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CERTIFICATE OF LIABILITY INSURANCE - RFQ 26-19 (3) Client#: 25411 WGIINC DATE(MM/DD/YYYY) ACORDT. CERTIFICATE OF LIABILITY INSURANCE 1 9/23/2020 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 CONTACT NAME: Katie Kremer Greyling Ins. Brokerage/EPICPHONE 770.552.4225 FAX 866.550.4082 A/C,No,Ext: (A/C,No): 3780 Mansell Road,Suite 370 E-MAIL ADDRESS: Katie.Kresner@greyling.com Alpharetta, GA 30022 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: National Union Fire Ins.Co. 19445 INSURED INSURER B: The Continental Insurance Company 35289 GI, Inc. INSURER C: New Hampshire Ins.Co. 23841 2035 Vista Parkway INSURER D: BerkleInsurance Company 32603 Suite 100 INSURER E West Palm Beach, FL 33411 INSURER F COVERAGES CERTIFICATE NUMBER: 20-21 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 WTH 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 INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY 4613985 08/01/2020 08/01/2021 EACH OCCURRENCE 62,000,000 CLAIMS-MADE ®OCCUR PREMISES(Ea olccurrDence) s500,000 MED EXP(Any one person) $25,000 PERSONAL&ADV INJURY x2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE x4,000,000 PRO- POLICY I ECT F-1 LOC PRODUCTS-COMP/OPAGG x4,000,000 OTHER: $ A AUTOMOBILE LIABILITY 9775972 08/01/2020 08/01/2021 CO(EaMBINED ccidentSINGLE LIMIT $2e 000e 000 a X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY Per accident $ B X UMBRELLA LIAB X OCCUR 6049958687 08/01/2020 08/01/2021 EACH OCCURRENCE 65,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE x5,000,000 DED I X1 RETENTION$10000 $ C WORKERS COMPENSATION 011569886 08/01/2020 08/01/2021 PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ® N/A (Mandatory in NH) E.L.DISEASE-EA E 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $190009000 D Professional Liab AC903850801 08/01/2020 08/01/2021 Per Claim$5,000,000 Incl Pollution Aggregate$5,000,000 Liabilit DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if mare space is required) Re: RFQ#26-19. City of Clearwater is named as an Additional Insured with respects to General &Automobile Liability where required by written contract. Should any of the above described policies be cancelled by the issuing insurer before the expiration date thereof,we will endeavor to provide 30 days'written notice (except 10 days for nonpayment of premium)to the Certificate Holder. CERTIFICATE HOLDER CANCELLATION Cit Of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 100 S Myrtle Ave#220 ACCORDANCE WITH THE POLICY PROVISIONS. Clearwater, FL 33756-0000 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #52387096/ 2327181 KKRE1 This page has been left blank intentionally.