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CERTIFICATE OF LIABILITY INSURANCE (3)ACCM 0r CERTIFICATE OF LIABILITY INSURANCE F72J1 - M /D D /YYYY) 5/2015 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 Phone No.: (212) 488 -0200 Fax No.: (212) 488 -0220 NAME: PHONE (AC, Na E.W. 4M;�k Frenkel &Company 350 Hudson Street — 4th Floor Aoo: CUSTONERDA New York, NY 10014 INSURER(S) AFFORDING COVERAGE NAIC A EG14362834 INSURED INSURER A: AIG SPECIALTY INSURANCE COMPANY 26883 POlydyne Inc. INSURERB: COMMERCE & INDUSTRY INSURANCE COMPANY 19410 One Chemical Plant Road PO Box 250 Riceboro GA 31323 INSURERC: HARTFORD INSURANCE COMPANY OF THE MIDWEST 37478 INSURER D: INSURER E: INSURER F: COVERAGES CCDTmif`ATC M"UD= . RCYIJnJK MUMMI=K. 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. LTR TYPE OF INSURANCE DL VWDR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE ❑X OCCUR XX EG14362834 12/31/2015 12/31/2016 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 500,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000. GENERAL AGGREGATE $ 5,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS- COMP /OP AGG $ 2,000,000 PRO - POLICY . - JECT LOC $ B, AUTOMOBILE LIABILITY CA4691818 12/31/2015 12/31/2016 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X'. ANY AUTO - ALL OWNED BODILY INJURY (Per person) $ OS ED AUTOS A'TOSULED X NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ ;IDED A RELLALIA6 X OCCUR EGU18403155 12/31/2015 12/31/2016 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 ESS LIAB CLAIMS -MADE RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTNE OFFICER/MEMBER EXCLUDED? N/A IOWNR30600 12/31/2015 12/31/2016 W TA U- TH- X TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEE $ 1,000,000 (Mandatory in NH) Ifyesdescribe under DESCRIPTION OF OPEMTIQtg,5 below E.L. DISEASE - POLICY LIMIT 1,000,000 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if nhore space is required) City of Clearwater is included as Additional Insured as required by contract and subject to the policy terms conditions and exclusions. 30 DAY CANCELLATION CLAUSE INCLUDED !`CDTICIf`ATC U^I mom City of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 100 S. Myrtle Ave. ACCORDANCE WITH THE POLICY PROVISIONS Clearwater, FL 33756 AUTHORIZED REPRESENTATIVE © 1988 -2010 ACORD CO RATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD