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NORTH GARDEN AVE GARAGE - 18-0033-EN - CERTIFICATE OF LIABILITY INSURANCE (2) DATE(MM/DD/YYYY) ACORN® CERTIFICATE OF LIABILITY INSURANCEF 9/30/2020 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: Houston Specialty Ins. Co. 12936 INSURED RESTCOR-01 INSURER B:Allstate Insurance Company 19232 Restocon Corporation 337 N Falkenburg Rd INsuRERc:Admiral Insurance Company 24856 Tampa FL 33619 INSURER D:Amerisure Mutual Ins.Co. 23396 INSURER E: Colony Insurance Company 39993 INSURER F: COVERAGES CERTIFICATE NUMBER:1573060226 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 EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY Y Y TEN25679 10/1/2020 10/1/2021 EACH OCCURRENCE $1,000,000 CLAIMS-MADE ® OCCUR DAMAGETORENTED PREMISES Ea occurrence $100,000 MED EXP(Any one person) $5,000 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: $ B AUTOMOBILE LIABILITY 648910425 10/1/2020 10/1/2021 COMBINEDSINGLELIMIT $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 $ C UMBRELLA LAB X OCCUR BEX0960334502 10/1/2020 10/1/2021 EACH OCCURRENCE $5,000,000 X EXCESS LABCLAIMS-MADE AGGREGATE $5,000,000 DED X RETENTION$0 $ D WORKERS COMPENSATION Y WC20408201402 10/1/2020 10/1/2021 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 E Pollution Liability CSP306078 10/1/2020 10/1/2021Occurrence/Agg $1,000,000/$1M B Auto-Texas 648910432 10/1/2020 10/1/2021 $1,000,000 B Auto-Georgia 648910431 10/1/2020 10/1/2021 $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) 18-0033-EN North Garden Parking Garage Parking Restoration City of Clearwater is additional insured with respect to General Liability if required by written contract subject to terms,conditions and exclusions of the policy. A Waiver of Subrogation in favor of City of Clearwater is applies to General Liability and Workers Compensation if required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Clearwater PC Bax 4748 AUTHORIZED REPRESENTATIVE Clearwater FL 34758-4748 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD