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CERTIFICATE OF LIABILITY INSURANCE (1072)A�RO� CERTIFICATE OF LIABILITY INSURANCE MMID O/YYVY) D/Y OAT0"5r,021 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 Aon Risk services central, Inc. Minneapolis MN Office CONTACT NAME: (AC. No. EXO: PHONE (B66) 293-7122 FARC Mo (600) 363-0105 E4MUL ADDRESS: 5600 west 83rd street 8200 Tower, suite 1100 INSURER(S)AFFORDING COVERAGE NAICa Minneapolis MN 55437 USA INSURED INSURER A: Mitsui Sumitomo Insurance USA Inc. 22551 Yarlmar America Corporation 101 International Parkway Adairsville GA 30103 USA INSURER B: INSURER C: INSURER D: GENERALAGGREGATE $2,000,000 INSURER E: A INSURER F: COVERAGES CERTIFICATE NUMBER: 570086896019 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. Limits shown are as requested TR 1115191 TYPE OF INSURANCE Vol POLICY NUMBER ODIYy LIMITS X COYMEflCIAL GENERAL VABILRY CLAIMS -MADE X❑OCCUR P EACH OCCURRENCE $1,000,000 pREMI6E9 Ea occu mce $300,000 MED EXP(my mw m--) $10,000 PERSONAL a ADV INJURY $1,000,000 GENLAGGREGATE LIMITAPPU" PER: % POLICY ❑ PERO- 7 LOC OTHER: GENERALAGGREGATE $2,000,000 PRODUCTS AGG $2,000,000 A AUTOMOBILE LIABILITY % ANYAUTO OWNED SCHEDULED AUTOS ONLYAUTOS HIREDAUTOS NON -OWNED ONLY AUTOS ONLY BVR8402337 04/01/202104/01/2022 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) BODILY INJURY(Per person) BODILY INJURY (Pe, ecclasn) PROPERTY DAMAGE Per ecoldeml UMBRELLALMB EXCESS LIAR OCCUR CLAIMSA ADE EACH OCCURRENCE AGGREGATE DEDI IRETENTION WORKERS COMPENSATION ANDPER EMPLOYEAT UASILRY Y'N ANY PROPRIETOR I PARTNER EXECUTIVE OFFICERMEMSEREXCLUOEOP ❑NIA (Mar ly M 106 x yyeeaa describe urdw DE6GRIPTION OF OPERATIONS below 6TATUTE I 1OTH- E.L EACH ACCIDENT E.L DISEASE -EA EMPLOYEE E.L. DGEASE-POLICY LBM DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACOR0101, Additiontl Remarks Schedule. may W aneched K more apace city of Clearwater is included as Additional Insured in accordance with the policy is mmaiPI) Fprovi sgsDsL�of xhe` Geftera) 1,ia�ity policy. CJ �a..l C 111 y APR 14 2021 CERTIFICATE HOLDER CANCELLATION I C16ill, Of Clearwater II iz city of Clearwater 100 South Myrtle Avenue, Suite 220 Clearwater FL 33756 USA SHOULD ANY OF THE ABO EXPIRATION DATE THEREOF. POLICY PROVISIONS. AUiHORREO REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD MSC#17766 Aon Risk Services PO Box 1447 Lincolnshire; IL 60069 MOG2021 0000102401 11"IIIIIllhllIII III.IuIIIIll, Ill IIuIIII Ill [Ill 1III1IIIulu11 City of Clearwater 100 South Myrtle•Avenue, Suite 220 Clearwater FL 33756