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CERTIFICATE OF LIABILITY INSURANCE - RFQ 14-11T HARVA-1' OP ID. MJ DA7E(NIMIDWYYYY) CERTIFICATE OF LIABILITY INSURANCE I 11/0312016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIIRMATiVELY 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 poh6es may require an endorsement. A statement on this certificate does not confer rights to the certificate I-*kler In fieu of such endorsement(s). PRODUCER CONTACT JCJ Insurance Agency NAME Kristin McIntosh . .. . ........ . . 2208 Hillcrest Street PHONE, m) E : -"5-1860 FAX -4 45-1 0 . 76 14ZNc 321 321 Orlando, FL 32803 EMAIL Mark E. Jackson i'j (p,` ADDRESS: Certs@j�i-insurance.com I N SU RE R(S) A FIFO RDIN G C 0 VE RAGE NAIL 9 20 1 '�, " I I - I I _. ­.. - - _ INSURER A: RLI Insurance Company 13056 . . . . . ......... . .. ........ INSURED Harvard Jolly, Inc. Travelers INSURERS: Travel e Casualty& Surety Co 19038 2714 Or MIL King Jr St. N. 9 / � _� - " - --- - - - --- I ... . .. St Petersburg, FL 33704 INSURER, C: Commerce & Industry Insurance 19410 INSURER D: INSURER E ... ....... COVERAGES CERTIFICATE NUMBER. REVISION NUMBER- Ti THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED N01WITHSTANDING 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. 4SR -POLICY EFF ObLicYow L1 R TYPECIFINSURANCE AIN S Q POLICY NUMBER JMM/DoJyyyy MMIDD-yyyi LIMITS B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAWS MADE X OCCUR 680170,9P725 11110812015 11/08120116 OAQAG� TO RENTEff 1,000,00 0 MED EXP (Any one person) S 10,000 PERSONAL & ADV INJURY 1,000,000 GENT AGGREGATE LIMIT APPLIES PER X PRO ..G.E. NE RA L. AGGREGATE 1I .. $ . ..... 2,00,0,00..0. POLICY LOC JECT PRODUCTS � COMP�OP AOG 2,000,000 ........ . .... . . ­111 ...... . - ----- DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) RE: Architect of Record Agreement RFC 14-11 Professional Services, CLEA474 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CA14CELLED BEFORE City of Clearwater THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O. Box 4748 ACCORDANCE WITH THE POLICY PROVISIONS. Clearwater, FL 33758-4748 AUTHORIZED REPRESENTATIVE 1988-2014 ACORD CORPORATION, All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD OTHER AUTOMOBILE LIABILITY COMBINED SINGLE WIT 1.,.0.00,000 B X ANY AUTO 'BA-IF692578 11108120116 _(�,,a acciderxj 1110812016 BODILY INJURY (Per Person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per ,$Ccident) $ HIRED AIL)TOS NON-OWNED AU'T'OS oRoP�ERTV CAM, dt . . . .. ...... . ...... $ iPprappid nt UMBRELLA LIAR X OCCUR ... $ 10,000,000 C X EXCESS LIAB ..... ..... . ...... . .... . .... CLAIMS MADE EBU063718182 11113812016 1110812016 AGGREGATE . $ 10,000,000 DED RETENTION ......... . . .. .. ...... ..... ........... WORKERS COMPENSATION x PER — OTH• 'UTE AND EMPLOYERS' LIABILITY YtN S4 , ER A ANY PROrR;t , , , FYI NIA OFF,CERIMEIIBE',� EXL6bIi PSW0001698 0110112016 0110112017 E EACH ACCIDENT .. ... . . ...... . ......... .. — 1000,0,00 , (Mandatory In NH es, desc UndelL ribe E 1. DISEASE EA EMPLOYEE . ....... S 11,000,000 DESCRIPTION OF OPERATIONS below El, L. DISEASE POLICY LIMIT 3 1,000,000 A Professional RDP0020593 0613012016 0613012016 Per Claim 5000000 Liability Aggregate 10:000:00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) RE: Architect of Record Agreement RFC 14-11 Professional Services, CLEA474 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CA14CELLED BEFORE City of Clearwater THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O. Box 4748 ACCORDANCE WITH THE POLICY PROVISIONS. Clearwater, FL 33758-4748 AUTHORIZED REPRESENTATIVE 1988-2014 ACORD CORPORATION, All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD