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CERTIFICATE OF LIABILITY INSURANCE (7)ACG1Rb® CCP CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 10/1/2021 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 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 Ames & Gough 8300 Greensboro Dr. Suite 980 McLean VA 22102 CONTACT NAME: PHONE FAX (A/c. No. Ext): 703-827-2277 (A/C No): 703-827-2279 ADDRESS: admin©amesgough.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Continental Insurance Company A(XV) 35289 INSURED WADETRI-01 Wade Trim, Inc. (A Florida Corporation) 201 North Franklin Street Suite 1350 Tampa FL 33602 INSURER B : Continental Casualty Company (CNA) A, XV 20443 INSURER C : National Fire Insurance Company of Hartford A(XV) 20478 INSURER D : Valley Forge Insurance Company A(XV) 20508 INSURER E : Travelers Property Casualty Company of America 25674 INSURER F : X COVERAGES CERTIFICATE NUMBER: 1558037954 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 Y POLICY EXP ) LIMITS C X COMMERCIAL GENERAL LIABILITY 6050071562 OFFICIAL LEGISLATIVE OCT021 RECORDS SRVCS 0 I/ 22 AND DEPT. EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) ( $ 1,000,000 MED EXP (Any one person) $ 15,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE POLICY OTHER: X LIMIT APPLIES PRO- X JECT PER: LOC PRODUCTS -COMP/OP AGG $ 2,000,000 $ D AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS 6050071576 10/1/2021 10/1/2022 COMBINED SINGLE LIMIT (Ea accident) $ 1.000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 6050071612 10/1/2021 10/1/2022 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 $ DED X RETENTION $ 10 000 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYIPROPRIE ER EXRTNER E ECUTIVE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N N / A 6050071609 10/1/2021 10/1/2022 X ER P STATUTE 0TH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 E B Excess Umbrella Professional Liability EX -7S149981 AEH591913816 10/1/2021 10/1/2021 10/1/2022 10/1/2022 Occurrence/ Aggregate $10,000,000 Per Claim $5,000,000 Aggregate $10,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: North Greenwood Finding of Necessity Study City of Clearwater is included as additional insured with respect to General Liability, Automobile Liability and Umbrella Liability when required by written contract. General Liability, Automobile Liability and Umbrella Liability policies are primary and non-contributory over any existing insurance and limited to liability arising out of the operations of the named insured and when required by written contract. General Liability, Automobile Liability, and Workers Compensation policies include a waiver of subrogation in favor of the additional insured where permissible by state law and when required by written contract. 30 -day Notice of Cancellation will be issued for the General Liability, Automobile Liability, Workers Compensation, Umbrella Liability and Professional Liability policies in accordance with policy terms and conditions. CERTIFICATE HOLDER CANCELLATION City of Clearwater 600 Cleveland St Suite600AUT Clearwater FL 33755 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. EPRFSENTATIVE U• ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD t -A AMES & GOUGH 2021 RE: Requesting Emails for Certificate of Insurance Distribution or Notification to Discontinue Dear Certificate Holder: Based on the trends from 2020 and 2021, several companies are transitioning into remote work on a more permanent basis. In order to maintain a successful delivery system for certificates of insurance, Ames & Gough has decided the most efficient method to be email distribution upon renewal. To ensure a timely delivery, we request that you provide an email to be added to the certificate on file. Please either write on the attached certificate of insurance with your information, OR provide the holder name, address and any project or reference numbers directly below: Insured name: Certificate holder name: Project name or reference if applicable: Email address for future delivery: Certificate is no longer needed: Return whichever form you have completed via email or fax listed below. This information can also be found on the upper right-hand corner of the certificate. Email: admin@amesgough.com Fax: 703-827-2279 Please contact Allison Buytenhuys at 703-827-2277 or abuytenhuys@amesgough.com with any questions. Thank you. Sincerely, Ames & Gough 8300 Greensboro Drive, Suite 980, McLean, Virginia 22102 Telephone: (703) 827-2277 Facsimile: (703) 827-2279 E -Mail: info@amesgough.com