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CERTIFICATE OF LIABILITY INSURANCE - RFQ 26-19 (13) DATE(MM/DD/YYYY) ACORN® CERTIFICATE OF LIABILITY INSURANCEF 9/24/2020 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 CONTACT NAME: Certificates/Commercial Lines Wallace Welch &Willingham, Inc. PHONE FAx 300 1st Ave. So., 5th Floor A/C No Ext): 727-522-7777 A/C,No:727-521-2902 Saint Petersburg FL 33701 ADDRESS: certificates@w3ins.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Nat'l Fire Ins Co of Hartford 20478 INSURED GEORFYO-01 INSURER B:Atlantic Specialty Insurance Company 27154 George F. Young of Florida Inc. INSURER C: Continental Casualty Co./CNA 20443 George F. Young Inc. 299 Dr.Martin Luther King St N INSURER D: Valley Forge Insurance Company/CNA 20508 St Petersburg FL 33701 INSURER E: Continental Insurance Company/CNA 35289 INSURER F: COVERAGES CERTIFICATE NUMBER:186444562 REVISION NUMBER: 3 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 EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY 6046046081 4/1/2020 4/1/2021 EACH OCCURRENCE $1,000,000 CLAIMS-MADE ® OCCUR DAMAGETORENTED PREMISES Ea occurrence $100,000 MED EXP(Any one person) $15,000 X Cross Liab PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY ® PRO- ECT 1:1 LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ D AUTOMOBILE LIABILITY 6046046064 4/1/2020 4/1/2021 COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIREDX NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident X PIP$10,000 Comp/Coll $1,000 Ded E X UMBRELLA LAB X OCCUR 6046241064 4/1/2020 4/1/2021 EACH OCCURRENCE $6,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $6,000,000 DED X RETENTION$1 C non $ D WORKERS COMPENSATION 6046241226 4/1/2020 4/1/2021 X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/M EMBER EXCLUDED? FqN/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 B Protection&Indemnity Liab B5JH26405 4/1/2020 4/1/2021 1,000,000 C Professional/Pollution Liab AEH591914142 10/15/2019 10/15/2020 Per Claim 2,000,000 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) City of Clearwater is additional insured on a primary and non-contributory basis with respect to General Liability if required by written contract subject to terms, conditions and exclusions of the policy. City of Clearwater is additional insured on a primary basis with respect to Auto Liability if required by written contract subject to terms,conditions and exclusions of the policy. 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, RFQ#26-19 P.O. Bax 4748 AUTHORIZED REPRESENTATIVE Clearwater FL 33758-4748 h °m ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Prod ucts-Com pleted Operations Coverage Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART |tisunderstood and agreed asfollows: i WHO |SANINSURED is amended to include as an Insured any person or organization whom you are required by written contract toadd asenadditional insured onthis coverage part, but only with respect toliability for bodily iniury, property damage orpersonal and advertising injury caused in whole or in part byyour acts or omissions, or the acts oromissions ofthose acting onyour behalf: A. in the performance of your ongoing operations subject to such written contract; or B. inthe performance ofyour work subject tosuch written contract, but only with respect tobodily injury or property damage included in the products-completed operations hazard, and only if: 1. the written contract requires you to provide the additional insured such coverage; and 2. this coverage part provides such coverage. U. But ifthe written contract requires: A. additional insured coverage under the 11-85 edition, 1O-&3edition, or1O-01 edition ofCG2OiO. orunder the 1O- O1edition ofCG2O37; or B. additional insured coverage with "arising out of' language; or C. additional insured coverage tothe greatest extent permissible bylaw; then paragraph i above is deleted in its entirety and replaced bythe following: WHO |SANINSURED is amended to include as an Insured any person or organization whom you are required by written contract toadd asenadditional insured onthis coverage part, but only with respect toliability for bodily injury, property damage orpersonal and advertising injury arising out of your work that is subject tosuch written contract. Ui Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with: A. coverage broader than required bythe written contract; or B. ehigher limit ofinsurance than required bythe written contract. � |V. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property damage, orpersonal and advertising injury arising out of: A. the rendering of, or the failure to render, any professional erohitecture|, engineering, or surveying services, including: 1. the prepering, eppnoving, orfailing to prepare orapprove meps, shop drawings, opinions, reports, surveys. field ondens, change orders ordrawings and specifications; and sssa 2. supervisory, inspection, architectural orengineering activities; or ==== B. any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached tothis coverage part. V. Under COMMERCIAL GENERAL LIABILITY CONDITIONS,the Condition entitled Other Insurance isamended to add the following,which supersedes any provision to the contrary in this Condition or elsewhere in this coverage ==== part: ==== CNA75079XX(10-16) PolicyNo: 6046046081 Page 1 of Endorsement No: 13 Nat'l Fire Ins Co of Hartford Effective Date: 04/01/2020 Insured Name: GEORGE F. rooNs INC. CNA CNA PARAMOUNT Blanket Additional Insured - Owners, Lessees or Contractors - with Prod ucts-Com pleted Operations Coverage Endorsement Primary and Noncontributory Insurance With respect to other insurance available to the additional insured under which the additional insured is a named insunad, this insurance is primary to and will not seek contribution from such other insurenoe, provided that enmitten contract requires the insurance provided bythis policy tobe: 1. primary and non-contributing with other insurance available to the additional insured; or 2. primary and to not seek contribution from any other insurance available to the additional insured. But except as specified above, this insurance will be excess of all other insurance available to the additional insured. \4. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS isamended asfollows: The Condition entitled Duties |nThe Event ofOccurrence, Offense, Claim orSuit isamended with the addition of the following: Any additional insured pursuant to this endorsement will as soon as practicable: 1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim; 2. send the Insurer copies of all legal papers reoeived, and otherwise cooperate with the Insurer in the invesUgation, defense, orsettlement ofthe claim; and 3. make available any other insurance, and tender the defense and indemnity of any claim to any other insurer or se|f-insurer, whose policy or program applies to e loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph 3. does not apply toinsurance onwhich the additional insured isenamed insured. The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice ofeclaim from the additional insured. \4i Solely with respect tothe insurance granted bythis endorsement, the section entitled DEFINITIONS is emended to add the following definition: Written contract means a written contract or written agreement that requires you to make a person or organization an additional insured onthis coverage part, provided the contract oragreement: A. is currently in effect or becomes effective during the term of this policy; and B. was executed prior to: 1. the bodily injury orproperty damage; or 2. the offense that caused the personal and advertising injury; for which the additional insured seeks coverage. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. All other terms and conditions ofthe Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA75079XX(10-16) Po|icyNo: 6046046081 Page 2of2 Endorsement No: 13 Nat'l Fire Ins Co of Hartford Effective Date: 04/01/2020 Insured Name: GEORGE F. rooNs INC. ��0ess Auto Policy CNA Policy Endorseintrwnt It is understood and agreed that this endorsement amends the BUSINESS AUTO COVERAGE FORM as fuUuvvs: SCHEDULE Name of Additional Insured Person Or Organization ANY PERSON OR ORGANIZATION THAT YOU ARE REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREEMENT TO NAME AS AN ADDITIONAL INSURED. 1. |nconformance with paragraph A.l.c. ufWho |s AnInsured ufSection U LIABILITY COVERAGE, the person urorganization scheduled above isaninsured under this policy. 2. The insurance afforded to the additional insured under this policy will apply on a primary and non-contributory basis if you have committed it to be so in awritten contract urwritten agreement executed prior 1uthe date of the ^accident^ for which the additional insured seeks coverage under this policy. All other terms and conditions ufthe policy remain unchanged This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective date of said policy a1the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown be|uvv' and expires concurrently with said policy. Form No: CNA71527XX(10-2012) Policy No: BUA 6046046064 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date: 04/01/2020 Endorsement No: 14; Page: 1 of 1 Policy Page: 87 of 236 Underwriting Company: Valley Forge Insurance Company, 151 N Franklin St, Chicago, IL 60606 mCopyright CNA An mn»to n*wrw*u.