The URL can be used to link to this page

CERTIFICATE OF LIABILITY INSURANCE (2)ACORD® 41.... --/CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 4/4/2019 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 JLT Specialty USA 350 Madison Avenue, 7th Floor New York, NY 10017 www.jltuS.com CONTACT Will Johnson PHONE FAX 1A/C, Na. Ext): 212-863-2216 (ac, No): E-MAIL ADDRESS: william.johnson@jltus.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Travelers Property Casualty Insurance Co 36161 INSURED Government Brands Holdings, LLC Bill2Pay, LLC 955A Cobb Place Blvd Kennesaw GA 30144 INSURER B : Indian Harbor Insurance Company 36940 INSURER c: Freedom Specialty Insurance Company 22209 INSURER D: Federal Insurance Company 20281 INSURERE: INSURER F : ,,/OCCUR COVERAGES CERTIFICATE NUMBER: 47984769 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 POLJCYNUMBER POLICY EFF IMM/DD/YYYY) POLICY EXP IMM/DD/YYYY) LIMITS A ✓ COMMERCIAL GENERAL LIABILITY ZLP 61M98795- 18-15 6/8/2018 6/8/2019 EACH OCCURRENCE $1,000,000 CLAIMS -MADE ,,/OCCUR DAMAGE RENTE PREM SESO(Ea occurrence) $ 300,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $ 2,000,000 GE ✓ 'L AGGREGATE POLICY OTHER: LIMIT APPLIES PEC PER: LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE ✓ LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY ✓ SCHEDULED AUTOS NON -OWNED AUTOS ONLY ZLP 61 M98795- 18-15 6/8/2018 6/8/2019 Ee aBadeetSINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A ✓ UMBRELLALIAB EXCESSLIAB OCCUR CLAIMS -MADE CUP -0L715194- 18- 15 6/8/2018 6/8/2019 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 $ DED ✓ RETENTION $10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N/A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ B C D Professional/ Cyber Liability Excess Professional Liability Crime MTP9036643 XMF1803589 8251-0648 3/26/2018 6/20/2018 2/21/2018 6/20/2019 6/20/2019 6/20/2019 Limit: $5,000,000; Retention: $50,000 Limit: $5,000,000; Retention: $50,000 Limit:$1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION Cityof Clearwater Attn: Customer Service 100 South Myrtle Avenue Clearwater FL 33756 I 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 isf-)144 —'44' Andre Eichenholtz ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 47984769 I GL Auto Prof Liab Excess 1 Will Johnson 14/4/2019 9:45:09 AM (EDT) 1 Page 1 of 1