The URL can be used to link to this page

CERTIFICATE OF LIABILITY INSURANCE (413)ACORDr, Client#: 292011 80MCKIMCRE CERTIFICATE OF LIABILITY INSURANCE Page 2 of 3 DATE (MM /DD /YYYY) 8/08/2016 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 BB &T Insurance Services, Inc 3318 West Friendly Ave., Ste. 400 Greensboro, NC 27410 INSURED McKim & Creed Inc. 1730 Varsity Drive #500 Raleigh, NC 27606 NAMEACT Jenny Fisher PHONE 804 678-5025 muss, jjfisher @bbandt.com INSURER(S) AFFORDING COVERAGE INSURER A: XL Specialty Insurance Company INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : FAX (A/c, No): 888 - 751 -3010 NAIC tf 37885 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS INDICATED. CERTIFICATE EXCLUSIONS INSR LTR IS TO CERTIFY THAT THE POLICIES NOTWITHSTANDING ANY REQUIREMENT, MAY BE ISSUED OR MAY PERTAIN, AND CONDITIONS OF SUCH _.. - -... -.... TYPE OF INSURANCE OF POLICIES ADDL INSR INSURANCE THE SUBR WVD LISTED BELOW HAVE BEEN TERM OR CONDITION OF ANY INSURANCE AFFORDED BY THE LIMITS SHOWN MAY HAVE BEEN _..._ _.... _._ -. POLICY NUMBER ISSUED TO CONTRACT OR POLICIES REDUCED POLICY EFF (MM /DD /YYYY)_AMM/DD (� 2016 AND Y CS DEP. THE INSURED OTHER DOCUMENT DESCRIBED BY PAID CLAIMS. POLICY EXP /YYY V NAMED ABOVE FOR THE WITH RESPECT HEREIN IS SUBJECT TO LIMITS EACH OCCURRENCE POLICY PERIOD TO WHICH THIS ALL THE TERMS, $ COMMERCIAL GENERAL LIABILITY r I OCCUR APPLIES PER: I LOC RECEIVED j� (� AUG 12 '.. CLAIMS -MADE PREMISES ERENTED occurrence) MED EXP (Any one person) $ GEN'L AGGREGATE LIMIT POLICY ECOT '' OTHER: PERSONAL & ADV INJURY GENERAL AGGREGATE $ $ PRODUCTS - COMPIOP AGG $ COMBINED SINGLE LIMIT (Ea accdeJ $ $ AUTOMOBILE LIABILITY __ ANY AUTO ''.. ALL OWNED ; AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED ' AUTOS OFFICIAL RECORDS LLGIS LiTI E S BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE accident $ _(Per $ UMBRELLA LIAB 1 EXCESS LIAB i OCCUR CLAIMS -MADE EACH OCCURRENCE AGGREGATE $ $ DED RETENT ON$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR .PARTNER!EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory In NH) If yes. describe under DESCRIPTION OF OPERATIONS Y / N ---'. : below N / A STATUTE I ES__ El. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A Professional Liability DPR9808035 09/05/2016 09/05/2017 $5,000,000 Per Claim $7;000,000 Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required) CERTIFICATE HOLDER CANCELLATION City of Clearwater Attn: City Clerk P.O. Box 4748 Clearwater, FL 33758 -4748 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 ACORD 25 (2014/01) 1 of 1 #S16641082/M16635820 ®1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CYP 5400 H City of Clearwater Attn: City Clerk P.O. Box 4748 Clearwater, FL 33758 -4748 ACORDTM Client #: 216019 20MCKIMCRE CERTIFICATE OF LIABILITY INSURANCE Page 2 of 3 DATE (MM /DD/YYYY) 8/24/2016 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 BB &T Insurance Services, Inc. Post Office Box 13941 Durham, NC 27709 919 281 -4500 INSURED McKim and Creed Inc 1730 Varsity Dr Ste 500 Raleigh, NC 27606 -2689 NA VcT Debbie Church PHONE (A/c, No, EA); 910- 772 -3720 _ - - - -- ray, No) 888- 746 -8761 E -MDRaa -- ADESS; dschurch @bbandt.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Charter Oak Fire Insurance Comp 25615 INSURER B : Travelers Property Casualty Co 25674 INSURER C : Farmington Casualty Company 41483 INSURER D : INSURER E : INSURER F : COVERAGES 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 TYPE OF INSURANCE ADDL INSR SUER WVD POLICY NUMBER POLICY EFF �MlDD/YYYY) 09/05/2016 POLICY EXP (MM /DD/YYYY) 09/05/2017 LIMITS A X! GENERAL LIABILITY X 6302G091871 COF16 EACH OCCURRENCE $1,000x000 $100,000 $10,000 CLAIMS -MADE I XJ OCCUR DAMAGE TO RENTED PREMISES fEa occurrence) MED EXP (Any one person) , _. 1 _ GEN'L AGGREGATE LIMIT APPLIES PER: PERSONAL &ADV INJURY GENERAL AGGREGATE $1,000,000 $2,000,000 1 POLICY X JECT I X I LOC PRODUCTS - COMROPAGG $2,000,000 I OTHER: $ B AUTOMOBILE LIABILITY X� ANY AUTO ALL OWNED - X X 8102G113498TIL16 09/05/2016 09/05/2017 (Ea COMBINED SINGLE LIMIT accident) $1,000,000 BODILY INJURY (Per person) $ I AUTOS XI HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B XI UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE X X CUP3G377649TIL16 09/05/2016 09/05/2017 EACH OCCURRENCE AGGREGATE $10,000,000 $10,000,000 $ I DED X RETENT ON $10000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILRY / N / A X UB4142T725 09/05/2016 09/05/2017 X PER STATUTE OTH- ANY EXCLUDED? ECUTIVE Y N N I .ER__ E.L. EACH ACCIDENT $1,000,000 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $1,000,000 $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) '- i,,, The City of Clearwater is included as an additional insured with respects to all coverage except Worker to.`..- Compensation where required by written contract before a loss. Such coverage is primary and non contributory. A Waiver of Subrogation also applies in favor of the City of Clearwater for CGL and 5F « -T r... 1 Automobile Liability coverage where required by written contract, before a loss. a thirty (30) day notice /��' . of cancellation shall be given the Certificate Holder prior to cancellation or non renewal. OFFICIAL �,. ,�- p�D it - - -- - t rf iSi A c trs DF ?.a. CANCELLATION City of Clearwater Attn: City Clerk 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 m �. ®1 88 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #S16707588/M16701174 JAW 5400 H City of Clearwater Attn: City Clerk PO Box 4748 Clearwater, FL 33758