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CERTIFICATE OF LIABILITY INSURANCE - RFQ 34-15 (2) ® DATE(MMIDDIYYYY) �� A� CERTIFICATE OF LIABILITY INSURANCE 3/30/2018 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 endorsements . PRODUCER CONTANAME:CT AJG Service Team Arthur J. Gallagher Risk Management Services, Inc. PHONE . 212-994-7100 FAAIX 212-994-7047 250 Park Avenue, 5th Floor c No New York NY 10177 E-MAIL .GGB.WSPUS.CERTREQUESTS@AJG.COM INSURERS AFFORDING COVERAGE NAIC# INSURER A:Liberty Insurance Corporation 42404 INSURED WSPGLOB-01 INSURERB:Zurich American Insurance Company 16535 WSP USA Inc. INSURER c:American Guarantee and Liability Ins Co 26247 One Penn Plaza New York, NY 10119 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 388774528 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 MMIDD/YYYY MMIDD/YYYY B X COMMERCIAL GENERAL LIABILITY Y GL0983581905 4/1/2018 4/1/2019 EACH OCCURRENCE $2,000,000 DAMACLAIMS-MADE XI PREMIS ES ETORENTED PREMISES Ea occurrence) ccurrence $300,000 X Contractual Liab MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $5,000,000 X POLICY❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $2,000,000 JECT OTHER: $ A AUTOMOBILE LIABILITY Y AS7621094060038 4/1/2018 4/1/2019 COMBINED SINGLE LIMIT $ Ea accident 2,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY L $ AUTOS ONLY Per accident C UMBRELLA LIAB X OCCUR AUC014438601 4/1/2018 4/1/2019 EACH OCCURRENCE $10,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000 DED RETENTION$ $ A WORKERS COMPENSATION WA762DO94060018(AOS) 4/1/2018 4/1/2019 X PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER AOFFIER/MEMBER EXCLUDED?NY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT $2,000,000 C (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $2,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Clearwater is included as an Additional Insured under the General Liability and Automobile Liability policies when required in a written agreement in accordance with policy terms, conditions, and exclusions for work and activities perfomed by the Named Insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Clearwater THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Engineering Department, ACCORDANCE WITH THE POLICY PROVISIONS. 100 S. Myrtle Ave. Clearwater FL 33756 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD