Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
WATER TREATMENT PLANTS 1 AND 3 WELLFIELD EXPANSION PHASE 1 - WELL INSTALLATION - PROJECT NO. 07-0037-UT - CERTIFICATE OF LIABILITY INSURANCE (2)
ACORD DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 07/29/2010 TM. PRODUCERPhone: (813) 988-1234 Fax: 813-988-0989 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ASSOCIATES AGENCY, INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE PO BOX 16190 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 11470 N. 53RD ST. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. TEMPLE TERRACE FL 33687 INSURERS AFFORDING COVERAGENAIC # Agency Lic#: R001766 OWNERS INSURANCE CO.32700 INSURER A: INSURED SOUTHEAST DRILLING SERVICES INC. AUTO OWNERS INSURANCE CO.18988 INSURER B: P.O. BOX 2764 INSURER C: LUTZ FL 33548 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. INSRADD'L POLICY EFFECTIVEPOLICY EXPIRATION TYPE OF INSURANCEPOLICY NUMBERLIMITS LTRINSRD DATE (MM/DD/YY)DATE (MM/DD/YY) 1,000,000 GENERAL LIABILITY 2070963207/01/1007/01/11$ EACH OCCURRENCE X DAMAGE TO RENTED 300,000 COMMERCIAL GENERAL LIABILITY$ PREMISES (Ea occurence) X MED. EXP (Any one person)10,000 CLAIMS MADEOCCUR$ A1,000,000 PERSONAL & ADV INJURY$ 1,000,000 GENERAL AGGREGATE$ GEN'L AGGREGATE LIMIT APPLIES PER:1,000,000 PRODUCTS-COMP/OP AGG.$ PRO- POLICYLOC JECT AUTOMOBILE LIABILITY 414299490007/01/1007/01/11 COMBINED SINGLE LIMIT 1,000,000 $ (Ea accident) X ANY AUTO ALL OWNED AUTOSBODILY INJURY (Per person) $ SCHEDULED AUTOS B X HIRED AUTOS BODILY INJURY $ (Per accident) X NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY $ AUTO ONLY - EA ACCIDENT ANY AUTO$ OTHER THANEA ACC AUTO ONLY: AGG$ 5,000,000 434623170107/01/1007/01/11 EACH OCCURRENCE$ EXCESS / UMBRELLA LIABILITY X 5,000,000 OCCURCLAIMS MADEAGGREGATE$ B $ $ DEDUCTIBLE 0 RETENTION$ $ WC STATU- X WORKERS COMPENSATION AND 2064073807/01/1007/01/11 OTHER TORY LIMITS EMPLOYERS' LIABILITY 500,000 E.L. EACH ACCIDENT$ B ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? 500,000 E.L. DISEASE-EA EMPLOYEE$ If yes, describe under 500,000 E.L. DISEASE-POLICY LIMIT$ SPECIAL PROVISIONS below OTHER: DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS Project: WTP 1 & 3 Wellfield Expansion Phase I The City of Clearwater Project # 07-0037-UT. The City of Clearwater and any others required by contract are additional insureds under the general liability and auto liability policies. All policies provide a waiver of subrogation in favor of The City of Clearwater. CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of Clearwater EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS 100 S. Myrtle Avenue, suite #221 WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO Clearwater, Fl 33756 DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, IT'S AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Attention:Mike Rogers ACORD 25 (2001/08)Certificate #203476© ACORD CORPORATION 1988