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CERTIFICATE OF LIABILITY INSURANCE (772)CERTIFICATE OF LIABILITY INSURANCE DATE (MMJDD /YYYY) 7/11/2016 THIS CERTIFICATEIS 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 certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER BRIDGE POINT INSURANCE GRP INC /PHS 427154 P: (866) 467 -8730 F: (888) 443- 6112>o 301 WOODS PARK DRIVE CLINTON NY 13323 CONTACT NAME: PHONE .Ext): (866) 467-8730 to .NO): (888) 443 -6112 ESS: INSURERS) AFFORDING COVERAGE NAIL* INSURERA _Hartford Casualty Ins Co INSURED DAHER CAPITAL GROUP LLC 9 3460 FAIRLANE FARMS RD STE 9 WEST PALM BEACH FL 33414 INSURER B LIABILITY INSURER C : INSURERD: 07/21/2016 0 6 2016 INSURERE EACH OCCURRENCE INSURERE: COVERAGES CERTIFICATE NUMBER: 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. INSR LTR TYPE OFLVSURANCE ADDL PV.SR SUER iYYD POLICY NUMBER POLTCYEFF (MM/DD/YYYU POLICY EAT alAVDD/YYYY) WETS A COMMERCIAL GENERAL -MADE Liab LIABILITY 39 SBM Z27758 RECEIVES AUG (j 07/21/2016 0 6 2016 07/21/201.7 EACH OCCURRENCE $1,000,000 CLAIMS X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $300,000 X General X MEDEXP(Anyoneperson) s10r 000 PERSONAL &ADVINJURY $1,000,000 GENII_ AGGREGATE LIMIT PRO- APPLIES PER: GENERAL AGGREGATE S2,000,000 POLICY X LOC PRODUCTS - COMP /OP AGG , 2, 00 0, 00 0 OTHER: A AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY SCHEDULED AUTOS NON -OWNED AUTOS ONLY OFFICIAL RECORDS ' I ��� 19 SBM Z27 7 5 ti � AND CQ SR/�/ 07 /21 /2017 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) BODILY INJURY (Per accident) $ X X PROPERTY DAMAGE (Per accident) UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE DEC RETENTION $ WORtiERSC "OL1P8tY.SR7TOM AND EMPLOY FRS' LLABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS /N N/A I STATUTE I I ORTH- E.L. EACH ACCIDENT E.L. DISEASE- EA EMPLOYEE $ below E.L. DISEASE - POLICY LIMIT S DESCRIPTION OFOPERA7 IONS / LOCATIONS IVEHIC(AdSORD 101 Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. City of Clearwater are an Additional Insured per the Business Liability Coverage Form SS0008 attached to this policy. 30 Day Notice of Cancellation applies in favor of City of Clearwater per form SS1220. CERTIFICATE HOLDER CANCELLATION City of Clearwater PO BOX 4748 CLEARWATER, FL 33758 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 1,�e- ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD t AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE Page of AGENCY BRIDGEPOINT INSURANCE GRP INC /PHS NAMED INSURED DAHER CAPITAL GROUP LLC 3460 FAIRLANE FARMS RD STE WEST PALM BEACH FL 33414 9 POLICY NUMBER SEE ACORD 25 CARRIER SEE ACORD 25 NAICCODE EFFECTIVE DATE SEE ACORD 25 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM FORM NUMBER: ACORD 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE The applicant shall defend, indemnify, save and hold the City harmless from any and all claims, suits, judgments and liability for death, personal injury, bodily injury, or property damage arising directly or indirectly from the performance by the applicant, its employees, subcontractors, or assigns, including legal fees, court costs, or other legal expenses. Applicant acknowledges that it is solely responsible for complying with the terms of this RFP. In addition, the applicant shall, at its expense, secure and provide to the City, prior to beginning performance under this RFP, insurance coverage as required in this RFP. ACORD 101 (2014/01) N m © 2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD