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NORTH GARDEN AVE GARAGE - 18-0033-EN - CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 1/17/2020 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 CONTACT NAME: Certificates/Commercial Lines Wallace Welch &Willingham, Inc. PHONEFAX 300 1 st Ave. So., 5th Floor A/c No Ext): 727-522-7777 A/c,Noy 727-521-2902 Saint Petersburg FL 33701 E-MAIL DD SS: certificates@w3ins.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Houston Casualty Company 42374 INSURED RESTCOR-01 INSURER B: Progressive Express Ins. Co. 10193 RestoCon Corporation 337 N Falkenburg Rd INsuRERc:Admiral Insurance Company 24856 Tampa FL 33619 INSURERD:Amerisure Mutual Ins.Co. 23396 INSURER E: Progressive County Mutual Ins.Co. 29203 INSURER F: Colony Insurance Company 39993 COVERAGES CERTIFICATE NUMBER:688028879 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MWDD/YYY MWDD/YYY A X COMMERCIAL GENERAL LIABILITY Y Y TEN23934 10/1/2019 10/1/2020 EACH OCCURRENCE $1,000,000 CLAIMS-MADE OCCUR PREMISES(E.o. rr PREMISES Ea occurrence) $100,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY jECT RO- LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY 011771650 10/1/2019 10/1/2020 COMBINED SINGLE LIMIT $1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident C UMBRELLA LAB X OCCUR BEX0960334501 10/1/2019 10/1/2020 EACH OCCURRENCE $5,000,000 X EXCESS LAB CLAIMS-MADE AGGREGATE $5,000,000 DED X RETENTION$n $ D WORKERS COMPENSATION Y WC204082112 10/1/2019 10/1/2020 X PEROTH- AND EMPLOYERS'LIABILITY Y/N STATUTEI ER ANYPROPRIETOR/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 $1,000,000 E Auto-TX 011772750 10/1/2019 10/1/2020 CSL $1,000,000 F Pollution Liability CSP306078 10/1/2019 10/1/2020 Occurrence/Agg $1,000,000/$1M DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) 18-0033-EN North Garden Parking Garage Parking Restoration City of Clearwater is additional insured with respect to General Liability if required by written contract subject to terms,conditions and exclusions of the policy. A Waiver of Subrogation in favor of City of Clearwater is applies to General Liability and Workers Compensation if required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Clearwater PO Box 4748 AUTHORIZED REPRESENTATIVE Clearwater FL 34758-4748 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD RestoCon Corporation Eff: 10/1/2019 to 10/1/2020 Policy No. TEN23934 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organ izations : Location And Description Of Completed Operations Only those parties required to be named as an ALL Additional Insured in a written contract with the Named Insured under this policy, entered into prior to loss or"occurrence". Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for"bodily injury" or"property dam- age" caused, in whole or in part, by "your work" at the location designated and described in the sched- ule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". CG 20 37 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 ❑ RestoCon Corporation Eff: 10/1/2019 to 10/1/2020 Policy No. TEN23934 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organ izations : Locations Of Covered Operations Only those parties required to be named as an Addi- ALL tional Insured in a written contract with the Named Insured under this policy, entered into prior to loss or "occurrence". Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following additional exclu- organization(s) shown in the Schedule, but only sions apply: with respect to liability for "bodily injury", "property This insurance does not apply to "bodily injury" or damage" or "personal and advertising injury" "property damage" occurring after: caused, in whole or in part, by: 1. All work, including materials, parts or equip- 1. Your acts or omissions; or ment furnished in connection with such work, 2. The acts or omissions of those acting on your on the project (other than service, maintenance behalf; or repairs) to be performed by or on behalf of in the performance of your ongoing operations for the additional insured(s) at the location of the the additional insured(s) at the location(s) desig- covered operations has been completed; or nated above. 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 ❑ RestoCon Corporation Eff: 10/1/2019 to 10/1/2020 COMMERCIAL GENERAL LIABILITY Policy No: TEN23924 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. TEN0215 01 14 PRIMARY AND NON-CONTRIBUTING INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM The following is added to SECTION IV-COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 4: Section IV: Commercial General Liability Conditions 4. Other Insurance: d. Notwithstanding the provisions of sub-paragraphs a, b, and c of this paragraph 4, with respect to the Third Party as defined below, it is understood and agreed that in the event of a claim or "suit" caused in whole or in part by the Named Insured's negligence, this insurance shall be primary and any other insurance maintained by the additional insured named as the Third Party below shall be excess and non-contributory. The Third Party to whom this endorsement applies is: Absence of a specifically named Third Party above means this endorsement applies only to those third parties required to be named as an Additional Insured as Primary and Non-Contributory coverage specified in a written contract with the Named Insured under this policy, entered into prior to the "loss" or "occurrence". All other terms, conditions and exclusions under this policy are applicable to this Endorsement and remain unchanged. TEN0215 01 14 Includes copyright material of Insurance Services Office, Inc. Pagel of 1 RestoCon Corporation Eff: 10/1/2019 to 10/1/2020 Policy No: TEN23934 COMMERCIAL GENERAL LIABILITY CG 24 04 05 09 WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Person Or Organization: Only such Person or Organization where required in a written contract with the Named Insured under this policy, entered into prior to the loss or`occurrence". Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV—Conditions: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard". This waiver applies only to the person or organization shown in the Schedule above. CG 24 04 05 09 9 Insurance Services Office, Inc., 2008 Page 1 of 1 ❑ WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 0313 RestoCon Corporation (Ed. 4-84) Eff: 10/1/2019 to 10/1/2020 Policy No. WC204082112 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule "Any person or organization required by written contract or certificate of insurance." "This endorsement is not applicable in California, Kentucky, New Hampshire, New Jersey, Texas and Utah." "This endorsement does not apply to policies in Missouri where the employer is in the construction group of code classifications. According to Section 287.150(6)of the Missouri Statues, a contractual provision purporting to waive subrogation rights is against public policy and void where one party to the contract is an employer in the construction group of code classifications." This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Policy No. Endorsement No. Insured Premium $ Insurance Company Countersigned by WG 00 03 13 Hart Forms&Services (Ed. 4-84) Copyright 1983 National Council on Compensation Insurance. Reorder No.14 4888