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CERTIFICATE OF LIABILITY INSURANCE (499) 76/27/2019 E(MM/DDYYY) A�" CERTIFICATE OF LIABILITY INSURANCE /Y 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). CONTACT PRODUCER McLaughlin Brunson NAME: Brian R Hadar A Risk Strategies CompanyHO No Ezt: 214 503-1212 p/c No: 214 503-8899 12801 N CENTRAL EXPY, STE 1710 E-MAIL Dallas, TX 75243 ADDRESS: certificate@mclaughlinbrunson.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Phoenix Insurance Company 25623 INSURED INSURER B: Travelers Indemnity Co of America 25666 Jones Edmunds &Associates, Inc,. 730 N.E. Waldo Road INSURERC: Travelers Indemnity Company 25658 Gainesville FL 32651 INSURER D: XL Specialty Insurance Company 37885 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 49652726 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR I POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A �/ COMMERCIAL GENERAL LIABILITY �/ �/ 680008N190672 6/30/2019 6/30/2020 EACH OCCURRENCE $1,000,000 DAMAGE TO CLAIMS-MADE 11/1 OCCUR PREM SES Ea RENTED $1,909,990 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY ✓� JECT � LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITYBA1958L731 6/30/2019 6/30/2020 COMBINED SINGLE LIMIT $ Ea accident 1,000,000 ✓ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ ✓ AUTOS ONLY V, AUTOS ONLY Per accident C �/ UMBRELLALIAB f OCCUR CUP008N201316 6/30/2019 6/30/2020 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED ✓ RETENTION$10,000 $ C WORKERS COMPENSATION UB008N190948 6/30/2019 6/30/2020 ✓ SPER TATUTE EORH AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? F—] 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 D Professional Liability DPR9944907 6/30/2019 6/30/2020 Per Claim $5,000,000 Annual Aggregate $5,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RFQ 26-19, Engineer of Record. The claims made professional liability coverage is the total aggregate limit for all claims presented within the annual policy period and is subject to a deductible.Thirty(30)day notice of cancellation in favor of the certificate holder on all policies. CERTIFICATE HOLDER CANCELLATION City of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Engineering Department ACCORDANCE WITH THE POLICY PROVISIONS. PC Box 4748 Clearwater FL 33758 AUTHORIZED REPRESENTATIVE Brian Hadar ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 49652726 1 19/20 GL/AL/UL/WC/PL I Joy C-1— 1 6/27/2019 5:29:37 PC9 (EDT) I Page 1 of 1