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CERTIFICATE OF LIABILITY INSURANCE (569)/ A� " CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 3/23/2021 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: 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 Wallace, Welch & Willingham P.O. Box 33020 Petersburg FL 33733 CONTACT NAME: Certificates/Commercial Lines PHONE FAX AIC No Ext): 727-522-7777 A/C No): 727-521-2902 E-MSt. ADDRESS: certificates@w3ins.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Continental Insurance Company/CNA 35289 3/16/2021 INSURED CUM&F-1 Cumbey & Fair Inc 2463 Enterprise Rd INSURER B: Argonaut Insurance Company 19801 INSURERC: Transportation Ins. Co. 20494 INSURER D: Valley Fore Insurance Company/CNA 20508 Clearwater FL 33763 INSURER E: Brid efield Casualty Ins. Co. INSURER F, $ 100,000 COVERAGES CERTIFICATE NUMBER: 925835483 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DDIYYYY LIMITS C X COMMERCIAL GENERAL LIABILITY 2086949437 3/16/2021 3/16/2022 EACH OCCURRENCE $1,000,000 F —V� CLAIMS -MADE OCCUR DAMAGE TO PREM SES a o_cur RENTED nce $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 GEN'L POLICY jE LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: D AUTOMOBILE LIABILITY 2088208783 3/16/2021 3/16/2022 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ X HIRED�( NON -OWNED AUTOS ONLY AUTOS ONLY A X UMBRELLA LIAB X OCCUR 2086949471 3/16/2021 3/16/2022 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 EXCESS LIAB CLAIMS -MADE DED X RETENTION $ In nnn $ E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N 83054368 3/16/2021 3/16/2022 X PER-----------7-7-0TH- STATUTE I I ER ANYPROPRIETOR/PARTNER/EXECUTIVE❑ N E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? NIA E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 B Professional/Pollution Liabilty 121AE000350502 3/16/2021 3/16/2022 Each claim $2,000,000 Claims made - retro date 2/19/16 Aggregate $2,000,000 Deductible $25,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RFQ #26-19 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 the terms and conditions and exclusions of the policy. A Waiver of Subrogation in favor of certificate holder applies to General Liability, Auto, and Workers Compensation if required by written contract. CERTIFICATE HOLDER CANCELLATION ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 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 100 S. Myrtle Avenue, #220 Clearwater FL 33756 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD