CERTIFICATE OF LIABILITY INSURANCE (6)� � DATE (MM/DD/YYYY)
4�� � CERTIFICATE OF LIABILITY INSURANCE
s/so/2oi�
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 u�,�uFA�T Agency
Erwin Insurance, LLC
P. O. Box 40826
(904)396-1440
Jacksonville FL 32203 INSURERA:ThA
INSURED INSURER B :
Intuition Systems, IAC. INSURERC:
(see attached Named Insured list) INSURERD:
9428 Baymeadows Rd.,#500 INSURERE:
Jacksonville FL 32256 INSURERF:
rnv�ow2�c (�CDTIFif_ATF NI IMRFR•CL1783015007
Indemni
REVISION NUMBER:
(904)396-1550
NAIC #
vTHIS.IS TO CERTIFY THAT THE POIICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTIMTHSTANDING 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 7YPE OF INSURANCE ADDL UBR pOLICY NUMBER MM/LDDY/YYYY MM/DDY/YYYY LIMITS
LTR
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $
CLAIMS-MADE � OCCUR PREM SES�Ea oNcur ence $
MED EXP (Any one person) $
PERSONAL 8 ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER: GENER,4L AGGREGATE $
POLICY � PR� � LOC PRODUCTS - COMP/OP AGG $
JECT
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
Ea accident
ANY AUTO
BODILY INJURY (Per person) $
ALL OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS AUTOS PROPERTY DAMAGE $
NON-OWNED Per accident
HIRED AUTOS AUTOS i $
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION $ $
WORKERS COMPENSATION X PER OTH-
AND EMPLOYERS' LIABILITY STATUTE ER
ANY PROPRIETOR/PARTNER/EXECUTIVE Y, N E.L. EACH ACCIDENT $ 1 000 000
OFFICER/MEMBER EXCLUDED? � N/A
A (Mandatory in NH) UB-8F43001-6-17 9/1/2017 9/1/2018 E.L. DISEASE - EA EMPLOYE $ 1 000 000
H yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1 000 000
DESCRIPTION OF OPERATIONS / LOCATiONS / VEHICLES (ACORD 107, Additional Remarks Schedule, may be attached if more space is required)
TE HOLDER
gail.rini@myclearwater.com
City of Clearwater
Attn: Customer Service
100 South Myrtle Ave
Clearwater, FL 33756
ACORD 25 (2014/01)
I NS025 r�m an� i
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.
AUTHORIZED REPRESENTATIVE
� /�.,��,,/ ,,�
John Alexander/JALEX3 �� �• �y"�"�`""'3i�
OO 1988-2014 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD