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ATE AC"R"® CERTIFICATE OF LIABILITY INSURANCE D01/22/2018DIrYYY) 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: 411 E.Wisconsin Avenue PHONE FAX No): Suite 1300 E-MAIL Milwaukee,WI 53202 ADDRESS: Attn:JCI.Certrequest@marsh.com INSURERS AFFORDING COVERAGE NAIC# 011077--5-17-18* INSURER A:Old Republic Insurance Company 24147 INSURED INSURER B:ACE Property and Casualty Insurance Company 20699 Johnson Controls,Inc. Tyco International Holding S.a.r.l. INSURER C: SimplexGrinnell LP (see attached Acord 101) INSURER D 5757 North Green Bay Avenue INSURER E: Milwaukee,WI 53209 INSURER F: COVERAGES CERTIFICATE NUMBER: CHI-008600186-03 REVISION NUMBER: 1 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. ILTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MM/POLDD/YYYY CY EFF MMIDDY� LIMITS A X COMMERCIAL GENERAL LIABILITY MWZY310897 10/01/2017 10/01/2018 EACH OCCURRENCE $ 10,000,000 CLAIMS-MADE M OCCUR DAMAGE TO RENTED 10,000,000 PREMISES Ea occurrence $ X Contractual Liability MED EXP(Any one person) $ 50,000 X XCU Included PERSONAL&ADV INJURY $ 10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 30,000,000 X POLICY PRO ❑ LOC PRO- JECT PRODUCTS-COMP/OP AGG $ INC INGENAGG OTHER: $ A AUTOMOBILE LIABILITY MWTB310896(Excludes New Hamp) 10/01/2017 10/01/2018 COMBINED SINGLE LIMIT Ea ccident $ 7,500,000 a A X ANYAUTO MW713310898(Primary NH$250k) 10/01/2017 10/01/2018 BODILY INJURY(Per person) $ A OWNED AUTOS ONLY SCHEDULED MWTB310899(Excess NH$7.25mm) 10/01/2017 10/01/2018 BODILY INJURY(Per accident) $ AUTOS HIRED NON-OWNED Excess NH Auto is Follow Form PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Ito Primary NH Auto $ X UMBRELLA LIAB X OCCUR G28162509 002 10/01/2017 10/01/2018 EACH OCCURRENCE $ 5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED 7 RETENTION$ $ A WORKERS COMPENSATION MWC 310893 00(AOS-see page 2) 7 10/01/2018 X PER oTH- AND EMPLOYERS'LIABILITY STATUTE ER A ANYPROPRIETORIPARTNERIEXECUTIVE YIN N MWXS 310894(OH&WA) 10/01/2017 10I0112018 5,000,000 OFFICER/MEMBEREXCLUE N N/A E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 5,000,000 If yes,describe under 5,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) See attached Acord 101 for additional information including Additional Insured,Primary/Non-contributory,Waiver of Subrogation and Notice of Cancellation provisions. CERTIFICATE HOLDER CANCELLATION City of Zephyrhills SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 5335 Eighth Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Zephyrhills,FL 33540.4312 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee �Cauao► @ 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD