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CERTIFICATE OF LIABILITY INSURANCE (1095) Client : 1916902 69OLIC DATE(MMIDDIYYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Michelle Janola McGriff Insurance ServicesP HONE 9417821880 FAX 8886328459 Arc,No,Ext): Arc,Na 12485-28th Street North E-MAIL anola me ri ADDRESS: 1 .com g Saint Petersburg, FL 33716 INSURER(S)AFFORDING COVERAGE NAIC# 727 327-7070 Great American Assurance Company 26344 INSURER A: p Y INSURED INSURER B:Travelers Property Casualty InsuranceCo 36161 Rowland Inc INSURER C:Great American Insurance Co of NY 22136 6855 102nd Avenue N Westchester Surplus Lines Insurance 10172 INSURER D: p Pinellas Park, FL 33782 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 CONTRACTOR 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 MMlDDlYYYY MMlDDlYYYY A X COMMERCIAL GENERAL LIABILITY GLP376329303 10/01/2020 10/01/2021 EACH OCCURRENCE $1,0009000 CLAIMS-MADE ®OCCUR FIR ISES(Ea occur°nce) $500,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO- POLICY JECT X LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY CA376329203 10/01/2020 10/01/2021 (CEO accident OMBINED SINGLE LIMIT $190009000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY FX AUTOS ONLY Per accident) ccident $ B X UMBRELLA LIAB X OCCUR ZUP1625122 10/01/2020 10/01/2021 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED I X RETENTION$10000 $ C WORKERS COMPENSATION C376330202 10/01/2020 10/01/2021 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $190009000 OFFICER/MEMBER EXCLUDED? ® N/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 $190009000 Pollution G71152613003 10/01/2020 10/01/2021 Each Condition: 2 Liability Aggregate: Deductible: $2,500 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Engineering Department Attn: Construction Office Specialist 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 PO Box 4748 ACCORDANCE WITH THE POLICY PROVISIONS. Clearwater, FL 33758-4748 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 2657612 / 2657573 MMJ This page has been left blank intentionally.