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CERTIFICATE OF LIABILITY INSURANCE - AOR HARVA-1 OP ID: KJ ACORD DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 11/09/2016 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 NAME: Kristin McIntosh JCJ Insurance Agency PHONE FAX 2208 Hillcrest Street A/c No EXt:321-445-1860 (A/C,No): 321-445-1076 Orlando,FL 32803 E-MAIL cents c-insurance.com Mark E.Jackson ADDRESS: @j J INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:RLI Insurance Company 13056 INSURED Harvard Jolly, Inc. INSURER B:Travelers Casualty &Surety Co 19038 2714 Dr ML King Jr St. N. INSURERC:Commerce&Industry Insurance 19410 St Petersburg, FL 33704 INSURER D INSURER E: INSURER F: 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 TYPE OF INSURANCE DDL UBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE 1XII OCCUR 6801709P725 11/08/2016 11/08/2017 DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY JjECT [::] LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER I $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1 000 000 Ea accident , , B X ANY AUTO BA-1 F692578 11/08/2016 11/08/2017 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 C X EXCESS LAB CLAIMS-MADE EBU063718182 11/08/2016 11/08/2017 AGGREGATE $ 10,000,000 DED RETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER A ANY PROPRIETOR/PARTNER/EXECUTIVE Y�N/A PSW0001698 01/01/2016 01/01/2017 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (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 A Professional RDP0025192 06/30/2016 06/30/2017 Per Claim 5,000,000 Liability Aggregate 10,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:Architect of Record Agreement RFQ 14-11 Professional Services. CERTIFICATE HOLDER CANCELLATION CLEA474 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Clearwater THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 4748 Clearwater, FL 33758-4748 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD