CERTIFICATE OF LIABILITY INSURANCE (17) 0 DATE(MMfDD)-ffY--)
AC40Rf> CERTIFICATE OF LIABILITY INSURANCE 10/26/2018
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 POLICIIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORTZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
_
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be en-Worse
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 1-813-229-8021 NAME: Tammy L Marshall, AAI
M. E. Wilson Company, LLC1AC.
813-984-3601 No�: $13-229-27
('V 95
E-MAIL
300 W. Platt St. ADDRESS: tmarshallemewilson.com
Ste 200 INSURERS AFFORDING COVERAGE NAIC A
Tampa, FL 33606 INSURERA. ALLIANCE OF NONPROFITS FOR INS RPG 10033
INSURED INSURER B:
MOSI INSURER C
Museum of Science and Industry, Inc.
4801 E. Fowler Avenue INSURERD ..,
INSURER E!
I.Tampa, FL 33617 INSURER F:
COVERAGES CERTIFICATE NUMBER: 54444339 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR POLICY EFF POLICY EXP
(MMJDD=
6IB YY)
TYPE OF INSURANCE POLICY NUMBER fMMIDDNYYYI I LIMITS I _
A X COMMERCIAL GENERAL LIABILITY X 1 201835882 04/05/18 04/05/19 ! EACH OCCURRENCE s 1,000,000
CLAIMS-MADE X OCCUR
PREWSES(Ea occurrence) S 500,000
MED EXP(Any one person) S 20,000
PERSONAL&ADV INJURY S 1,000,000
___PE,N'L AGGREGATE LIMIT AP P L 1 ES PER: GENERAL AGGREGATE S 3,000,000
POLICY
PRO-
JEC7 LOC
PRODUCTS-COMP/OIP AGG S 3,000,00D
X
OTHER: S
• AuTOMOBI LE L AB I LITY 201835882 04/05/18 04/05/19 COMBINED SINGLE LIM'T S 1,000,000
Ea accident
ANY AUTO BODILY INJURY(Per parson} S
I SCHEDULED ciden'
OWNED
AUTOS ONLY AUTOS BOO I LY INJURY U RY(Per ar. S
X HIRED NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY (Por accident]
S
• UMBRELLA LIAB X OCCUR 1 201735882UMB 04/05/18 04/15/19 EACH OCCURRENCE S 4,000,000
X EXCESS LIAS CLAIMS-MADE AGGREGATE S 4,000,000
DED X : RETENTIONS 10,000 S
WO RKER S COMPENSATION PER OTH.
AND EMPLOYERS'LIABILITY YiN STATUTE ER ANYPROPRIETOR/PARTNERL;EXECUTIVE E,L_EACH ACCIDENT
OFFICERJMEMBEREXCLUDED7 F7 NIA
(Mandatory In INK) E.L.
DISEASE-EA EMPLOYEE S
If�e$.describe under
SCRIPT70N OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S
• Professional Liability ;201835882 04/05/18 04/05/19 Aggregate 1,000,000
DESCRIPTION OF OPERATIONS)LOCATIONS i VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If mare space is required)
The certificate holder is an additional insured with respect to General Liability as required by direct written
contract or agreement.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFOR-1-
City of Clearwater THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
P 0 Box 4748 AUTHORIZED REPRESENTATIVE
Clearwater, FL 33758
USA
01988-2201 r ACCIRD CORPORATION. All rights reserved.
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
tmarshall
C4AAA110