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CERTIFICATE OF LIABILITY INSURANCE (940) RECEIVED GASB MIN 0001391 SP 0712 -COI-f'01391-1 Clearwater Gas System 400 N Myrtle Ave Clearwater,FL 33755 AC R'Y CERTIFICATE OF LIABILITY INSURANCE r 1112W018 DATE(MMIDOtYYYY) 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 poilcytiesj 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 Marsh USA Inc. NAME: 1560 Sawgrass Corporate Pkwy,Suite 300 PWC,No HONE xt): _ rvAc No): Sunrise,FL 33323 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAiC p CN105058E54-All"-GAWUP-17-18 _ INSURER A:GreenvAch insurance Company 22322 INSURED Waste Pro USA,Inc. INSURER s:XL Insurance America,Inc. 24554 2101 W.SR 434,Site#305 INSURER C:North American Elite Insurance Company29700 Longwood,FL 32779 INSURER 0:XL Spedalty Insurance ConLany37885 INSURER E: INS - INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-004875451.12 REVISION NUMBER: 1 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. 1NSR AbDL SUOR LTR TYPE OF INSURANCE WyD POLICY NUMBER MMIDWYYYY MM ODNYYY LIMITS A X COMRIERCIALGENERALLIABILiTY GEC300138201 1112212018 11122/2019 EACH OCCURRENCE $ 1,00UM CLAIM844ADE OCCUR PREMISES Ea aacu ante $ 50000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1.000,000 AGGREGATE LIMIT APPLIES PER: GENERALAY3GREGATE $ 2.000,000 �GENIT POLICY❑PRO- ❑LOC JECT PRODUCTS-COMP/OP AGG $ 2,0OO,ODO OTHER S A AUTOMOBILE UAE1LirY PAE94378MOI 1112212018 1112212019 COMBINED SINGLE LIMIT $ 2 QOD� Ea accident X ANY AUTO SIR:$1,000,000 BODILY INJURY{Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Por accident) $ x HIREDX NON-OWNED P, PERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ $ X UMBRELLA LIAB X OCCUR UMB 2MO569 02 1112212{118 I V2212019 EACHOCCURRENCE $. S,flDD,000 EXCESS LIAO CLAkMS-MADE AGGREGATE $ 5,000,000 DED I I RETENTION$ $ B WORKERS COMPENSATION RVVD300138001(AOS) —1102 19 X PEft 5TH- AND EMPLOYERS'LIABILITY Y 1 N TATII'I'E ER ANYPROPRI ETORIPARTNERIEXECUTI VE OFFICERIMEMBEREXCLUOED7 rN] NIA E.L-EACH ACCIDENT $ 1,000,000 (Mandatory In NH) E L.DISEASE-EA EMPLOYEE $ 1,000,0oo It yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ 1,000.0W D Workers Compensation RWE943549701(FL) 11/2212010 1112212019 Ernpbyers Liability: 1,000,000 SIR: 500,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101,Additnal Remarks Schedule,may he attached if more space N required) CERTIFICATE HOLDER CANCELLATION Clearwater Gas System SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE= 400 N Myrtle Ave THE EXPIRATION DATE THEREOF, NOTICE WELL BE DELIVERED IN Clearwater,FL 33755 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Juan Hernandez _ ©9988-2016 ACORN CORPORATION- All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: GN105058554 LOC#: Lauderdale � D ADDITIONAL REMARKS SCHEDULE Page 2 et 2 AGENCY NAMED INSUR£D Marsh USA Inc. Waste Pro USA,Inc. 2101 W.SR 434,Suite#305 POLICY NUMBER Longwood,FL 32779 CARRIER NAIC CODE £FFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Pollution Legal Liabilily Carrier:Indian Harbor insurance Company Policy Number;PECO04900301 Dates.GIM12018.0110112019 Limits:$5,000,000 SIR:$250,000 Storage Tank Liability Limit;$1,000,000 ACORD 101(2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD