The URL can be used to link to this page

CERTIFICATE OF LIABILITY INSURANCE (779)H /CL., CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD/YYYY) 8/11/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. HOLDER. THIS BY THE POLICIES AUTHORIZED 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 Wallace Welch & Willingham, Inc. 300 1st Ave. So., 5th Floor Saint Petersburg FL 33701 CONTACT Ed Buggy PHONE (A/C No ,Ext)• 727- 522 -7777 FAX . No) 727- 521 -2902 E-MAIL certifcates @w3ins.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :Everest Indemnity Insurance Co 10851 INSURED CRITSYS -01 Critical System Solutions 2830 Scherer Dr N # 300 St Petersburg FL 33716 INSURER B:Bridgefield Employers Ins. Co. 10701 INSURER C :Old Dominion Ins. Co. 40231 INSURER D: INSURER E : CLAIMS -MADE INSURER F : OCCUR v • RC VIoIJ,Y IYUMIStk: 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 INSD SUBR WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYYL LIMITS A x COMMERCIAL GENERAL LIABILITY 51GL007342161 6 ` ��yy RECEIVE • AU CH 1 a 7 c A' �y�p.� OFFICI��11 ItECQRIJ B1T6846X LEGIS /� rT1Ulier..��.a��} r.r�J t Y G 8/15/2016 ,201E 0tEp-8 8/15/2017 /15/2017 EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) $1,000,000 $300,000 CLAIMS -MADE X OCCUR GEN'L X MED EXP (Any one $5,000 person) PERSONAL & ADV INJURY GENERAL AGGREGATE $1,000,000 $2,000,000 AGGREGATE LIMIT APPLIESPER: POLICY X ECT LOC PRODUCTS - COMP/OP AGG $2,000,000 OTHER: Limited Prof. (Ea accident) SINGLE LIMIT $ $1,000,000 C AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS x SCHEDULED AUTOS NON -OWNED AUTOS BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A • X UMBRELLA LIAB EXCESS LIAB X — OCCUR CLAIMS -MADE 5100002671161 8/15/2016 8/15/2017 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 $ DED X RETENT ON $10,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? Y (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 83039728 8/15/2016 8/15/2017 PER STATUTE OTH- ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is requi ad) CANCELLATION City of Clearwater PO 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) ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD