CERTIFICATE OF LIABILITY INSURANCE (2)Client#: 987776 INTUISYS
DATE (MM/DD/YYY�
ACORD,T, CERTIFICATE OF LIABILITY INSURANCE 70/27/2015
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 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 CON A Staci Richter
NAME:
USI Insurance Services LLC P"o"E 904-450-4717 F^X 877-775-0285
,vc No Ext : A/C, No :
4601 Touchton Road, Ste. 3210 A��RESS: staci.richter@usi.biz
Jacksonville, FL 32246 INSURER(S) AFFORDING COVERAGE NAIC #
iNSUReRa: Sentinel Insurance Co. 11000
INSURED INSURERB: F2(J@�8I IIlSUi811C@ COtll�i811j/ 20281
Intuition Systems, Inc.; Intuition LLC; iNSUReR c: Gemini Insurance Company 10833
Bi112Pay, LLC; Intuition College Savings
Solutions LLC; Veritec Solutions, LLC �NSURER �: Hartford Accident and Idemnity 22357
INSURER E :
COVERAGES CERTIFICATE 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 TypE OF INSURANCE ADDL SUB POLICY EFF POLICY EXP LIMITS
LTR INSR WVD POLICY NUMBER MM/DD MM/DD
A GENERALLIABILITY 21SBABW9587 12/31/2014 12/31/201 EACHOCCURRENCE $1000000
X COMMERCIAL GENERAL LIABILITY PREMISES Ea o"�Tu ° n� $1 OOO OOO
CLAIMS-MADE a OCCUR MED EXP (Any one person) $ � � ���
PERSONAL & ADV INJURY $ � �OOO�OOO
GENERALAGGREGATE $Z�OOO�OOO
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $Z�OOO�OOO
X POLICY PR� LOC $
JECT
p AUTOMOBILE LWBILITY � 21UECZP2380 12/31/2014 12/31/201 EO aBliN�eDSINGLE LIMIT 1,000,000
X ANY AUTO i BODILY INJURY (Per person) $
ALL OWNED SCHEDULED � BODILY INJURY (Per accident) $
AUTOS AUTOS
X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $
AUTOS Per accident
$
q X UMBRELLA LIAB X occuR 21SBABW9581 12/31/2014 12/31/201 EACH OCCURRENCE $5 000 000
EXCESS LIAB CLAIMS-MADE AGGREGATE $S OOO OOO
DED X RETENTION $� O OOO $
WORKERS COMPENSATION WC STATU- OTH-
AND EMPLOYERS' LIABILITY y� N
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? � N / A
(Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
B Crime 82092987 72/31/201412/31/201 5,000,000
C E8�0 Liability VNPL001371 9/12/2014 12/31/201 5,000,000
C C ber Liabili VNPL001371 9/12/2014 12/31/201 2 000 000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required)
City of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Attn: Customer Service ACCORDANCE WITH THE POLICY PROVISIONS.
100 South Myrtle Avenue
Clearwater, FL 33756 AUTHORIZED REPRESENTATIVE
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O 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S16551930/M15229099 SBREQ