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CERTIFICATE OF LIABILITY INSURANCE (31)AC � ® (,,� CERTIFICATE OF LIABILITY INSURANCE DAT 06/23/2021(/DD YYY) 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. Philadelphia PA Office One Liberty Place 1650 Market Street suite 1000 Philadelphia PA 19103 USA CONTACT PHONE(866)FAX (A/C. No. Ext): 283-7122 (A/C. No.): (800) 363 0105 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Cigna Corporation Et Al 900 Cottage Grove Road Bloomfield CT 06002 USA INSURER A: Lexington Insurance Company 19437 INSURER B: INSURER C: INSURER D: INSURER E: INSURER F: CLAIMS -MADE n OCCUR COVERAGES CERTIFICATE NUMBER: 570087975542 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 INSR LTR TYPE OF INSURANCE ADDL INSD SOBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICYEXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS -MADE n OCCUR RECEIVED DAMAGE 1 0 RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GEN'POLICYEGREGATE LIMIT APPLIES PER:JUL 0 8 2021 GENERAL GCOMP/OPAGG I I PRO - I IJECT LOC PRODUCTS OTHER: AUTOMOBILE LIABILITY OFFICIAL RECORDS AND COMBINED SINGLE LIMIT ANY AUTO LEGISLATIVE SRVCS DEPT. BODILY INJURY eJURY(Per person) OWNED — SCHEDULED AUTOS BODILY INJURY (Per accident) AUTOS ONLY HIRED AUTOS NON -OWNED AUTOS ONLY PROPERTY DAMAGE (Per accident) — ONLY _, UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS -MADE AGGREGATE DED RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY PER STATUTE OTH- ER Y / N ANY PROPRIETOR / PARTNER / EXECUTIVEE.L. I I N / A EACH ACCIDENT OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE -EA EMPLOYEE If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT A ManageCare Liab 33085874 Managed Care E&O 07/01/2021 07/01/2022 Agg-Claims Made $50,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) see the attached list of Additional Named Insureds. CERTIFICATE HOLDER CANCELLATION Holder Identifier Certificate No : 570087975542 .rd 231 City of Clearwater Attn: City Clerk PO Box 4748 Clearwater FL 33758-4748 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD