Loading...
CERTIFICATE OF LIABILITY INSURANCE (1133)A�o,Rp® CERTIFICATE OF LIABILITY INSURANCE DATEO(9 3/2024YYY) 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 South, Inc. Franklin TN office 501 Corporate Centre Drive Suite 300 Franklin TN 37067 USA CONTACT NAME: 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: Twin City Fire insurance Company 29459 INSURER B: Hartford Fire Insurance Co. 19682 INSURERC: Hartford Casualty Insurance Co 29424 INSURER D: Endurance American Insurance Company 10641 INSURER E: Hartford Accident & Indemnity Company 22357 INSURER F: CLAIMS -MADE CERTIFICATE NUMBER: 570108349607 • 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY -EFF (MM/DD/YYY POLICYEXP MM/DD/YYYY1, LIMITS A X COMMERCIAL GENERAL LIABILITY 20ECSOL5318 10/01/2024 10/01/21)25- EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR General Liability SIR applies terns & DAMAGE TO REN rED PREMISES(Eaoccurrence) $1,000,000 per policy conditions MED EXP (My one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY mPRO-X JECT LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: B AUTOMOBILE LIABILITY 20 UEN OL5319 Auto (AOS) 10/01/2024 10/01/2025 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X 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) C X UMBRELLALIAB X OCCUR 20xHu0L5322 10/01/2024 10/01/2025 EACH OCCURRENCE $1,000,000 EXCESS LIAB — CLAIMS -MADE umbrella AGGREGATE $1,000,000 DED X RETENTION $10 000 — E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N 2OWNOL5323 - AOS 10[01/2024 10/01/2025PER X STATUTE OTH- ER A ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? N N/A 20wBROL5321 10/01/2024 10/01/202$ E.L. EACH ACCIDENT $1,000,000 (Mandatory in NH) If yes, describe under MA, WI E.L. DISEASE -EA EMPLOYEE $1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more apace is required) Re: All Operations of the Named Insured. City 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 CANCELLATION Holder Identifier Certificate No : 570108349607 City of Clearwater Attn: City Clerk P.O. Box 4748 Clearwater FL 33758 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 C.XF� i`% l:�rAr� �JiLs<t1U1C01 VK�I� eJ � ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 03 03 004791 014947 P Certificate No: 570108349607 City of Clearwater Attn: City Clerk P.O. Box 4748 Clearwater FL 33758 USA Tuesday, September 24, 2024 SON To whom it may concern: Following a concentrated effort to reduce our environmental footprint and provide timely certificate delivery, Aon will begin delivering our Certificates of Insurance electronically in PDF format. Please utilize one of the following methods to ensure you will receive the electronic copy of your Certificate (Certificate No: 570108349607) for future renewals: - Visit aon.com/e-cert; or - Utilize the QR Code below to enter/validate your information. If your email address has changed or will be changing in the future, or you no longer require this certificate, please let us know using one of the methods above. Thank you for your cooperation and willingness to help us reduce our impact to the environment. Aon Risk Services 5801 Postal Road PO Box 818037 Cleveland, Ohio 44181-9600