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CERTIFICATE OF LIABILITY INSURANCE (866) SPAR&AS-01 AMOORE ACORD"' ATE CERTIFICATE OF LIABILITY INSURANCE 10/24/2017Y) 10/24/2017 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: Palmetto Insurance-The Rodgers Agency PHONE g64 654-1220 FAX 864 654-6616 P.O.Box 510 A/C No Ext: ) (A/C,No): Clemson,SC 29633 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Hartford Casualty Ins Co INSURED INSURER B:Hartford Ins. Co of the Midwest Sparks&Associates Inc. INSURER C:USLI 107 Clemson Street INSURER D: Clemson,SC 29631 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE [XI OCCUR 22SBABE1206 11/10/2017 11/10/2018 DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY D PRO- JECT [::] LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: Emp.Benefits $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident A ANY AUTO 22SBABE1206 11/10/2017 11/10/2018 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X X NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LAB CLAIMS-MADE 22SBABE1206 11/10/2017 11/10/2018 AGGREGATE $ 1,000,000 DED X RETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N B ANY PROPRIETOR/PARTNER/EXECUTIVE 22WECIU8036 01/01/2017 01/01/2018 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ 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 C Errors&Omissions SP1551073D 08/16/2017 08/16/2018 E&O Incl.Cyber 5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Clear Water Gas System listed as Additional Insured. Additonal Insured included for General Liability and Commercial Auto. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Clearwater and THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Clearwater Gas System ACCORDANCE WITH THE POLICY PROVISIONS. 711 Maple Street Clearwater,FL 33755 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID:SPAR&AS-01 AMOORE LOC#: 1 A� ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Palmetto Insurance-The Rodgers Agency Sparks Associates Inc. g g Y 107 Clemson son Street POLICY NUMBER Clemson,SC 29631 EE PAGE 1 CARRIER NAIC CODE EE PAGE 1 SEE P 1 EFFECTIVE DATE:SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Cyber Liability Coverage: Cyber Liability Carrier: USLI Policy Number: SP 1551073D Policy Term: 8/16/16-8/16/17 Limits: Third Party Liability $1,000,000 Transmission of Malicious Code Liability $1,000,000 Unauthorized Access Liability $50,000 Professional Reputation Restoration Expense Retro Date: N/A Rentention: $5,000 ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD