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CERTIFICATE OF LIABILITY INSURANCE (303)'`�!t�® CERTIFICATE OF LIABILITY INSURANCE /Y DATE (MM/DDYYY) 8/10/2018 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 The Hilb Group of Florida, LLC - Tampa `,, ' 3438 Colwell Ave Tampa FL 33614-1615 CONTACT Jason Travis PHONE FAX sA/C. No. Ext): 813-636-4000 (A/C, No): 813-281-1086 ADDRESS: info@hockmaninsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Phoenix Insurance Company (The) INSURER B : Liberty Insurance Underwriters, Inc. 25623 19917 INSURED ADVASYS-01 Advanced Systems Engineering, t- ' Inc. 13555 Automobile Blvd., #330 ` ' Clearwater FL 33762 INSURER c: The Travelers Indemnity Company 25658 INSURER D : Travelers Casualty and Surety Company 19038 INSURER E: INSURER F : CLAIMS -MADE COVERAGES CERTIFICATE NUMBER: 1747414036 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 INSD SUBR WVD POLICY NUMBER POLICY EFF IMM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 660-1C914015 8/17/2018 8/17/2019 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMITAPPLIES POLICY LX I Ter- OTHER: PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 A AUTOMOBILE X LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY X SCHEDULED AUTOS NON -OWNED AUTOS ONLY Y Y 660-1C914015 8/17/2018 8/17/2019 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ C X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE Y Y CUP -1L307504 8/17/2018 8/17/2019 EACH OCCURRENCE $5,000,000 AGGREGATE $ 5,000,000 DED X RETENT ON $ 10 000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A Y UB -8K553636 8/17/2018 8/17/2019 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 AEE101878-0003 3/10/2018 3/10/2019 2,000,000 Each Claim 2,000,000 Ann Agg 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 and reported basis. Certificate holder is listed as an additional insured with respects to General Liability, Auto Liability, Excess Liability policies on a primary and non-contributory basis. Waiver of Subrogation in favor of the additional insured applies to the GL, Auto Liab,Excess Liability, & WC Policy CERTIFICATE HOLDER CANCELLATION City Of Clearwater City Clerk PO Box 4748 Clearwater FL 337584748 USA 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) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD