CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
A�" CERTIFICATE OF LIABILITY INSURANCE 04/24/2018
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 have ADDITIONAL INSURED provisions or 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 Brandie Zuckerman
NAME:
Moody Insurance Agency,Inc. a/CNr o Ext): (303)824-6600 a/c,No): (303)370-0118
8055 East Tufts Avenue E-MAIL brandie.zuckerman@moodyins.com
ADDRESS:
Suite 1000 INSURER(S)AFFORDING COVERAGE NAIC#
Denver CO 80237 INSURERA: Transportation Insurance Co. 20494
INSURED INSURER B: Continental Insurance Company 35289
Clearwater Collection 15,LLC. INSURER C: Continental Casualty Company 20443
Clearwater Plainfield 15,LLC. INSURER D:
5690 DTC Boulevard Ste 515 INSURER E:
Greenwood Village CO 80111 INSURER F:
COVERAGES CERTIFICATE NUMBER: 18-19 Clearwater 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 MAYBE 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 INSURANCEAUULbUbK POLICY EFF POLICY EXP
LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1'000'000
CLAIMS-MADE FX OCCUR PREM SDAMAGES Ea oNcurDrence $ 300,000
MED EXP(Any one person) $ 15,000
A Y 5084421535 05/09/2018 05/09/2019 PERSONAL&ADV INJURY $ 1,000,000
MOTHER
LAGGREGATE LIMITAPPLIES PERGENERAL AGGREGATE $ 2'000'000
POLICY ElPRO FX LOC PRODUCTS-COMP/OP AGG $ 2,000,000
JECT: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
Ea accident
ANYAUTO BODILY INJURY(Per person) $
B OWNED SCHEDULED C5084421549 05/09/2018 05/09/2019 BODILY INJURY(Pe r accide nt) $
AUTOS ONLY AUTOS
X HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY /� AUTOS ONLY Per accident
Hired&Non-Owned $ 1,000,000
X UMBRELLA LIAB X OCCUR EHOCCURRENCE $ S,000,OOO
AC
C EXCESS LAB CLAIMS-MADE 5084421521 05/09/2018 05/09/2019 AGGREGATE $ 5'000'000
DED I X1 RETENTION $ 10'000 $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS'LIABILITY Y/N STATUTE ER
ANY PROPRIETOR/PARTNER/EXECUTIVEElN/A E.L.EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
City of Clearwater is included as additional insured with respect to General Liability.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
City of Clearwater Municipal Services Building ACCORDANCE WITH THE POLICY PROVISIONS.
100 South Myrtle Ave
AUTHORIZED REPRESENTATIVE
Clearwater FL 33756 „;y -,
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD