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CERTIFICATE OF LIABILITY INSURANCE (506) Client#: 1049203 LONGAS1 DATE(MM/DDNY) ACORDT. CERTIFICATE OF LIABILITY INSURANCE 1 07/02/2019yY 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: USI Insurance Services, LLCPHONE 813 321-7500 FAX A/C,No,Ext): (A/C,No): 2502 N Rocky Point Drive E-MAIL ADDRESS: Suite 400 INSURER(S)AFFORDING COVERAGE NAIC# Tampa, FL 33607 INSURER APhoenix Insurance Company 25623 INSUREDINSURER B: Liberty Libe Insurance Underwriters,Inc. 19917 Long&Associates INSURER C Architects/Engineers, Inc. INSURER D 4525 S Manhattan Ave INSURER E Tampa, FL 33611 INSURER F COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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. ADDLSUBR LTR TYPE OF INSURANCE NSR WVD POLICY NUMBER POLICY EFF POLICY EXP/YLIMITS (MM/DDYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY X X 66045281-957 06/24/2019 06/24/2020 EACH OCCURRENCE $1,000,000 CLAIMS-MADE 4 OCCUR PREMISESOEa occur°nce $1,000,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY JECT � LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B Professional AEXNYABC70LO903 09/15/2018 09/15/2019 $2,000,000 per claim Liability $2,000,000 annl aggr. DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Professional Liability coverage is written on a claims-made basis. Achitect of Record Agreement CERTIFICATE HOLDER CANCELLATION Cit of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 100 S. Myrtle Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Clearwater, FL 33756 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S26085635/M26085633 MRLEW This page has been left blank intentionally. CERTIFICATE OF LIABILITY INSURANCE =MM/DDffYYY) /03/2019 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 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 enclorsernont(s). PRODUCER CONTACT CHARLES D.TALLEY,JR. NAME:--- CHARLES D.TALLEY,JR.INSURANCE, INC. PHONE rAx - 813 685-9393 813-643-9556 4A1G.Nt,.Extg_.—._._ _ 1 iAF ,No)_ _ 1335 OAKFIELD DR. E-MAIL chuck@ctalleyins.com BRANDON,FL 33511 -INSURERP( AFFORDING COVERAGE NAIC# INSURER A: ALLIED PROPERTY AND CASUALTY INS COMPA 42579 INSURED INSURER B: .....----- __......_._. ._._.. &ASSOCIATES ARCHITECTS ENGINEERS INC INSURER C _........ ------- 4525 S MANHATTAN AVE. INSURER D MPA,FL 33611-2305 INSURER E: _.... ......_._.......... __ .._. _. INSURER F: COVERAGES CERTIFICATE NUMBER: 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, LTR .._... TYPE OF INSURANCE_ ( POLICY NUMBER MM R2 YE.FF Y MMIDUIYYYY.,..... LIMITS _... . COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS-MADE ... OCCUR DAMAGE TOITRYl'-D- ..... _.. ' I- - _,Iy ItLM35E ..(Ea OCE.!Jrre llCej $ -- MED EXP(Ally one person) $ --- -- PERSONAL&ADV INJURY $ --- GEN'LAGGREGATE LIMIT APPLIES PER. (GENERAL AGGREGATE 5 POLICY 0 PRO- JECT LOC ECT PRODUCTS-COMP/OP AGG ,, (')THER. i$- AUTOMOBILE LIABILITY GOMRINED SINGLE.LIMIT -- _(Eaa c!'dan.— $ 1 000,000 l ANY AUTO BODILY INJURY(Per person) $ A ALL OWNED SCHEDULED ----- -- - -- - AUTOS _ AUTOS ACP BAPC 3056738228 07/08/2019 07/08/2020 BODILY INJURY(Per accident) $ NON-OWNED faC7a kFtrv>�AMC HIRED AUTOS AUTOS If— (Per accidp0)1 $ UMBRELLA LIAB OCCUR _._ EACH OCC:'URRL�,CE $ EXCESS LIAB ...... ...__ _....... ..... .......—._ C4,AIM5 MADE AGGREGATE $ DED RL1 EIvrION$ ( S WORKERS COMPENSATION PCR' %yl Ii- -- ;AND EMPLOYERS'LIABILITY Y/N- IPTATUTI- ._ ER ,1 NY PRtsF'Rl[-TCRF PARTNFft,EXECUTIVG E L EACH ACCIDENT $ 500,000 A rJFFIC11RIMEM01,'A"EXCLUDED'' r NIA ACP WCP 5984978651 06/24/2019;06/24/2020 -- .-. -...__ If yes,describe In NH) E L DISEASE-EA EMPLOYEI $ 500,000 If yes,descritao tinder ,........ _ ...._....---- _..._... DESCRfIry11t;7pJ-OF OPEr�I:.tIONS;re3ow '.E.L D*'J'A..SE..-POLICY LIMIT :$ 500,000 I _ I I DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is requlred) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF CLEARWATER ACCORDANCE WITH THE POLICY PROVISIONS. ENGINEERING,RFQ#26-19 POB 4748 AUTHORIZED REP TAT'IVE CLEARWATER,FL 33575-4748 _ I ©1988-2014 ACO D C RPORATION. All rights reserved.. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD