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CERTIFICATE OF LIABILITY INSURANCE (679)Client#: 1406278 131 MASSESER ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD/YYYY) 12/30/2015 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 BB &T-J. Rolfe Davis Insurance PO Box 4927 Orlando, FL 32802 -4927 407 691-9600 CONTACT NAME: (A/CC,N a, Ext): 407 691 -9600 (Fc, No): 888 - 635 -4183 E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC It INSURER A : Catlin Specialty Ins. Co. (CRC) 15989 INSURED Massey Services, Inc. 315 Groveland Street Orlando, FL 32804 INSURER B: Indian Harbor Insurance Co(AJG) 36940 INSURER C 01/01/2017 INSURER D $2,000,000 INSURER E : INSURER F : X COVERAGES CERTIFICATE NUMBER: 16/17 Master REVISION NUMBER: 1 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 OF INSURANCE ADDL ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY XGC- 98296 -0117 r ApplicatpM � rr vg -cam € - 3 e 01/01/2016 01/01/2017 EACH OCCURRENCE $2,000,000 CLAIMS -MADE X OCCUR PREMISES (Ea RENTED $100,000 $ 0 X Errors & Omissions MED EXP (Any one person) X Pesticide /Herbicide PERSONAL & ADV INJURY $2,000,000 GE 'L AGGREGATE POLICY OTHER: X LIMIT APPLIES JECOT PER: LOC GENERAL AGGREGATE $10,000,000 PRODUCTS - COMP /OP AGG $4,000,000 Per Proj Agg $4,000,000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ SCHEDULED AUTOS NON -OWNED AUTOS '- " "" " °" ` `"`` "" COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B x UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE US00074197L116A 01/01/2016 01/01/2017 EACH OCCURRENCE $15,000,000 $15,000,000 AGGREGATE DED X RETENT ON $$10,000 PR/CO Agg $15,000,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A PER STATUTE OTH- ER E L EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION City of Clearwater 645 Pierce Street 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 004,0c7 okfo ACORD 25 (2014/01) 1 of 1 #S15355304/M15354354 © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD PSBE