CERTIFICATE OF LIABILITY INSURANCE (5)Client#: 581763
INFOSENDI
ACORD- CERTIFICATE OF LIABILITY INSURANCE
DATE(MWDDIYYYY)
3/31/2020
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(les) 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 1 2 ¢NTACT ROcio Gutierrez
�PHa�N�E
Marsh & McLennan Agency LLC 949-425-7301 FAX
(AMmoi' ( ' No):
Marsh & McLennan Ins. Agency LLC
; ADDRESS: occerts@marshmma.com
1 Polaris Way #300
INSURER(S) AFFORDING COVERAGE
NAIL a
Aliso Viejo, CA 92656
INSURER A : Federal Insurance Company
20261
INSURED INSURER 8: NOVA Casualty Company
42552
InfoSend, Inc. INSURER C : Underwriters at Lloyd's London
555555
4240 E La Palma Avenue
INSURER D:
_
02/01/2021
Anaheim, CA 92807
INSURER E :
$1,000,000
INSURER F :
COVERAGES
CERTIFICATE NUMBER:
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.
LTRR
TYPE OF INSURANCE
ADD.
INSR
SUER
WVD
POLICY NUMBER
POLICY EFF
(M DIYYYY)
POLICY EXP
(MM/ODIYYYY)
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
36031149
04/01/2020
_
02/01/2021
EACHpAqMA OCCURRENCEEECpp
$1,000,000
CLAIMS -MADE
X OCCUR
PREMISESfEiroggerwe)
$1,000,000
MED EXP (Any one person)
$10,000
PERSONALS ADV INJURY
$ 1,000,000
GENL
X
AGGREGATE
POLICY
OTHER
LIMIT APPLIES
PRO -
JECT
PER:
LOC
GENERAL AGGREGATE
$2,000,000
PRODUCTS - COMP/OP AGG
$ Included
$
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
OWNED
AUTOSE�ONLY
AUTOS ONLY
SCHEDULED
AUTOS
NON -OWNED
AUTOS ONLY
73587120
04/01/2020
02101/2021(CA
aB idem) E LIMIT
$1,000,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
,_----------,-----_--
$
A
_ X
UMBRELLA UAB
EXCESS LIAB
X i OCCUR
1 CLAIMS -MADE
79896856
04/01/2020
02/0112021
EACH OCCURRENCE
$5,000,000
AGGREGATE
s5,000,000
DED
RETENTIONS
S
B
SCOENSATION
WORKERMP
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y/ N
OFFICER/MEMBER EXCLUDED9 N
(Mandatory In NH)
If yes,SCorder describe
DERIPTION OF OPERATIONS below
BBWWK1000066300
N / A
0210112020
02/01/2021 X /STATUTE
FOR µ
E.L. EACH ACCIDENT
$1,000,000
E. L. DISEASE - EA EMPLOYEE
El,000,000
DISEASE - POLICY LIMIT
$1,000,000
C
Tech E&O & Cyber
• TRICE01263
02/01/2020
_LE.L.
02/01/2021
$5,000,000 Aggregate
$25,000 Retention
12/01/06 Retroactive
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remains Schedule, may W attached If more space Is required)
Certificate Holder is included as additional insured as respects to General Liability per attached
endorsements. Waiver of Subrogation applies to Workers Compensation per attached endorsement.
CERTIFICATE HOLDER
CANCELLATION
City of Clearwater
100 S. Myrtle Avenue
Clearwater, FL 33758-0000
ACORD 25 (2016103) 1 of 1
#S47783271M4778296
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
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