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CERTIFICATE OF LIABILITY INSURANCE (907)1 ® ARO CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 5/21/2018 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 Wallace Welch & Willingham, Inc. 300 1st Ave. So., 5th Floor Saint Petersburg FL 33701 CONTACT NAME: Certificates/Commercial Lines PHONE 727.522-7777 FAX (A/C. No. Est): (A/C, No): 727-521-2902 ADDRESS: certificates@w3ins.COm INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Amerisure Ins. Co. 19488 INSURED ADMORGA-01 The A D Morgan Corp 716 N Renellie Dr Tampa FL 33609 INSURER B : Illinois Union Ins. Co. 27960 INSURER C : Travelers Property Casualty Co of Amer. 25674 INSURER D : $ 1,000,000 INSURER E : $ 100,000 INSURER F : COVERAGES CERTIFICATE NUMBER: 903238349 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 LTR TYPE OF INSURANCE ADDL IVSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY CPP20826110601 5/20/2018 5/20/2019 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence) $ 100,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 X XCU Included PERSONAL 8 ADV INJURY $ 1,000,000 X Contractual liab GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE POLICY OTHER: X LIMIT APPLIES jE�a PER: LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE X Xy LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY y SCHEDULED AUTOS NON -OWNED AUTOS ONLY CA20826100601 5/20/2018 5/20/2019 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ PIP $ 10,000 C X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE ZUP41M3132318NF 5/20/2018 5/20/2019 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 $ DED X RETENTION $ 1n non A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y IN - N / A WC20826120601 6/26/2018 6/26/2019 X STATUTE OTH- ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 B Professional Liability incl E8O G27059910006 5/20/2018 5/20/2019 Limit of Liability Deductible 1,000,000 25,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Pro ect: Construction Management at Risk Services for Continuing Contracts City of Clearwater defined as The City of Clearwater itself, its council, the community redevelopment agency of the city of clearwater, a Florida governmental agency created pursuant to Part III, Chapter 163, Florida Statute, its duly appointed officers, or other public bodies, officers, employees, volunteers, representatives and agents are Additional Insureds on a primary and non-contributory basis including completed operations with respect to General Liabilitysubject to terms, conditions and exclusions of the policy form. City of Clearwater defined as The City of Clearwater itself, its council, the community redevelopment agency of the city of clearwater, a Florida governmental agency created pursuant to Part III, Chapter 163, Florida Statute, its duly appointed officers, or other public bodies, officers, employees, volunteers, representatives and agents are Additional Insured with respect to Auto Liability per Auto Coverage form. A Waiver of Subrogation in favor of City of Clearwater defined as The City of Clearwater itself, its council, the community redevelopment See Attached... CERTIFICATE HOLDER CANCELLATION City of Clearwater Attention: City Clerk P.O. Box 4748 Clearwater FL 33758-4748 I ) `i;T ii fFFIC'LAi RF(Y )i ('1C JJ 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 ACORD 25 (2016/03) LEGII L �i IVE SRY S DEP1. © 1988-2015 ACORD CORPORATION. All rights reserved. The �CRD name analogo ar registered marks of ACORD ACORD® AGENCY CUSTOMER ID: ADMORGA-01 LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Wallace Welch & Willingham, Inc. NAMED INSURED The A D Morgan Corp 716 N Renellie Dr Tampa FL 33609 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER• 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE agency of the city of clearwater, a Florida governmental agency created pursuant to Part III, Chapter 163, Florida Statute, its duly appointed officers, or other public bodies, officers, employees, volunteers, representatives and agents applies to General Liability if required by written contract. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD