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CERTIFICATE OF LIABILITY INSURANCE (6)
Client#: 93777 GOVEBRAN DATE(MM/DD/YYYY) ACORD,. CERTIFICATE OF LIABILITY INSURANCE 12/30/2020 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 CONTA NAME:CT Patricia O'Neil Edgewood Partners Ins.Center f PHONE- 67__ --- 38 _ T FAx - -- -- I tA/cz rvol Exp) -- -..__ ____ �SAIc ��---- 2405 Satellite Blvd.,Ste.200 E-MAIL ----_ -- ADDREss patricia.oneil@epicbrokers.com Duluth,GA 30096 _.._-__ . _____ _._._...._ _._._ INSURERS)AFFORDING COVERAGE NAIC#. 770 232-0202 INSURER A:Hartford Fire Insurance Company 19682 INSURED INSURER B:Trumbull Insurance Company 27120 Bi1121Pay,LLC Hartford Casual Insurance Company 29424 9428 Baymeadows Rd.Ste 500 D INSURER : P v INSURER D:Indian Harbor Insurance Co 36940 Jacksonville,FL 32256 Freedom Specialty Insurance Company. 23787 INSURER E:FdS P tY 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 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. POLICIES. LTR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR IN R,WVD- POLICY NUMBER MMIDD/YYYY MM/DDIYYYY A X COMMERCIAL GENERAL LIABILITY X X 2000NEF2748 1612012020 06/20/2021'',EACH OCCURRENCE $1 000 000 ------------ ----- - ; G _ CLAIMS-MADE f X',OCCUR I. ;PREMDAMAISEES(Tp Ea occuRENTEDrrence) $300 000 MED EXP(Any one person) $10,000_ PERSONAL&ADV INJURY $1,000,000 GENLAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY JECOT n LOC ( PRODUCTS-COMP/OPAGG $2,000,000 C I—I OTHER: $ B AUTOMOBILE LIABILITY X X :2000NEF2748 0612012020 0612012021'CO(EaMBINED accident)SINGLE LIMIT $1,000,000 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 . $ Comp-1000 $Col11,000 C X UMBRELLA LIAB X iOCCUR X X 20XHUEF3101 6/20/2020 0612012021 EACH OCCURRENCE $5x000 OOO EXCESS LIAB y CLAIMS-MADE AGGREGATE $5 OOO OOO DED i X RETENTION$10000i $ A WORKERS COMPENSATION X 20WEAH8FBG 1/01/2021 01/01/2028 X ;PER OTH- AND EMPLOYERS'LIABILITY Y/NSI1Il ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1 OOO OOO OFFICER/MEMBER EXCLUDED? FN] 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 $1,000,000 D Professional Liab I X MTP903664302 6/20/2020 06120/2021; 5,000,000 D Cyber Liability X MTP903664302 6/20/2020 06/20/2021 5,000,000 E Excess D&O& XMF2009627 6/20/2020 06/20/20211 5,000,000 DESCRIPTION OF OPERATIONS./LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may beattached if more space is required) CERTIFICATE HOLDER CANCELLATION City Of Clearwater Attn: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Customer Service ACCORDANCE WITH THE POLICY PROVISIONS. 100 South Myrtle Ave Clearwater,FL 33756 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 #S2520147/M2520110 RRIC1