The URL can be used to link to this page

CERTIFICATE OF LIABILITY INSURANCE (516) Client#: 25411 WANTGROU DATE(MM/DD/YYYY) ACORDT. CERTIFICATE OF LIABILITY INSURANCE 6/19/2019 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Katie Kresner NAME: Greyling Ins. Brokerage/EPICPHONE 770.552.4225 FAX 866.550.4082 A/C,No,Ext: (A/C,No): 3780 Mansell Road,Suite 370 E-MAIL ADDRESS: Katie.Kresner@greyling.com Alpharetta, GA 30022 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: National Union Fire Ins.Co. 19445 INSURED INSURER B: The Continental Insurance Company 35289 Wantman Group, Inc. INSURER C: New Hampshire Ins.Co. 23841 2035 Vista Parkway Lexington Insurance Company 19437 INSURER D: 9 p Y Suite 100 INSURER E West Palm Beach, FL 33411 INSURER F COVERAGES CERTIFICATE NUMBER: 18-19 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 4613985 08/01/2018 08/01/2019 EACH OCCURRENCE $1,000,000 CLAIMS-MADE 4 OCCUR PREMISESTON,occur ence $500,000 MED EXP(Any one person) $25,000 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: $ A AUTOMOBILE LIABILITY 9775972 08/01/2018 08/01/201 EOaaccs .,dentINGLELIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY Per accident $ B X UMBRELLA LAB X OCCUR 6049958687 08/01/2018 08/01/2019 EACH OCCURRENCE $5 OOO 000 EXCESS LAB CLAIMS-MADE AGGREGATE s5,000,000 DED I X RETENTION$10,000 $ C WORKERS COMPENSATION 11569886 08/01/2018 08/01/2019X I PER STATUTE OERH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? 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$1,000,000 D Professional Liab 027015040 08/01/2018 08/01/2019 Per Claim$5,000,000 Incl Pollution Aggregate$5,000,000 Liability DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re: RFQ#26-19. City of Clearwater is named as an Additional Insured with respects to General &Automobile Liability where required by written contract. Should any of the above described policies be cancelled by the issuing insurer before the expiration date thereof,we will endeavor to provide 30 days'written notice(except 10 days for nonpayment of premium)to (See Attached Descriptions) 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 Ave#220 ACCORDANCE WITH THE POLICY PROVISIONS. Clearwater, FL 33756 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S1651000/M1140858 KKRE1 DESCRIPTIONS (Continued from Page 1) the Certificate Holder. SAGITTA 25.3(2016/03) 2 of 2 #S1651000/M1140858