Loading...
CERTIFICATE OF LIABILITY INSURANCE (98)City of Clearwater Certificate issued to City of Clearwater 02/04/2009 Slapin--Lieb & Co. 02/04/2009 City of Clearwater City Clerk PO Box 5748 Clearwater, FL 33758 RE: Certificate of Insurance Malcolm Pirnie, Inc. F -B Enclosed please find General Liability Certificate of Insurance evidencing coverage as of 02/01/09 which we trust should suffice your needs. If you have any questions or concerns, please feel free to call our office. Sincerely, Slapin Lieb & Co. CC: Anne Marie Conigliaro, MPI/WHI --- ... Brittany- Broughal,- MPI/WHX QCORQM CERTIFICATE OF LIABILITY INSURANCE 02/04/2009' PRODbCER (908)654-0300 FAX (908)654-0332 Slapin-Lieb & Co. 200 Sheffield Street 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. Suite 104 Mountainside, NJ 07092-2314 INSURERS AFFORDING COVERAGE NAIC # INSURED Malcolm Pirnie, Inc. INSURERA: Commerce & Industry Ins. Co. 19410 104 Corporate Park Drive INSURERS: American Intn'l Specialty Lines 26883 P. 0. Box 751 INSURER C: White Plains, NY 10602-0751 INSURER D: INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR ANY REQUIREMENT , 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' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE iMM/DDfYYi POLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 X COMMERCIAL GENERAL LIABILITY _-- --? - -'-- DAMAGETO-RENTED RE ,E?4EanrrjjrPnnP.) $ l , OOO OOO CLAIMS MADE 7 OCCUR MED EXP (Any one person) $ 2 5 , 000 A GL 1633241 02/01/2009 02/01/2010 PERSONAL & ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 21000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 21000,000 POLICY X JECOT X LOC AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT $ X ANY AUTO (Ea accident) 11000,000 ALL OWNED AUTOS BODILY INJURY $ (Per person) SCHEDULED AUTOS A X HIRED AUTOS CA 1633242 (AOS) 02/01/2009 02/01/2010 BODILY INJURY $ X NON-OWNED AUTOS (Per accident) CA 1633243 (MA) 02/01/2009 02/01/2010 PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 20, 000, 000 X OCCUR ? CLAIMS MADE - - . AGGREGATE $ 20, 000, 000 B PROU 1633244 02/01/ZO09 02/01/2010 $ DEDUCTIBLE $ - RETENTION $ $ WORKERS COMPENSATION AND - WC STATU- TORY LIMITS EMPLOYERS' LIABILITY '. _ } •• •` - E.L. EACH ACCIDENT $ - ANY PROPRIETOR/PARTNERIEXECUTIVE _ OFFICER/MEMBER EXCLUDED? E.L. DISEASE- EA EMPLOYEE $ If yes, describe under SPECIAL PROVISIONS below ?' ...' - -,l^t-??= =-•- - -?,r...,?--- • -•"- -' "'"- E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Re: All Operations of the Named Insured. ..See attached for details... `Except 10 days premium non-payment. PGdTIGI/`ATC LIr% n?o reNrFl I ATICIN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL City of Clearwater 30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, City Clerk BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY PO BOX S748 OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Clearwater, FL 33758 AUTHORIZED REPRESENTATIVE Richard Ra olla Exec. V.P. JL_ ACORD 25 (2001/08) ©ACORD CORPORATION 1988 City of Clearwater Certificate issued to City of Clearwater 02/04/2009 Sla in-Lieb & Co. NAMED INSURED: MALCOLM PIRNIE: Endorsements or Modifications as Applicable: General Liability (CG 0001 12107): 1/A, 2, 3, 4, 5, 6 Automobile (CA 0001 10/01: CT, LA, NH, VA): 1/B, 3, 4, 5, 6 Automobile (CA 0001 03/06: All Other States): 1/B, 3, 4, 5, 6 Excess Liability (71154 08/04): 7 ALL OPERATIONS OF THE NAMED INSURED. 1/A: If required by written contract or agreement, the City of Clearwater, FL is included as additional insured, but only for work performed by the Named Insured per CG2010 (07/04) and CG2037 (07/04) per copies attached. 1/B: If required by written contract or agreement, the City of Clearwater, FL is included as additional insured, per CA 2048 (02/99) per copy attached. 2: Excludes Professional Liability 3: If required by written contract or agreement, includes Waiver of Subrogation. 4. If required by written contract or agreement, this insurance is primary to the extent coverage is provided by the policy for the Certificate Holder as respects work performed for the Certificate Holder by the Named Insured. 5. If required by written contract or agreement, includes Contractual Liability 6. If required by written contract or agreement, includes Separation of Insureds 7. Policy is follow-form excess of General Liability and Automobile Liability policies except as respects per project and per location aggregate limits. POLICY NUMBER: GL1633241 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS _ SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE- Of Additional Insured Person(s) Name Or Or anization s : Locations Of Covered Operations Where required by written contract As required by written contract Information required to complete this Schedule, if not shown above will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by, 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s)- at the location(s) desig- nated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclu- sions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equip- ment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project CG 20 10 07 04 0 160 Properties, Inc., 2004 Page 1 of 1 ? POLICY NUMBER: GL1633241 COMMERCIAL GENERAL LIABILITY CG 20370704 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modes insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART ___ ...-...._.. _..- . _.._:...._.._-_ -..._ -._.- SCHEDULE Name Of Additional Insured Person(s) Or O anlzation s : Location And Description Of Completed Operations wired b written contract Information required to complete this Schedule, if not shown above, will be shown In the Declarations. Section 11- Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard". CG 20 37 07 04 0 ISO Properties, Inc., 2004 POLICY NUMBER: CA' +33242 & CA1633243 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM -unless With respect to coverage providedb y this endorsement, the provisions of the Coverage Form apply modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provi- sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indi- cated below. Endorsement Effective: 02/01/2008 Countersigned By: Named Insured: Malcolm Pirnie, Inc. Authorized Re resentative SCHEDULE Name of Person(s) or Organization(s): Where required by written contract (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form, CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 0 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 (2001/08)