The URL can be used to link to this page

CERTIFICATE OF LIABILITY INSURANCE (9) DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE I 10/29/2018 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 2 certificate does not confer rights to the certificate holder in lieu of such endorsement(s). z PRODUCER CONTACT Aon Risk services South, Inc. -NAME: PHONE FAX L Atlanta GA Office (A/C.No.Ext): C866) 283-7122 A/C.No.: (800) 363-0105 4) 3550 Lenox Road NE E-MAIL p suite 1700 ADDRESS: _ Atlanta GA 30326 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURERA: XL Specialty Insurance CO 37885 Coca-Cola Beveraqes Florida, LLC INSURER B: Greenwich Insurance Company 22322 10117 Princess Palm Avenue suite 100 INSURER C: XL Insurance America Inc 24554 Tampa FL 33610 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570073681381 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. Limits shown are as requested AUIJ INSR POLICY EFF POLICY EAP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS B X COMMERCIAL GENERAL LIABILITY RGE EACH OCCURRENCE $750,000 CLAIMS-MADE X❑OCCUR SIR applies per policy terns & conditions $100,000 PREMISES Ea occurrence MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 op GEN'LAGGREGATE LIMITAPPLIES PER. GENERAL AGGREGATE $1,750,000 M X POLICY ❑PEO F-1 LOC PRODUCTS-COMP/OPAGG $1,750,000 M 0 OTHER: 0 I— BRAD943781702 10/29/201810/29/2019 COMBINED SINGLE LIMIT n AUTOMOBILE LIABILITY $2,000,000 Ea accident X ANYAUTO BODILY INJURY(Per person) Z OWNED SCHEDULED BODILY INJURY(Per accident) N AUTOS ONLY AUTOS HIREDAUTOS NON-OWNED PROPERTY DAMAGE R ONLY AUTOS ONLY Per accident w N A X UMBRELLALIAB X OCCUR Us00071476L118A 10/29/2018 10/29/2019 EACH OCCURRENCE $5,000,000 V EXCESS LAB CLAIMS-MADE AGGREGATE $5,000,000 DED I X RETENTION$10,000 C WORKERS COMPENSATION AND RWD300120102 10/29/2018 10/29/2019 X SPER OTH- EMPLOYERS'LIABILITY YTATUTE IER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACHACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000— DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) city of Clearwater is included as Additional Insured in accordance with the policy provisions of the General Liability, Automobile Liability and Umbrella Liability policies. . CERTIFICATE HOLDER CANCELLATION 3u SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. city Of Clearwater AUTHORIZED REPRESENTATIVE 100 South Myrtle Avenue z: Clearwater FL 33756-5520 USA �. ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD