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CERTIFICATE OF LIABILITY INSURANCE (436) DATE( A� MM/DD/YYYY) 3/13/2017 DATE(" CERTIFICATE OF LIABILITY INSURANCE 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: Certificates/Commercial Lines Wallace, Welch &Willingham FAx P.O. Box 33020 M20%, 727-522-7777 A/c No): 727-521-2902 St. Petersburg FL 33733 ADDRESS:certificates @w3ins.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Nat'l Fire Ins Co of Hartford 20478 INSURED CUM&F-1 INSURERB:Admiral Insurance Company Cumbey&Fair Inc INSURER C:Bridgefield Employers Ins. Co. 10701 2463 Enterprise Rd INSURER D:Continental Casualty Co./CNA 20443 Clearwater FL 33763 INSURER E:Continental Insurance Co./CNA 35289 INSURER F: COVERAGES CERTIFICATE NUMBER: 966161024 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 POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD/YYY MM/DD/YYY D X COMMERCIAL GENERAL LIABILITY 2086949437 3/16/2017 3/16/2018 EACH OCCURRENCE $1,000,000 IX OCCUR PREMISES TORENTED CLAIMS-MADE PREMISES Ea Occurrence) $100,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 POLICY jECT El LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY C2088208783 3/16/2017 3/16/2018 COMBINED SINGLE LIMIT $ (Ea accident) 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) E UMBRELLA LAB X OCCUR C2086949471 3/16/2017 3/16/2018 EACH OCCURRENCE $2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000 DED X RETENTION$10,000 $ C WORKERS COMPENSATION 83054368 3/16/2017 3/16/2018 X PER OTH- U.S.L.H. AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? F1 N/A (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 B Professional Liab E000002866102 3/17/2017 3/17/2018 Each claim $2,000,000 Claims Made Aggregate $2,000,000 Retro Date 2/19/2000 Deductible $25,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Certificate holder is additional insured on a primary and noncontributory basis with respect to General Liability if required by written contract. Certificate holder is additional insured with respect to Auto Liability per Auto Coverage Form and on the Excess Policy subject to the underlying policy terms and conditions. A Waiver of Subrogation in favor of Certificate Holder applies to General Liability&Auto Liability if required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Clearwater THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City Clerk 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