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CERTIFICATE OF LIABILITY INSURANCE (1044) -"1 J -INC-01 WALLEN1 ACORO� DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE�•� 7/2/2020 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 License#1000009384 CONTACT Wendy Allen Hub International Carolinas PHONE FAX 1001 Morehead Square Drive (A/C,No,Ext): (A/C,No): Suite 400 E-MAIL wendy.allen@hubinternational.com Charlotte,NC 28203-0013 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Cincinnati Specialty Underwriters Ins Co 13037 INSURED INSURER B:Cincinnati Insurance Company 10677 JEM-TECH Inc. INSURER C7 1290 Ashboro Cir SE INSURER D: Palm Bay,FL 32909 INSURER E 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCURCSU0112152 3/26/2020 3/26/2021 DAMAGE TO RENTED 1O®,000 LAIX X PREMISES Ea occurrence MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑ PRO ❑ LOC 2,000,000 JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ X ANY AUTO X EBA 0520717 1/17/2020 1/17/2021 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION WORKERS COMPENSATIONPER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder is included as additional insured on genera liability on a primary and noncontributory,if required by contract. The general liability and Auto liability include a waiver of subrogation. Carrier will mail notice of cancellation to certificate holder at least 30 days before the effective date of the cancellation. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cit of Clearwater THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Procurement Department,ITB#25-20 PO Box 4748 Clearwater,FL 33758-4748 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CSGA 4087 12 12 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - PER CONTRACT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to Paragraph 8.Transfer of Rights of Recovery Against Others to Us of SECTION IV-CONDITIONS: If you have agreed, in a written contract or agreement, to provide a waiver of any right of recovery against a person or organization, we will waive any right of recovery we may have against that person or organization 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 that person or organization for which you have agreed to in a written contract to provide said waiver. Includes copyrighted material of Insurance CSGA 4087 12 12 Services Office, Inc.,with its permission. P8ge 1 of 1 COMMERCIAL GENERAL LIABILITY CSGA 4027 0813 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY~ ADDITIONAL INSURED - VENDORS WHEN REQUIRED BY CONTRACT w RACm This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROD UCTS/COK8PLETED OPERATIONS LIABILITY COVERAGE PART A. SECT|ONNN -WHKJ |S ANINSURED iaamend- course ofbusiness, inconnection with ed to include as an additional insured any per- the distribution orsale ofthe products; son(a) or organization(s) (referred to below as vendor) when required in a written contnaot, but f. Demonstration, installation, servicing only with respect to "bodily irjur/' or "property or repair opemtions, except such op- damage" arising out of "your products" which emtiona performed at the vendor's are distributed or sold in the regular course of premises in connection with the sale of the vendor's businesa, subject to the following the product; additional exclusions:� g. Products whioh, after distribution or 1. The insurance afforded the vendor does sale byyou, have been labeled orre- not apply to: labeled orused asa container, part or ingredient of any other thing or sub- a. "Bodily injury"or"property damage"for stance byorfor the vendor; or which the vendor is obligated to pay damages byreason ofthe assumption h. "Bodily irjury' or "property damage" of liability in a contract oragreement. arising out of the sole negligence of This exclusion vendor its acts or does notapp|yto |iabi|- - ityfnrdamageathatthevendorwould aionaorthose ofits employees orany- have inthe absence ofthe contract or one else acting onits behalf. However, agreement; this exclusion does not apply to: b. Any express warranty unauthorized by (1) The exceptions contained in Sub- you; paragraphs or f.;or you� c. Any physical orchemical change inthe (2) Such inapectiona, adjustments. product made intentionally bythe ven- tests or servicing as the vendor dorhas agreed to make or normally ' undertakes to make in the usual d. Repaokaging, except when unpacked course ofbusiness, in connection solely for the purpose of inapection, with the distribution or sale of the demonstration, testing, orthe substitu- products. tion of parts under instructions from the menufactuner, and then repack- 2' This insurance does not apply to any in- aged in the original container; suned person or organizagion, from whom you have acquired such produots, or any e. Any failure to make such inapectiona, ingnedient, pert or container, entering into, adjustments, tests or servicing as the accompanying orcontaining such products. vendor has agreed to make or nor- mally undertakes or-meUyundertakes to make in the usual Any coverage provided by this endorsement will beprimary and noncontributory. Includes copyrighted material ofInsurance CSGA 40270813 Services Office, |no.. with its permission. Page 1of1