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CERTIFICATE OF LIABILITY INSURANCE (34)AC �® �- CERTIFICATE OF LIABILITY INSURANCE DAT 0(6/ ///D20 3YYY) 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 100 North 18th Street 15th Floor Philadelphia PA 19103 USA CONTACT PHONEFAX (A/C. No. Ext): (866) 283-7122 (A/C. No.): (800) 363-0105 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED The Cigna Group 900 Cottage Grove Road Bloomfield CT 06002 USA INSURER A: Lexington Insurance Company 19437 INSURERS: INSURER C: INSURER D: INSURER E: INSURER F: CLAIMS -MADE ( I OCCUR COVERAGE CERTIFICATE NUMBER: 570100165892 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 INSRP TYPE OF INSURANCE INSD WYD POLICY NUMBER (MM/DD/YYY (MM/DD/YYYY) LIMITS _ COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS -MADE ( I OCCUR DAMAGE 1 O RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE PRO- I LOC JECT ' 1 —1 POLICY n 1 PRODUCTS - COMP/OP AGG OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY ( Per person) OWNED — SCHEDULED BODILY INJURY (Per accident) — AUTOS ONLY HIRED AUTOS — 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- ANY PROPRIETOR / PARTNER / EXECUTIVE Y / N N / A E.L. 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 Managed Care Liability 33085874 Managed Care E&0 SIR applies per policy terns 07/01/2023 & condi 07/01/2024 :ions 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 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Holder Identifier 570100165892 Certificate No 000000 02 02 003337 010373 P SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. city of Clearwater Attn: city Clerk PO Box 4748 Clearwater FL 33758-4748 USA AUTHORIZED REPRESENTATIVE n/% M p-97441 p Q . ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Holder Identifier 570100165892 Certificate No 000000 02 02 003337 010373 P '°` 1'® CERTIFICATE OF LIABILITY INSURANCE °ATo`6 0/°2023wY) 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(les) 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 100 North 18th Street 15th Floor Philadelphia PA 19103 USA CONTACT NAME: PHONE (866) 283-7122 (AIC. No. Ext): FAX No.): (800) 363-0105 EMAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIL # INSURED The Cigna Group 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-MADEri OCCUR REV 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 'CTR TYPE OF INSURANCE INSD UBR POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS-MADEri OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL& ADV INJURY GEN'LAGGREGATE AT LIMIT APPLIES PER: GENERAL AGGREGATE POLICY I I JECT f PRO- I LOC PRODUCTS - COMP/OP AGG OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY ( Per person) OWNED — SCHEDULED AUTOS BODILY INJURY (Per accident) — AUTOS ONLY HIRED AUTOS ONLY _ NON -OWNED AUTOS ONLY PROPERTY DAMAGE (Per accident) _ UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS -MADE AGGREGATE DED RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER STATUTE OTH- ER ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A E.L. EACH ACCIDENT (Mandatory in NH) If describe under E.L. DISEASE -EA EMPLOYEE yes, DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT A Managed Care Liability 33085874 managed Care E&O SIR applies per policy terns 07/01/2023 & condi-ions 07/01/2024 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 City of Clearwater Attn: City Clerk PO Box 4748 Clearwater FL 33758-4748 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. Holder Identifier : 570100165892 Certificate No AUTHORIZED REPRESENTATIVE t szl a W eJ f a ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD