CERTIFICATE OF LIABILITY INSURANCE (553) DATE(MMIDDIYYYY)
ACC)R" CERTIFICATE OF LIABILITY INSURANCE
06!04!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 ACONTRACT 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 Karen Brinkley -
NAME:
Iron-Ridge,Insurance, PHONE (800)775-8526 Fl X (239)288-7544
A!C No Ext: AIC Na•
4971,Royal Gulf Circle,-,. EMAIL kbdnkley@ironridgeinsu�anoe.com
ADDRESS
INSURER(5)AFFORDING COVERAGENAIC A
Fort Myers FL 33966 INSURERA: Liberty Insurance Underwriters,Inc 19917-
INSURED INSURER B:
Cribb Philbeck Weaver Group,Inc. INSURERC:
3918 North Highland Ave INSURER D:
INSURER E
Tampa FL 33603 INSURER F:
COVERAGES CERTIFICATE NUMBER: CL206405296 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.
ILTR TYPE Of INSURANCE [NSD Vl1lD POLICY NUMBER POU Y EFF MMlOa EXP LIMITS
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $
CLAIMS-MADE OCCUR PREMISES Ea occurrence 5
MED EXP(Anyone person) $
PERSONAL&ADV INJURY S
GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $
RPOLICY O JJECOT_ LOC PRODUCTS-COMPlOPAGG $
.OTHER: s
AUTOMOBILELIABILITI/ _ _ - ' - - Eaa�d DtSINGLELIMIT. .
ANY AUTO , -BODILY INJURY(Per person) $
OWNED r I SCHEDULED BODILY INJURY(Peraccident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE 5
AUTOS ONLY AUTOS ONLY Per accident
. 5
UMBRELLA LIAR OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE S
DED RETENTION S 5
WORKERS COMPENSATION
PER TH-
AND EMPLOYERS'LIABILITYY!N STATUTE ER
ANY PROPRIETORIPARTNERIEXECUITIVE ❑ NIA E.L.EACH ACCIDENT 5
OFFICERNEMBER EXCLUDED? --
(MandatoryJnAIHI_ E.L.DISEASE-EA£MPLOYEE $
It yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
Per Claim $2,000,000
Professional Liability
A AEXNYABFENW003 06103I2020 0610312021 Aggregate $4,000,000
DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached It more space is require ) c e V Q
Professional Liability is written on a claims-made basis r
JUN 0 9 2020
eitty of Clearwater
engineering Department
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
City of Clearwater ACCORDANCE WITH THE POLICY PROVISIONS.
Engineering;RFQf126-19
AUTHORIZED REPRESENTATIVE
P.O.BOX 4748
Clearwater FL 33758-4748 . '
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