The URL can be used to link to this page

CERTIFICATE OF LIABILITY INSURANCE (674)A4` /f5k. 2015 W'::"' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/27/2015 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 Marsh USA, Inc. 4400 Comerica Bank Tower CONTACT NAME: FFAX PHONE ,C No): E -MAIL ADDRESS: 1717 Main Street Dallas, TX 75201 -7357 COMMERCIAL GENERAL LIABILITY Attn: dallas.certs@marsh.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Catlin Specialty Insurance Company 15989 CN102137489 –DBS -14-15 INSURED GariandlDBS, Inc. 3800 E. 91 st Street INSURER B: Liberty Mutual Fire Insurance Company 23035 INSURER C : Liberty Insurance Underwriters Inc. 19917 INSURER D: Travelers Property Casualty Company of America 25674 Cleveland, OH 44105 INSURER E: The Cincinnati Insurance Company 110677 INSURER F : Peerless Insurance Co 124198 COVERAGES CERTIFICATE NUMBER: HOU- 002712167 -01 REVISION NUMBER:I 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 ADDL SUBR POLICY NUMBER POLICY EFF MM /DD/YYYY POLICY EXP MM/ D/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY GLH- 692246 -1215 12/05/2014 12/05/2015 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) $ 10,000 X SIR - $100,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JE� F-1 LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ OTHER: B AUTOMOBILE LIABILITY AS2151- 290169014 12/05/2014 12/05/2015 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED AUTOS X NON -OWNED AUTOS C UMBRELLA LIAB X OCCUR 1000021688 -05 12/05/2014 12/05/2015 EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER/EXECUTIVE YIN OFFICER /MEMBER EXCLUDED? (Mandatory in NH) N/A PJUB -21 9M968-4-14 12/05/2014 12/05/2015 X IPER STATUTE ERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEd $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 E Installation Floater CAP5211252 (Ded: $50,000) 1205/2014 12/05/2015 Limit 900,000 F Leased/Rented Equip IM8993894 (Ded: $2,500) 1205/2014 12/0512015 Limit 100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is included as additional insured where required by written contract with respect to General Liability and Auto Liability. City of Clearwater Attn: Purchasing PO Boy.. 4748 Clearwater, FL 33758 Le1_1 � I"a at A_1 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. Manashi Mukherjee .34�� ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 1 0550- 01 -00- 0002500 -0002- 0005452 AGENCY CUSTOMER ID: CN102137489 LOC #: Dallas ACOREP ADDITIONAL REMARKS SCHEDULE L Page 2 of 2 AGENCY Marsh USA, Inc. NAMED INSURED Garland /DBS, Inc. 3800 E. 91st Street Cleveland, OH 44105 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ITHIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, I FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Other property deductibles may apply as per policy terms and conditions. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD