CERTIFICATE OF LIABILITY INSURANCE (5) ATE
A�® CERTIFICATE OF LIABILITY INSURANCE D08/29/2022D/YYYY)
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 CONTACT
Marsh USA,Inc. NAME:
PHONE 1301 5th Avenue,Suite 1900 (A/C,No Ext): FAX
No):
Seattle,WA 98101 E-MAIL
Attn:Seattle.CertRequest@marsh.com/FAX 212-948-4326 ADDRESS:
INSURER(S)AFFORDING COVERAGE NAIC#
CN 102835048-stn4-GAWUE-22-23 INSURERA:Travelers Property Casualty Company Of America 25674
INSURED Itron,Inc. INSURER B:The Travelers Indemnity Company 25658
Attn:Yvonne Tanak INSURER C:XL Specialty Insurance Company 37885
2111 N.Molter Road INSURER D:AIG Specialty Insurance Company 26883
Liberty Lake,WA 99019-9469
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: SEA-003585595-16 REVISION NUMBER: 16
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 TypE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
LTR INSD WVD POLICYNUMBER MM/DD MM/DD
A X COMMERCIAL GENERAL LIABILITY HC2J-GLSA-9F337679-22 08/31/2022 08/31/2023 EACH OCCURRENCE $ 2,000,000
DAMAGE TO RENTE
CLAIMS-MADE 1XI OCCUR PREMISES(Ea occur ence) $ 1,000,000
MED EXP(Any one person) $ 10,000
PERSONAL&ADV INJURY $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 4,000,000
X POLICY❑ PRO [:] LOC PRODUCTS-COMP/OP AGG $ 4,000,000
JECT
OTHER: DEDUCTIBLE $ 250,000
B AUTOMOBILE LIABILITY CAP-lJ668762-22 08/31/2022 08/31/2023 COMEaBaccidentdenos NGLE LIMIT $ 2,000,000
X ANY AUTO BODILY INJURY(Per person) $
OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS ONLY AUTOS
X HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY Per accident
Comp/Coll Deductible $ 2,500
X UMBRELLA LAB X OCCUR US00086273LI22A 08/31/2022 08/31/2023 EACH OCCURRENCE $ 10,000,000
EXCESS LAB CLAIMS-MADE AGGREGATE $ 10,000,000
DED X RETENTION$10,000 $
A WORKERS COMPENSATION UB-8N023175(AOS) 10/01/2022 10/01/2023 X PER OTH-
AND EMPLOYERS'LIABILITY STATUTE ER
A Y/N UB-8N033212(WI,MA,NE) 10/01/2022 10/01/2023 1,000,000
ANYPROPRIETOR/PARTN ER/EXECUTIVE E.L.EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? F N/A
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
If yes,describe under 1,000,000
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
D Errors&Omissions 01-476-73-48 08/31/2022 08/31/2023 Limit: 2,000,000
SIR: $1,000,000 2,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
Employee Dishonesty coverage is included in the Crime coverage.Errors and Omissions coverage includes Cyber coverage.
City of Clearwater,Florida is included as additional insured where required by written contract with respect to General Liability and Auto Liability.
CERTIFICATE HOLDER CANCELLATION
City of Clearwater,Florida SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
100 S Myrtle Avenue THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Clearwater,FL 33756 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
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ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD