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FLORIDA GAS AND ELECTRIC CORPORATION - BID 04-08 - CERTIFICATE OF LIABILITY INSURANCE (3),a?coRO?' CERTIFICATE OF LIABILITY INSURANCE - . DA°°"YYY' 122/28/28/2010 PRODUCER (727) 521-4253 FAX: (727) 527-9455 Northeast Underwriters Inc. 4790 lst Street North 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. Petersburg FL 33703 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Admiral Insurance Company - 24856 . Florida Gas & Electric Corp. INSURER B:AmeriCan States Insurance CO. 24732 8011 Land O' Lakes Boulevard INSURER C: Travelers Excess&Surplus. .. , . . - 29696 INSURER D: Bridgefield Casualty In 10335 Land O' Lakes FL 34638 INSURER E:Ohio Casualty 24074 . 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 0 0% NSRI3 TYPE OF INSURAtICR POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 0 ,000 X GOMMERDI?L GENERAL LIABILITY PREMISES _100,000 A CLAIMS MADE X OCCUR X06804055 1/1/2011 1/1/2012 MED EXP (Any one person $ 5,000 PERSONAL 6 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 7C POLICY PRO LOC AUT OMOBILE LIABILITY COMBINED SING I T X ANY AUTO LE L MI (Ea accident) $ 1,000,000 8 ALL OWNED AUTO$ 0=41908910 1/l/2011-. 1/1/2012 BODILY INJURY SCHEDULED AUTOS (Per perwn) X HIRED AUTOS REC E BODILY INJURY x NON-OWNED AUTOS . (Per accident) $ . PROPERTY DAMAGE Z ?O 1? (P er accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OFFICIAL n DS A° k; EA ACC OTHER THAN S ;4 S I. D r S`ImS. DE AUTO ONLY: qGG $ EXCESS I UM13RELLA LIABILITY EACH OCCURRENCE $ 4,000,000 X OCCUR 71 CLAIMS MADE AGGREGATE $ 4,000,000 Products/Completed $ 4,000,000 A DEDUCTIBLE 806804055 1/1/2011 1/1/2012 $ X RETENTION $ 10,00 $ WORKERSCOMPENW1 - .?_ AND EMPLOYERS' LIABILITY _ -- STATU- X OTH- Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE ? E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) 30-33253 1/1/2011 1/1/2012 E.L. DISEASE - EAEMPLOYE S 1,000,000 If.yas. describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT s 1,000,000 D OTHERInland Marine Rented/Leased Equip. 1154269302 8/31/2010 8/31/2011 Dod. 4;1,000 250,000 DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS It is agreed the Certificate Holder is named as Additional Insured's with respect to General Liability and Commercial Auto Coverage. I C n4L Ur_M City of Clearwater Attn: City Clerk PO Box 4748 Clearwater, FL 34618-4748 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED REPRESENTATIVE` {en Ki j owski/SMB -? =---- AUVKU Z5 (ZOOS/01) INS025 (200901) ©1988.2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORO® CERTIFICATE OF LIABILITY INSURANCE `6ft?' DATE (MM/DOIYYYY) 12/28/2010 PRODUCER (727) 521-4253 FAX: (727) 527-9455 Northeast Underwriters Inc. 4790 12t Street North 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. Petersburg FL 33703 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A Colony Insurance CompanyLines 39993 Florida Gas & Electric Corp. INSURER B' General Ins Co of America 24 732 8011 Land O' Lakes Boulevard INSURER C: Travelers Excess surplus 29696 INSURERD:Bridgefield Casualty In 10335 Land O' Lakes FL 34638 INSURER E: OhlO Casualty 24074 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 POLICY EFFECTIVE POLICY EXPIRATION MMID LIMITS .. E E RAL LIABILITY EACH OCCURRENCE S 1 000 000 ?G COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTF-:5- PREMI,SESjEa occurrence $ 100,000 A CLAIMS MADE X? OCCUR 1/1/2011 1/1/2012 K06804055 : MED EXP (Any one person) S $ 000 4 I PERSONAL & ADV INJURY S 1,000,000 E GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER'. PRODUCTS - COMP/OP AGG $ 2,000,000 PRO 7 LOC POLICY 1 jECT AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1 000 000 X ANY AUTO , , (Ea accident) B ALL OWNED AUTOS 14CC27743610 1/1/2010 1/1/2011 ^^ BODILY INJURY SCHEDULED AUT08 I $ (Per person) X HIRED AUTOS -„_•, BODILY INJURY $ X NON-OWNED AUTOS (Per accident) ' PROPERTY DAMAGE S (Per accident) GARAGE LIA6ILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG $ EXCESSIUMBREL LA LIABILITY EACH OCCURRENCE I s 4,000,000 X OCCUR CLAIMS MADE AGGREGATE 4,000,000 cts T/Completed Products s 4,000,000 _. L?Ee'dc,rtati= --- . X RETENTION $ 10 , 000 $ C WORKERS COMPENSATION ' WC STATU X OTR TORY AND EMPLOYERS LIACILITY YIN 1 ANY PROPRIEfOR/PARTNERJEXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) 00^33253 1/1/2011 1/1/2012 E-L. DISEASE - EA EMPLOYEES 1,000 000 IF yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1 000, 000 D OTHERIniand Marine 13M1154269302 .8/31/2010 8/31/2011 Ded. $1,000 250,000 Rented/Leased Egpip. DESCRIPTION OF OPERATIONS) LOCATIONS /VEHICLES I EXCLUSIONS ADDED 6Y ENDORSEMENT I SPECIAL PROVISIONS It is agreed the certificate Bolder is named as Additional Insured's with respect to General Liability and Commercial Auto Coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Clearwater DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN Attn : City Clerk NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL PO Box 4748 Clearwater, FL 34618-4748 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ki/SMB K Kij ? - * k^-^-°- en ows ?- :. s•- r - ACORD 25 (20_0.9_/0.1_) 0.1988-2009 ACORD CORPQRJ?ZION_._All rights_[eserved_ _ INS0261Ooov) The ACORD name and logo are reglstered marks of ACORD