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CERTIFICATE OF LIABILITY INSURANCE (463) Client#:1049387 JONESEDMI ACOR& CERTIFICATE OF LIABILITY INSURANCE pAT (N/201'YYYY'A. 7/03/2017 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 certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: USI Insurance Services, LLC, PHONE FAX 1715 N.Westshore Blvd. Suite 700 E-MAILo,Ext`813 321-7500 A/c,No Tampa, FL 33607 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A;Phoenix Insurance Company 25623 INSURED Jones Edmunds&Associates,Inc. INSURER B;Travelers Indemnity Company 25658 ----- ---- — - INSURER C:Travelers Casualty and Surety —31194 730 N.E.Waldo Road INSURER D:XL Specialty Insurance Company 37885 Gainesville, FL 32641 INSURER E:Travelers Property Casualty 25674 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 CONTRACTOR 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. LTRR ADDUSUBR POLICY EFF POLICY EXP TYPE OF INSURANCE IINSR WVD POLICY NUMBER MM/DD/YYYYZ (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERA(ABILITY ',I X ',. X 6802J380395 6/30/2017 06/30/201 EACH OCCURRENCE _ $1,000,000 -_ —�. CLAIMS-MADE ' X'..OCCUR . PREMISESa occur°nce $1,000,000 MED EXP(Any one person) I$10,000 PERSONAL&ADV INJURY $1,000,000 _ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY ^;!JECOT LOC ( 1 'I / PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ AUTOMOBILE LIABILITY µCOMBINED SINGLE LIMIT- - - E X X j BA1958L731 6/30/2017 06/30/2018'(Eaaccldent) 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ u ALL OWNED SCHEDULED AUTOS BODILY INJURY(Per accident) $ _._.�AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS 'Per accident $ B X UMBRELLA LIAR '.,X OCCUR X X CUP6513Y228 06/30/2017,06/30/201 EACH OCCURRENCE _ s5,000,000.. EXCESS LIAB -- 1 _ .CLAIMS-MADE AGGREGATE___ $5,000,000 DED X RETENTION$10 000 _ $ WORKERS COMPENSATION PER OTH- C X UB3911TO35 6/30/2017 06/30/2018,X TAT ER 'AND EMPLOYERS'LIABILITY - ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N ! I E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N/A I --------:— --- (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE$1,000,000 If yes,describe under t DESCRIPTION OF OPERATIONS.below E.L.DISEASE__POLICY LIMIT $1,000,000 D Professional DPR9915739 6/30/2017 06/30/2018 $5,000,000 per claim Liability $5,000,000 annl aggr. DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Professional Liability coverage is written on a claims-made basis. Project: 2015 Engineer of Record City of Clearwater is listed as additional insured with respect to the General and Auto Liability policies. CERTIFICATE HOLDER CANCELLATION City of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Engineering Dept.,RFQ#34-15 ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 4748 CLEARWATER, FL 33758 AUTHORIZED REPRESENTATIVE pL9� fit. Oct--W-,a-1 ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #S21051741/M21051713 M RLEW