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CERTIFICATE OF LIABILITY INSURANCE (970)® AC-ARD i , CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/ YYYY) 09/170 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 South, Inc. Franklin TN office 501 Corporate Centre Drive Suite 300 Franklin TN 37067 USA CONTACT PHONE (866) 283-7122 FAX 800-363-0105 (A/C. No. Ext): (A/C. No.): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Malcolm Pirnie, Inc. 44 South Broadway 12th Floor, Suite 1200 White Plains NY 10601 USA INSURER A: Hartford Fire Insurance Co. 19682 INSURER B: Hartford Casualty Insurance CO 29424 INSURER C: Hartford Accident & Indemnity Company 22357 INSURER D: Twin City Fire Insurance Company 29459 INSURER E: INSURER F: CLAIMS -MADE I X IOCCUR RAGES CERTIFICATE NUMBER: 570089185307 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 OF INSURANCE AD ADM INSD SUBR WVD POLICY NUMBER POLICY EFF MNUDD/YYYY) )UUCP EXP (MM/DD/YYY - LIMITS A X COMMERCIAL GENERAL LIABILITY 20ECS0L53T8 General Li ab SIR applies OFFICIAL inn EI er�-poicy terns SEP 2 8 2021 RECORDS}�� _'I r ,� /7021 ,� - & conditions AND�p 10/0172077 EACH OCCURRENCE $1,000,000 CLAIMS -MADE I X IOCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $1,000,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GENL AGGREGATE LIMIT APPLIES _ H POLICY i X I PE X OTHER: PER: LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 A AUTOMOBILE X — — LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY — —. SCHEDULED AUTOS NON -OWNED AUTOS ONLY 20 UEN OL f ��" �/ E SR � Auto (A05) WS �A.ADTI 10/01/2022 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY ( Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) B X —-- UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 20XHU0L5322 Umbrella 10/01/202110/01/2022 EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 DED X RETENTION 510 000 C D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBEREXCLUDED? n (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS belowE.L. N/A 20wN0L5323 AOS 20wPROL5321 WI 10/01/202110/01/2022 10/01/2021 10/01/2022 x PER STATUTE OTH- ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: All operations of the Named Insured. C'ty of Clearwater is included as Additional Insured as required by written contract, but limited to the operations of the Insured under said contract, with respect to the General Liability, Auto Liability and umbrella Liability policies. General Liability and Auto Liability evidenced herein is primary and non-contributory to other insurance available to the Additional Insured, but only to the extent required by written contract with the insured. A Waiver of Subrogation is granted in favor of Additional Insured as required by written contract but limited to the operations of the Insured under said contract, with respect to the General Liability, Auto Liability, umbrella Liability and workers' Compensation policies. CERTIFICATE HOLDER city of Clearwater Attn: City Clerk P.O. Box 4748 Clearwater FL 33758 USA CANCELLATION 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 5f,m+L..gra Holder Identifier : co (100 N- Certificate No ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD