CERTIFICATE OF LIABILITY INSURANCE (5)Client#: 987776 INTUISYS
DATE (MM/DD/YYYY)
ACORD,� CERTIFICATE OF LIABILITY INSURANCE 1/04/2017
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
certiflcate holder in lieu of such endorsement(s).
PRODUCER coNrncr Staci Richter
NAME:
USI Insurance Services LLC PHONE 904-450-4717 Fi4X
wc No eXc : ac, No : 877-775-0285
4607 Touchton Road, Ste. 3210 nDOR�ESS: staci.richter@usi.com
Jacksonville, FL 32246
INSURED
Intuition Systems, Inc.; Intuition LLC;
Bi112Pay, LLC; Intuition College Savings
Solutions LLC; Veritec Solutions, LLC
Intuition ABLE Solutions, LLC
COVERAGES
CERTIFICATE NUMBER:
INSURER(S) AFFORDING COVERAGE NAIC #
iNSUReRa: Sentinel Insurance Co. 11000
iNSUReR s: Federal Insurance Company 20281
iNSUReR c: Gemini Insurance Company 10833
iNSUReR o: Hartford Accident and Idemnity 22357
iNSUReR e: Lloyds of London
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 INSR YWD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY
A GENERALLIABILITY 21SBABW9581 12/31/2016 12/31/201 EACHOCCURRENCE $7 000000
X COMMERCIAL GENER,4L LIABILITY PREMISES Ea o�Tu ° nce $1 OOO OOO
CLAIMS-MADE � OCCUR MED EXP (Any one person) $ � � ���
X BlanketAdd�� �IIS. PERSONAL&ADVINJURY $�,���,���
X Blanket Waiver GENERALAGGREGATE $Z��O�,���
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ Z�OOO,OOO
X POLICY PR� LOC $
JECT
p AUTOMOBILE LIABILITY 21 UECZP2380 12/31/2016 12/31/201 Ea aBcideD SINGLE LIMIT $,� �000�000
X ANY AUTO BODILY INJURY (Per person) $
ALL OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS AUTOS
X HIREDAUTOS X NON-OWNED PROPERTYDAMAGE $
AUTOS Per accident
X lanket AI X Blanket WOS $
q X UMBRELLA LIAB X occuR 21SBABW9581 12/31/2016 12/31/201 EACH OCCURRENCE s5 000 000
EXCESS LIAB CLAIMS-MADE AGGREGATE $rJ OOO OOO
DED X RETENTION $'I O OOO $
WORKERS COMPENSATION WC STATU- OTH-
AND EMPLOYERS' LIABILITY Y� N T Y I
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? � N / A
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
B Crime 82092987 12/31/201612/31/201 5,000,000
C E&O Liability VGPL001281 12/31/2016 72/31/201 5,000,000
E C ber Liabilit B1230FC04032A16 12/31/2016 12/31/201 5 000 000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additlonal Remarks Schedule, if more space is required)
Erisa coverage under Crime Policy: Limit $500,000; Deductible $25,000, Effective date 12/31/16 -12/31/17
,TE H
City of Clearwater
Attn: Customer Service
100 South Myrtle Avenue
Clearwater, FL 33756
TION
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
� I ����. 8vivo��
O 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S19627546/M19559746 RVRZP