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CERTIFICATE OF LIABILITY INSURANCE (6) Client#:581763 INFOSENDI DATE(MMIDDIYYYY) ACORD,. CERTIFICATE OF LIABILITY INSURANCE 2/01/2021 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: (f the certificate holder is an ADDITIONAL INSURED,the poi icy(ies) T u st 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 Rocio Gutierrez NAME: Marsh&McLennan Agency LLC PHONE (A/C,No,Ell:949 900 1780 - - Marsh&McLennan Ins.Agency LLC E-MAIL g ADDRESS: re rocio. utierz marshmma.com 1 Polaris Way#300 ---__ - _.__. . _. ..__ _. __... . _--__ ____-_ .. ---__ INSURERS)AFFORDING.COVERAGE NAIC# Aliso Viejo,CA 92656 wFederal etierallnsuranceCompany 20281 INSURED INSURER B:Comp—st Insurance Company 12177 InfoSend,Inc. wsuRER c:Underwriters at Lloyd's London 555555 4240 E La Palma Avenue Anaheim,CA 92807 INSURER D: INSURER E I 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 INSR SW D ' POLICY EFF POLICY EXP LIMITS LTR /NSR�WVD POLICY NUMBER MMIDD/YYYY MMIDD/YYYY -. A X COMMERCIAL GENERAL LIABILITY ,36031149 2/01/2021 02/01/2022 EACH OCCURRENCE $1000000 ;DAM AGETO RENTED ,)CLAIMS-MADE I X',OCCUR !PREMISES(Ea occurrence) $1,000,000 MEDEXP(Any.oneperson)_ $10i000- PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY ECT LOC PRODUCTS-COMP/OP AGG slncluded OTHER: $ A AUTOMOBILE LIABILITY 7358712002101/2021102101/202i COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ X ANY AUTO ( BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY _-__- AUTOS _...-._-.__ .__.-..._. HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ A X UMBRELLA LIAB X OCCUR 79896856 2/01/2021 02/01/2022 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE °AGGREGATE $5 OOO OOO DED J RETENTION$ $ B WORKERS COMPENSATIONWCV55O4862/CA-OR 2/01/2021 02/01/2022 X PER AND EMPLOYERS'LIABILITY 'OTH- ----— B ANY PROPRIETOR/PARTNER/EXECUTIVE, WCV6217250/TX-FL-IL 2/01/2021 02/01/2022 E.L.EACH ACCIDENT $1 000 000 OFFICER/MEMBER EXCLUDED? N ,N/A- (Mandatory in NH) I E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes;describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$1,000,000 C *Prof Liab/Cyber TRICE01496 0210112021 02/01/2022, $5,000,000 Agg./Claim C *Retro 12/01/06 $25,000 Retention A I Crime 68054862 2/01/2021 02/01/2022 $300,0001$5,000 Ret. DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate Holder is included as additional insured as respects to General Liability per attached endorsements.Waiver of Subrogation applies to Workers Compensation per attached endorsement. CERTIFICATE HOLDER CANCELLATION City of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 100 S. Myrtle Avenue ACCORDANCE WITH THE POLICY PROVISIONS. Clearwater,FL 33758-0000 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 #S7015859/M7013059 WOAXB CHUBS" Liability Insurance Endorsement POUCY'Perii)d 02/01/2021 10 02/01/2022 Policy Mimber 36031149 InSurad InfoSend,Inc. Name of Company FEDERAL fNSIJR,AN(-"E COMI'AN Y ffits Endorwinent applies to the following I"Orms: GENERAL LIAR11,14"Y Under Who Is An Insured,the following provision is added, Who Is An Insured Additional Insured- Persons cw organizations 4mwn in the Schedule we,irtsureds,,but fficy are iniatreds only if you are Scheduled Person obtigated pursuant to as contract or agreckricnt w provide thein with inch irmwice as is aftbrded by Or Organization this f'toficy. However,the person or organization,is an insured ordy: * if and then only ro the ement dw,pericm or organiLation is des rib in the Schedutc, * to the extentsuch contract or agrecynent requircs ffic person or organization to be afforded status w;,art insaur ed'4 * for activities that(lid not occur,in whole or in part,before the execution of the contract or ag reemei it:and witb resipect to damages,loss,coo or expeow for injury or danragc to whidi this insmrancc applies, No person or or.glanization Nan insured under this proviitow that is marc specifically idenrified winder any other provision of the Who Is An Insurect section(re-ardlessof any hutuationapplicable thercto), M with respect to any ass'unqmcm offiability((it another perion or organizatiom by theyn in as contract or a-reement,This hafiration do not apply to the habitity for damages, loss,cost or expensc pear injury or daluage,to which this insurance atppfics,that ffic fwrson or organization wouicl have in the absence of such contract or agrecMCM, wbutry Insurance AdcWonat Irsured ScfTPdu1Qd Parson or orgarriza tion continuod Forn?80-02-2.187(Race 5-0,71 Endorsement Page I ................ .................... CHUSS" LIQ-4@1hi"En do rs e men t (continued) I hider Conditions,the frillowi rig priwi,6)n is Kidded to(ho condilion fitled()thcr Insucine c. Conditions Other Insurance— U you are obligated,pursuant m a contract oragreemew,w provide the penk)n or orgiflization Primary, Noncontributory ihown in 11W Schedule wrih primary insurancamrch m,N,afforded by this,policy,then in such easee Insurance—Scheduled 1his insurance is primaryand we will mast seek,coraributionfrom insurance avaihihicto such person Person Or Organization or organization, Schedute City of Clearwater 100 S. Myrtle Avenue Clearwater, FL 33758-0000 All other terawswid condifions remain unchanged, r") Authorized Representative 0A babOtty Insurance Additon al Insured-Sch#dWed Person Or,0%anozatton last page Form 80-02-2367(Rev 5-07) Endorsernant Page 2 INSURED: InfoSend,Inc. POLICY#: WCV5504862/CA-OR POLICY PERIOD: 02/01/2021 TO: 02/01/2022 WORKERS COMPENSATION AND EMPLOYEAS LIABILITY INSURANCE PO UCY WC 99 03 13 C (Td. 7-09, WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA We have the rigril w fiecovcH our prnents burn aRyone,iiiable for an mjury covered by thii policy We w riot enforce eto right against the,paTsan or organUaIbR narriiad in d1he Scheau4o. iThis agrearnera app,496 only IG the extent that you,perforrn Yvark t.wder a wrilloen cxvilrarn ld-w rewire q you to oblain thz agreement from us.r You rniust Maint2i.n payroH raccids accurateN, sQgregating lf1161 remunerabon of w.iur ornokwaes while aripgod In the work doscriN)d iri,the Schadule. The additiwiall promium tor this, andorsernom shaV be 0 Schedule Any pomon r.,,,r arganLration ffi,,;jt yci,u pc;,rforrr�a,wii',nk for thet it, Ladle Im an injury, covered by th4s polky, th2t prkg to The unjury has wrtlen contract reqOr4iq a waives of our right to recrivpr from 1,hern Person or Organization Job Description City of Clearwater 100 S.Myrtle Avenue Clearwater,FL 33758-0000 7his entorsement,changesthe pohrytin whj&,I 4--trade W art(iseifeilme an The daw Vssvev uniess came msestate e. (The,infamiatior be is r"[uirpd only whpa this,pridorsement is issued subseqwnt to ptepwadon of the paficy,p 'C9 03 13 C (Ed,7.09N