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CERTIFICATE OF LIABILITY INSURANCE (530)® A� o CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YYYY) 09/27/2019 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER Aon Risk Services South, Inc. Franklin TN Office 501 Corporate Centre Drive Suite 300 Franklin TN 37067 USA CONTACT NAME: PHONE (866) 283-7122 FAX 800-363-0105 (A/C. No. Ext): (A/C. No.): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Malcolm Pirnie, Inc. 44 South Broadway 9th Floor White Plains NY 10601 USA INSURER A: Greenwich Insurance Company 22322 INSURER B: XL Specialty Insurance Co 37885 INSURER C: XL Insurance America Inc 24554 INSURER D: $1,000,000 INSURER E: INSURER F: CLAIMS -MADE X OCCUR COVERAGES CERTIFICATE NUMBER: 570078502171 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. Limits shown are as requested INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD -POLICY EXP cMM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY GEC001076118 10/01/ 10/01/2020 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR General Liability SIR applies per p21'(r/S q t f` ti ons DAMAGE TO RENTED PREMISES (Ea occurrence) $1,000,000 ,BEtbFidi MED EXP (Any one person) $10, 000 PERSONAL & ADV INJURY $1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: .. GENERAL AGGREGATE $2,000,000 POLICY X PRO -I X ILOC JECT I _.rl PRODUCTS - COMP/OP AGG $2,000,000 OTHER: B AUTOMOBILE LIABILITY AEC001075818 (V �.. 10/01/2019 W,'01/2020 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X ANY AUTO Auto (AOS) t L /I l_V __ i,) - I, .'-j iJ L t -1. BODILY INJURY ( Per person) OWNED - SCHEDULED BODILY INJURY (Per accident) AUTOS ONLY HIRED AUTOS AUTOS NON -OWNED PROPERTY DAMAGE (Per accident) ONLY AUTOS ONLY B X UMBRELLA LIAB X OCCUR UEC001075918 10/01/2019 10/01/2020 EACH OCCURRENCE $1,000,000 - EXCESS LIAB CLAIMS -MADE Umbrella AGGREGATE $1,000,000 DED X RETENTION 510 000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITYAOS RWD943516314 10/01/2019 10/01/2020 x PERTUTE I 0OTH B ANY PROPRIETOR PARTNER / EXECUTIVE YNN RWR943516714 10/01/201910/01/2020 E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER/EXCUDED? (Mandatory in NH) N/A AK,WI E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: All Operations of the Named Insured. City of Clearwater is included as Additional Insured as required by written contract, but limited to the operations of the insured under said contract, with respect to the General Liability, Auto Liability and Umbrella Liability policies. General Liability and Auto Liability evidenced herein is primary and non-contributory to other insurance available to the Additional Insured, but only to the extent required by written contract with the insured. A waiver of Subrogation is granted in favor of Additional Insured as required by written contract but limited to the operations of the Insured under said contract, with respect to the General Liability, Auto Liability, Umbrella Liability and Workers' Compensation policies. CERTIFICATE HOLDER CANCELLATION Holder Identifier : 570078502171 Certificate No City of Clearwater Attn: City Clerk P.O. Box 4748 Clearwater FL 33758 USA 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 e JrF c �iatLil�tO ��78t1 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD