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CERTIFICATE OF LIABILITY INSURANCE (524)Client#: 216019 20MCKIMCRE page 2 of 3 ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 8/23/2019 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 McGriff Insurance Services Post Office Box 13941 Durham, NC 27709 919 281-4500 CONTACT NAME: Yardley (A/C, No, Ext): 919 281-4500 i (A/c No); 8887468761 _ ADD ESS: BYardley@McGrifflnsurance.com INSURER(S) AFFORDING COVERAGE NAIC a INSURER A : Charter Oak Fire Insurance Company 25615 INSURED McKim and Creed Inc 1730 Varsity Dr Ste 500 Raleigh, NC 27606-2689 INSURER B : Travelers Property Casualty Co of Amer 25674 INSURER c : Travelers Casualty & Surety Company 19038 INSURER D : EACH OCCURRENCE INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN M riAy6 ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, ED BY PAID CLAIMS. INSR LTR _ TYPE OF INSURANCE ADDLSUBR��11��EEi11F�b��f(00�� INSR WVD POLICY NU FF YYY) POLICY EXP (MWDD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 6302G091871C 09/05/2019 09/05/2020 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR PEMS STO RENTDence) Si00,000 UG 2 9 AUG 2019 MED EXP (Any one person) $1 q 000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: OFFICIAL RECORDS AND GENERAL AGGREGATE $ 2,000,000 I POLICY X PRO- X LOC LEGISLATIVE SRVCS DEI T. PRODUCTS - COMP/OPAGG $2,000,000' OTHER: $ A AUTOMOBILE LIABILITY 8105N4432441 09/05/2019 09/05/2020 COMBINEDSINGLE LIMIT ! U 1 0000 $ s00r X ANY AUTO BODILY INJURY (Per person) $ OWNED AUTOS ONLY l SCHEDULED AUTOS BODILY INJURY (Per accident) $ X HIRED AUTOS ONLY X NON•OWNED AUTOS ONLY PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA LIAB X OCCUR CUP5J8991491 09/05/2019 09/05/2020 EACH OCCURRENCE $10,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $10 000 000 DED X RETENT ON $10,000 $ `+ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY UB4J71761319 09/05/2019 09/05/2020 X STATUTE _H- _ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? Y / N N NIA E.L. EACH ACCIDENT $1000000 (Mandatory In NH) - E.L. DISEASE . EA EMPLOYEE $1,000,000 It yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space is required) The City of Clearwater is included as an additional insured with respects to all coverage except Workers' Compensation where required by written contract before a loss. Such coverage is primary and non contributory. A Waiver of Subrogation also applies in favor of the City of Clearwater for CGL and Automobile Liability coverage where required by written contract, before a loss. a thirty (30) day notice of cancellation shall be given the Certificate Holder prior to cancellation or non renewal. CERTIFICATE HOLDER CANCELLATION City of Clearwater Attn: City Clerk PO Box 4748 Clearwater, FL 33758 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 44sr Asa ACORD 25 (2016/03) 1 of 1 1016 #S24206949/M24206639 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BFY McGriff Insurance Services POBox 819 Wilson NC 27894-0819 5400 H City of Clearwater Attn: City Clerk PO Box 4748 Clearwater, FL 33758 1015 page 1 of 3 08/23/2019