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CERTIFICATE OF LIABILITY INSURANCE (555)Client#: 2175323 69DEUELAS page 2 of 2 ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYVY) 6/08/2020 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER McGriff Insurance Services 12485 - 28th Street North Saint Petersburg, FL 33716 727 327-7070INSURER CONTACT NAME: Lisa Jakubowskf (A/C, o, Ems: 7273277070 FAX No): 8886328451 aoo_aLEss: L_isa.Jakubowskf@mcgriffinsurance.com INSURER(S) AFFORDING COVERAGE NAIC ff A : Owners Insurance Company 32700 INSURED Deuel & Associates dba Compass Engineering & Surveying, Inc. 565 S. Hercules Avenue Clearwater, FL 33764 INSURER B: Great Midwest Insurance Company RECEIVE U OFFICIAL RECORDS INSURER C : $ INSURER D INSURER E 1 OCCUR 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 LTR TYPE OF INSURANCE ADDLSUBR INSR WVD POLICY NUMBER POLICY EFF (MWDD/YYYY (� �`°" POLICY EXP MWDD/YYYY ND LIMITS EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY RECEIVE U OFFICIAL RECORDS DgMAGF�TO RENTED PREEMIS 5 (Ea occurrence)___ $ CLAIMS -MADE 1 OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJU RY $$ GENERAL AGGREGATE GEN'L AGGREGATE POLICY OTHER: LIMIT APPLIES I JECOT L PER; LOC PRODUCTS - COMP/OP AGG $ $ _ _ _._ A AUTOMOBILE X _ X X LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY Drive Oth Car X SCHEDULED AUTOS NON -OWNED AUTOS ONLY 5277369300 IEGISLATIV 11 6/2021 (EOMaBIcN�BDtSINGLE LIMIT $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE 5 AGGREGATE $ $ DED RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ _ C Professional Liab C AEGM000012200 06/15/2020 06/15/2021 See Below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may bo attached If more space Is required) Professional Liability (Claims Made) - $1,000,000 Each Claim; $2,000,000 Aggregate; $5,000 Each Claim Retroactive Date 6/15/2005 CERTIFICATE HOLDER CANCELLATION City of Clearwater Attn: City Clerk PO Box 4748 Clearwater, FL 33758 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORMED REPRESENTATIVE ACORD 25 (2016/03) 1 of 1 #S25886601/M25876848 L 1389 0 1 988-201 5 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD EH2 1388 • McGriff Insurance Services PO Box 819 Wilson NC 27894-0819 5400 H City of Clearwater Attn: City Clerk PO Box 4748 Clearwater, FL 33758 page 1 of 2 06/08/2020