIOP AGG $ 3,000,000 JECT 3 OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY ' y""�; Ea accident $ ANY AUTO �""" "n , .� ;'. BODILY INJURY (Per person) $ _ _ _ . ALL ONMED SCHEDULED � � � BODILY INJURY (Per accident) $ AUTOS NON-OWNED i� PROPERTY DAMAGE $ HIRED AUTOS AUTOS {� 2 � 2 15 '� Per accident __ __ ____ . �' S UMBRELLA LIAB OCCUR �+,', "' EACH OCCURRENCE $__ _ ' :� E%CESS LIAB CLAIMS-MADE �;, _ ��- , �. - �,� � 'F� j"� AGGREGATE $ ___ ___ _ DED RETENTIONS s V -� �� $ WORKERS COMPENSATION �.,.- -" X PER OTH- STATUTE ER AND EMPLOYERS' W181UTY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE Workers Compensation E.L. EACH ACCIDENT $ _ 1,000,000 OFFICER/MEMBER EXCLUDED? a N/ A (Mandatory in NH) See Attached EL. DISEASE - EA EMPLOYE $ ___ �,OOO,OOO H yes, descnbe under 1,000,000 DESCRIPTION OF OPERATIONS below E L DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATION3/ VEHICLES (ACORD 101, Additional Rsmarks Schedule, may be attached it more space Is required) ALARM DIVISION 05-8749, 702 SW 8TH STREET, BENTONVILLE, AR 72716 � ;:. ., .._ EVIDENCE OF INSURANCE FOR ALARM CENTRAL FOR �r �:� WAL-MART STORE #6420 - 2575 GULF-TO-BAY BLVD. CLEARWATER, FL 33765 � �.�,•—r,, !� L r�ce.'.,.. �coT�c�ceTF un� nFQ CANCELLATION CITY OF CLEARWATER 100 SOUTH MYRTLE AVENUE CLEARWATER,FL 33756 ACORD 25 (201M01) 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. Ann-Marie Fleming Q.m'Y� - �-1GLU-t �¢,rri�c.�f�- �O 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: J48574 LOC #: New York � � ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY Marsh USA, Inc. POl1CY NUMBER CARRIER NAIC CODE NAMEDINSUREO WAL-MART STORES, INC. Its Subsidiaries and Its A�liates 702 Southwest 8Ih Streel Bentonville, AR 72716 EFFECTIVE OATE: ACORD 101 (2008/01) U 2005 AGUKU cUrcrvrt�a i wn. F►n ngnis reservea. The ACORD name and logo are registered marks of ACORD