OVERLEA STREET AND STEVENSON DRIVE GRAVITY SEWER IMPROVEMENTS PROJECT - 03-0037-UT - CERTIFICATE OF LIABILITY INSURANCEACORD CERTIFICATE OF LIABILITY INSURANCE dPID $M DATE(MMIDD/YYYY)
sRwco-�. oi/21/11
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Fairehild, Addison & MeKone HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEf�D OR
P. O. Box 1030 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Brandon FL 33509-1030
Phone:813-681-4893 Fax:813-685-8610 INSURERSAFFORDINGCOVERAGE NAIC#
INSi1RED INSURERA: MOI1tCJOIiLeL'�7 Insurance
iNSUReRe: Travelers o�' Florida 02974
BRW Contracting � IIIC . INSURER C:
PO Box 1128 INSURER D:
Land O'Lakes FT� 34639
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.
LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE (MMIDDm) DATE (MMIDD/YY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1� OOO � OOO
A X X COMMERCIALGENERALLIABILITY BKW54366316 �Z�ZJr�11 �L�ZrJ�12 PREMISES(Eaoc urence) $ 1�0 �0��
CLAIMS MADE X� OCCUR MED EXP (Any one person) $ 1� � ���
PERSONALBADV INJURY $ 1� OOO � OOO
X Blanket Add � 1 =I1S GENERALAGGREGATE $ 2� 0�0 � ���
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2� OOO � OOO
POLICY X PRO-
JECT LOC
AUTOMOBILE LIABILITY
A X ANYAUTO BAW5�4366316 0].�25�11 O].�2rj�],2 � aaBcde �� INGLE LIM1T $ 1� �QO � Q�0
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUFOS (Per person)
X HIRED AUTOS
BODILY INJURY $
X NON-OWNEDAUTOS (Peraccident)
PROPERTY DAMAGE $
(Per accident)
GARAGELIABILITY AUTOONLY-EAACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR � CLAIMS MADE AGGREGATE $
$
DEDUCTIBLE �
RETENTION $ g
WORKERS COMPENSATION AND TORY LIMITS ER
EMPLOYERS' LIABILI'fY
ANY PROPRIETOR/PARTNERIEXECUTIVE
E.L EACH ACGDENT $
OFFICER/MEMBER EXCLUDED7 E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $
OTHER
B Equipment Floater 660-0024L266 O1/25/11 O1/25/12 Per Sched
Rental Eq 150,000
DESCRIPTION QF OPERATIONS / LOCATIONSI VEHICLES I EXCWSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Projeet: Overlea & Stevenson Dr Gravity Sewer Project
_ s_ �
C�rL�=�caie iioiaer is addiiionai insured wizn respect to general iiaiaility
including waiver of subrogation. Policies are primary.
Email: alice.eckman@myclearwater.com
CERTIFICATE HOLDER CANCELLATION
City of Clearwater
Attn: Alice Eckman
100 South Myrtle Ave, Ste 220
Clearwater FL 33756-5520
ACORD 25 (2001/08)
CITYCI.O I SHOULD ANY OF THE A80VE DESCF218�D POLICIES SE CANCELLED BEFORE THE EXPIRATIONI
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O DAYS WRITfEN
NOTICE TO THE CEF271�ICAT� HOL�ER 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
Fairchil
TION 1988