CERTIFICATE OF LIABILITY INSURANCE (32)CERTIFICATE OF LIABILITY INSURANCE
DATE(MM)DDIYYYY)
04/02/2021
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 1-813-229-8021CONTACT T Marshall
NAME a0�y
M. E. Wilson Company, LLC PHONE _ _ pt �_apA_iam FAX... Rt q_Sl ilo-e9gS
300 W. Platt St.
Ste 200
Tampa, FL 33606
INSURED
MOSI
Museum of Science and Industry, Inc.
4801 E. Fowler Avenue
r'amna. FL 33617
A; ALLIANCB OF NONPROFITS FOR IMS RRG
rnVPRAGFS rFRTIFICATF NIHARFR- 61897750 RFVISICIN NIIMRFR-
10023
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 ADDLITYPE OF INSURANCE IVSD U 0 POLICYNUMBER Mffi ICY EFF MWDDDYEXP LIMITS
LTR
A
X COMMERCIAL GENERAL LIABILITY
AUTHORIZED REPRESENTATIVE
202135882UMB 04/05/21 04/05/22
EACH OCCURRENCE $ 1,000,000
USA
CLAIMS -MADE 1XI OCCUR
DAMAGET
PREMSES EaEN=TE0 nce $ 500,000
MED EXP (Any one pension) $ 20,000
PERSONAL S ADV INJURY S 1,000,000
GENL AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE S 3,000,000
POLICY ❑ PRO-
JECT LOC
PRODUCTS -COMPIOP AGG $ 3,000,000
$
OTHER:
A
AUTOMOBLELIABIUTY
202135882
04/05/21
04/05/22
COMBINED SINGLE UNIT $
Ee accident 1,000,000
BODILY INJURY (Per person) $
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
IX
BODILY INJURY(Per accident) $
PROPERTVDAMAGE $
Per accident
X HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
S
A
UMBRELLA LIAB
X
OCCUR
202135882UMB
04/05/21
04/15/22
EACH OCCURRENCE S 4,000,000
AGGREGATE $ 4,000,000
X
EXCESS UAB
CLAIMS -MADE
DED I X I RETENTIONS 10,000
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETORIPARTNEFVEXECUTNE
OFFICER/MEMBER EXCLUDED?
NIA
PER
STATUTE ER
E.L. EACH ACCIDENL $
(Mandatory in NH)
E.L. DISEASE -EA EMPLOYEE $
N yes, describe under
DESCRIPTION OF OPERATIONS bele.
E.L. DISEASE - POLICY LIMIT $
A Improper Sexual Conduct
202135882
04/05/21
04/05/22 Aggregate Limit 1,000,000
A Professional Liab
202135882
04/05/21
04/05/22 Aggregate 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may W attached If mora space is required)
The certificate holder is an additional insured with respect to General Liability as required by direct written
contract or agreement.
CFRTIFICATF wni OFR CANCELLATION
U 7988-2UTO ALJUKU L:UKYUKA I IUN. Au rignTS reserVec.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
tmarshall
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Clearwater
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
P O Box 4748
AUTHORIZED REPRESENTATIVE
Clearwater, FL 33758
USA
�
U 7988-2UTO ALJUKU L:UKYUKA I IUN. Au rignTS reserVec.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
tmarshall