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CERTIFICATE OF LIABILITY INSURANCE (179)Client #: 2962 SDIENVI3 ACORQ. CERTIFICATE OF LIABILITY INSURANCE DATE (MMDD ; Y) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(ies) must be endorsed. 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). PRODUCER ISU Suncoast Insurance Assoc P.O. Box 22668 Tampa, FL 33622-2668 813 289 -5200 CONTACT NAME: PHONE FAX (/C No. Ext): 813 289 -5200 (A/C, No): 813 2894561 ADDRESS: PRODUCER CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC S INSURED S D I Environmental Services, Inc. 3903 Premier North Drive Tampa, FL 33618 INSURER A : Phoenix Insurance Company 25623 INSURER B : Travelers Indemnity Company 25658 INSURER C : Travelers Casualty and Surety C 19038 INSURER D : American Safety Indemnity Compa 25433 INSURER E : DAMAGE TO RENTED PREMISES (Ea occurrence) INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUCH r/VD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY OCCUR 6801960L23A 06/30/2011 06/30/2012, EACH OCCURRENCE $1,000,000 X DAMAGE TO RENTED PREMISES (Ea occurrence) $1, OOO , OOO CLAIMS -MADE X MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $2,000,000 POLICY PRO- JECT LOC $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BA2562L144 RECEIVED ' 2011 �r� 07/29/2011 , �� 07/29/2012 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ (Per eccRdentpAMAGE $ X X $ $ B X UMBRELLA LIAR EXCESS UAB X OCCUR CLAIMS -MADE � CU ,7 � _ , ��`"�� 0/2011 06/30/201Z EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 DEDUCTIBLE $ X RETENTION $ 10000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR /PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A UB7082Y944 09/01/2010 09/01/2011 X TO 3TATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE - $1,000,000 E . DISEASE - POLICY LIMIT $1,000,000 D Professional Liability ENVO1 06241006 09/02/2010 09/02/2011 $1,000,000 per claim $1,000,000 annl aggr. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space s required) Professional Liability is written on a Claims Made and Reported Basis. CERTIFICATE HOLDER CANCELLATION City of Clearwater Attn: City Clerk PO Box 4748 Clearwater, FL 33758 -4748 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE OLD ekt ACORD 25 (2009/09) 1 of 1 #S330303/M330300 @1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD KIM