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CERTIFICATE OF LIABILITY INSURANCE (410)C Client #: 1049203 LONGAS1 ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD /YYYY) 7/06/2016 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 USI Insurance Services, LLC 1715 N. Westshore Blvd. Suite 700 Tampa, FL 33607 CONTACT PHONE FAX (A/C, Lo, Ext): 813 321 4500 (ac, No): ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Phoenix Insurance Company 25623 INSURED Long & Associates Architects /Engineers, Inc. 4525 S Manhattan Ave Tampa, FL 33611 INSURER B : AXIS Insurance Company 37273 INSURER C 06/24/2017 INSURER D: $1,000,000 INSURER E INSURER F : X ERAGES CERTIFICATE 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 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 X X 6604528L957 - 06/24/2016 , 06/24/2017 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $1, 000 , 000 MED EXP (Any one person) $10,000 $1,000,000 PERSONAL & ADV INJURY GE 'L AGGREGATE POLICY OTHER: X LIMIT APPLIES JECPRO- T PER: LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP /OP AGG $2,000,000 $ AUTOMOBILE _ LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _AUTOS SCHEDULED AUTOS NON -OWNED •- iil 3 L ;01 p rC.m)RDS pt� AND AND COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE OFFICIAL LEGI.7LA� y \/ E SRVCS EOI3 DEPT EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ 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 I N / A PER STATUTE OTH- ER L. E. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ B Professional Liability AEA000109012015 09/15/2015 09/15/2016 $2,000,000 per claim $2,000,000 annl aggr. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Professional Liability coverage is written on a claims -made basis. Achitect of Record Agreement CERTIFICATE HOLDER CANCELLATION City of Clearwater 100 S. Myrtle Avenue 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 oLA>" �.- OL...�. ACORD 25 (2014/01) 1 of 1 #S18207595/M18098224 © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MRLEW USI INSURANCE SERVICES CERTIFICATE RETURN MAIL PROCESSING P.O. BOX 5007 NOVATO, CA 94948 -5007 CITY OF CLEARWATER 100 S MYRTLE AVE CLEARWATER FL 33756 -5520