The URL can be used to link to this page

CERTIFICATE OF LIABILITY INSURANCE (807) A/C ® DATE(MM/DD/YYYY) `..� CERTIFICATE OF LIABILITY INSURANCE 10/07/2016 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 CONTACT MCGRIFF,SEIBELS&WILLIAMS,INC. NAME: PHONE P.O.Box 10265 A/CC No Ext: 800 476-2211 aC,No): Birmingham,AL 35202 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:The Travelers Indemnity Company of America 25666 INSURED INSURER B:Midwest Employers Casualty Co./ASIWCF M.T.Deason Co.,Inc.;MTD Manufacturing,Inc. 2820 Commerce Boulevard INSURER :Sentry Insurance Group Irondale,AL 35210 INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:VFG782MU 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY 6301G92767ATIA16 09/01/2016 09/01/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �OCCUR DAMAGE TO RENTED 300,000 PREMISES Ea occurrence $ MED EXP(Any one person) $ 10,000 X X PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑JECT PRO F—] LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY BA1G949022TIA16 09/01/2016 09/01/2017 COMBINED SINGLE LIMIT 1,000,000 Ea accident $ X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED X X BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS Per accident $ Comp Ded$1000 Coll Ded$1000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ TH- B WORKERS COMPENSATION Member#332400 01/01/2016 01/01/2017 X STATUTE OER C AND EMPLOYERS'LIABILITY Y/N PMAL129001 (AL) ANY PROPRIETOR/PARTNER/EXECUTIVE 90531170100161 (AOS) E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate Holder is included as Additional Insured as respects General Liability and Auto Liability per written contract. General Liability applies as Primary and Non- Contributory per written contract. Waiver of Subrogation applies in favor of the Certificate Holder as respects General Liability and Auto Liability per written contract. In the event of cancellation by the insurance companies,the General Liability and Auto Liability policies have been endorsed to provide 30 days notice of cancellation except for nonpayment to the Certificate Holder shown below. 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 ATTN: Purchasing Department,ITB#53-15 AUTHORIZED REPRESENTATIVE P.O.Box 4748 Clearwater,FL 33758-4748 Page 1 of 1 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD