The URL can be used to link to this page

CERTIFICATE OF LIABILITY INSURANCE (525) CERTIFICATE OF LIABILITY INSURANCE DATE /DD 8/2299/2001919 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 endorsement(s). PRODUCER CONTAUI NAME: Chayla Deitz Stahl & Associates Insurance, Inc. a/CNE. Ext: (727)391-9791 q/c,NO: (727)393-5623 110 Carillon Parkway E-MAIL chayla.deitz@stahlinsurance.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# St. Petersburg FL 33716 INSURERA:Hart£ord Casualty Insurance Co 29424 INSURED INSURER B:Hartford Accident & Indemnity 22357 Wannemacher Jensen Architects Inc INSURERC:Twin City Fire Insurance Co. 29459 180 Mirror Lake Dr N INSURERD:Lloyds of London INSURER E: Saint Petersbur FL 33701 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1981648738 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 MAYBE 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 INSD WVD POLICY NUMBER MM/DDNYYY MM/DDNYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE ❑X OCCUR DAMAGE TO RENTED 300,000 PREMISES Ea occunence $ 21SBMZI2463 8/29/2019 8/29/2020 MED EXP(Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JECT OTHER: Employee Benefits $ 2,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident B X ANYAUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED 21UECHV1993 8/20/2019 8/20/2020 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS Per accident PIP-Basic $ 10,000 X UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED X RETENTION $ 10,000 21SBMZI2463 8/29/2019 8/29/2020 $ WORKERS COMPENSATIONX PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? C (Mandatory in NH) 21WECZR6330 8/29/2019 8/29/2020 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 00286505A 8/29/2019 8/29/2020 Each Claim 2,000,000 Claims Made Aggregate 2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Architect of Record Agreement RFQ 11-14 City of Clearwater is included as additional insured with respects to general liability and auto liability as required by written contract. CERTIFICATE HOLDER CANCELLATION Laura.Davis@MyClearwater.com SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Clearwater THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN P. 0. Box 4748 ACCORDANCE WITH THE POLICY PROVISIONS. Clearwater, FL 33758-4748 AUTHORIZED REPRESENTATIVE Kelly Petzold/DEITZC x P — ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401)