The URL can be used to link to this page

CERTIFICATE OF LIABILITY INSURANCE (5) DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 07/19/2016 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 have ADDITIONAL INSURED provisions or 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 2 certificate does not confer rights to the certificate holder in lieu of such endorsement(si. PRODUCER CONTACT AOn Risk services South, Inc. -NAME: PHONE FAX 0 Atlanta GA Office (AIC.No.Ext): (866) 283-7122 A/C.No.: (800) 363-0105 32 3565 Piedmont Rd NE,Blgl,#700 E-MAIL 0 Atlanta GA 30305 USA ADDRESS: _ INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURERA: XL Specialty Insurance Co 37885 Coca-Cola Beveraqes Florida, LLC INSURER B: Travelers Property Cas Co of America 25674 10117 Princess Palm Avenue suite 400 INSURER C: The Travelers Indemnity Co. 25658 Tampa FL 33610 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570063042904 REVISION 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. Limits shown are as requested AUU INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF POLICY YYYY MM/DD/EAP LIMITS B X COMMERCIAL GENERAL LIABILITY HJGLSA9c590176TIL16 EACH OCCURRENCE $1,000,000 CLAIMS-MADE ❑X OCCUR DAMAGE TO RENTED $100,000 PREMISES Ea occurrence MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 p GEN'LAGGREGATE LIMITAPPLIES PER GENERAL AGGREGATE $2,000,000 Fi X POLICY PEO ❑LOC PRODUCTS-COMP/OPAGG Excluded CO) 0 OTHER: 0 C HK-CAP-9c590060-IND-16 06/01/201611/01/2016 COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) 0 Z OWNED SCHEDULED BODILY INJURY(Per accident) Ol AUTOS ONLY AUTOS R HIREDAUTOS NON-OWNED PROPERTY DAMAGE V ONLY AUTOS ONLY Per accident w Comp/Coll Ded $3,000 A X UMBRELLA LAB X OCCUR us00071476L115A 05/29/2015 11/01/2016 EACH OCCURRENCE $25,000,000 V EXCESS LAB CLAIMS-MADE AGGREGATE $25,000,000 DED I X RETENTION$10,000 C WORKERS COMPENSATION AND HKUB9c58990316 06/01/201611/01/2016 X I PERSTATUTE I OTH- EMPLOYERS'LIABILITY Y/N ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCI DENT $1,000,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000- B Products Liab HJDSS9c590059TIL16 06/01/2016 11/01/2016 Prod/Comp Opps. Agg $2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) city of Clearwater is included as Additional Insured in accordance with the policy provisions of the General Liability and Products Liability policies. . - CERTIFICATE HOLDER CANCELLATION �. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE - POLICY PROVISIONS. city of Clearwater AUTHORIZED REPRESENTATIVE 112 S. Osceola Avenue Clearwater FL 33756 USA Jv. ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD