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CERTIFICATE OF LIABILITY INSURANCE (842) ACS CERTIFICATE OF LIABILITY INSURANCE DATE`MMIDO[MY' �. 7128/2017 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 INSURERS), 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 NAME: Linda Fontenot PHONE; FAx Insgroup,Inc. -E%tl: IX No); 1455 West Loop South 9th Floor -ADDRESS: lontenot@insgroup.net Houston,TX 77027 T INSURERS AFFORDING COVERAGE NAIL$t INSURER A: Starr Indemnity&Liability Co. INSURED Heath Consultants Inc. INSURER B: Underwriters Lloyds London 9030 Monroe Road JNSURER C Houston Texas 77061 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 AOOL SUSR POLICY EFF POLICY E7CP LTR TYPE OF INSURANCE POLICY NUMBER--LMM1DDffMJ LIMITS A COMMF Ric IAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE �OCCUR DAMAGE To RENTED 100,000 PREMISES Ea orclmence. _ $ MED EXP(Any one erson) $ '10,000 1000090437171 7130/2017 7/30/2018 PERSONAL&ADV INJURY $ 2,000,0130 GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 FIPOLICY E C-r LOC 2,000,000 JE OTHER: I $ R E AUTOMOBILE LIABILITY COMa a cBcI ideNED nt SINGLE LIMIT $ 1,000]000 _ _ rxANY AUTO BODILY INJURY(Perpesorl) $ ALL OWNED SCHEDULED BODILY INJURY Peraccidenl AUTOS AUTOS 1 0001.98851171 7/30120/7 7/30/20 { 1 HIREO AUTO X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident A X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 10.000,000 EXCESSLIAB CLAIMS-MADE 1000095274979 7/30/2017 7/3012018 AGGREGATE $ 10,000,000 BED I I RETENTION$10,000 $ WORKERS COMPENSATION PER OTH- AHD EMPLOYERS'LIABILITY Y 1 N STATUTE Eft ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ NIA E.L.EACH ACCIDENT .$ (Mandatory In NH) E.L-DISEASE-EA EMPLOY!_ $ If yes,desi;Ahc under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S. B Professional Liability 6169199A 7130/2017 7/30/2018 Aggregate/Each Claim $10,000,000 B Pollution Liability 6169199A 7/30/2017 7/30/2018 Aggregate/Each Claim $5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 10-E,Additional Remarks Schedule,may 6a attached if more space Is required) CERTIFICATE HOLDER CANCELLATION City of Clearwater; RECET"D SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn.:Clearwater Gas Systems THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O.Box 4748 ACCORDANCE WITH THE POLICY PROVISIONS, Clearwater FL 33758-4748 JUL 31 2017 AUTHORIZED REPRESENTATIVE GAS AUMIN Henry Hochman! ©'1988-2014 ACORD CORPORATION, All rights reserved. ACORD 25(2014101) The ACORD name and Ingo are registered marks of ACORD