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CERTIFICATE OF LIABILITY INSURANCE (69)ACORQ CERTIFICATE OF LIABILITY INSURANCE i2/10/2200 PRODUCER (651)644-7200 FAX (651)644-9137 Lee F. Murphy, Inc. 2515 Wabash Ave. #300 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. St. Paul, MN 55114-2000 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Am Internat' 1 Specialty Lines Ins . (BISA) Ceres Environmental Services, Inc. ETAL INSURERS: Commerce and Industry Insurance C o. (BISA) 3825 85th Avenue North, Suite #101 INSURERc: Hanover Insurance company Brooklyn Park, MN 55443 INSURER D: INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' NSRn TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE flMIDDIYY POLICY EXPIRATION XL_ LIMITS GENERAL LIABILITY PROP 7076886 06/03/2008 06/03/2009 EACH OCCURRENCE $ 11000,00 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100 , 000 CLAIMS MADE a OCCUR MED EXP (Any one person) $ 10,000 A cl Pol 1 -Occur PERSONAL & ADV INJURY $ 1 1 000 , 000 r of Claims Made : RETO DATE IS 4-15 -99 GENERAL AGGREGATE $ 2 , 000 , 00 LIMIT APPLIES PER: LAGGREGATE GENN PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X JECOT LOC AUT OMOBILE LIABILITY CA 7076888 06/03/2008 06/03/2009 COMBINED SINGLE LIMIT $ X ANY AUTO (Ea accident) 1,000,000 ALL OWNED AUTOS _ ?. .__. BODILY INJURY SCHEDULED AUTOS HIR ED PHYSICAL DAMAGE A (Per person) $ X HIRED AUTOS DE DUCTIBLE $1,000/$1,00 PD, ?? - IBODILYINJURY $ X NON-OWNED AUTOS (Per accident) I _ ? L ??•? PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY O F F CI!`, i _ ;_..'?`? IJ AUTO ONLY - EA ACCIDENT $ ANY AUTO _ LEG ISLA f W E SRVCS j 3c- PT OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY PROU 7076887 06/03/2008 06/03/2009 EACH OCCURRENCE $ 10, 000, 00 _j C] CLAIMS MADE AGGREGATE $ 10,000,000 A $ DEDUCTIBLE $ Fx RETENTION $ 10,000 $ WORKERS COMPENSATION AND WC 531-69-14 12/08/2008 12/08/2009 X wcsTATU- 0TH- EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 1,000,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYE $ 1,000,000 r ib d If d escr e un e es, SF?ECfAL?ROV18fON5below ------ --POLICY-LIMIT- O C OTHER rntractors Scheduled L uipment Coverage LIM RHX 8406400 SED/RENTED EQUIPMENT $500,000/DED $1,000 08/18/2008 08/18/2009 Limit $4,157,173. Deductible $10,000. DESCRIPTI N OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS City of Clearwater Florida is listed as Additional Insured under the General Liability Policy ith regard to: RFP #37-07, Disaster Debris Removal and Disposal Services. ^-2-^A- uAl nee rALM 11=1 I ATInL1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL City of Clearwater, Florida 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Attn: City Clerk BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY BOX 4748 P O OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. . . Clearwater, FL 33758-4748 AUTHORIZED REPRESENTATIVE jN ]? I ( ? / l L J \ Rodney Skr ek LAH ACORD 25 (2001108) ©ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001108)