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2011 SIDEWALK CONTRACT - 11-0012-EN - CERTIFICATE OF LIABILITY INSURANCE OP ID: CW CERTIFICATE OF LIABILITY INSURANCE DAT 06101D1YYYY) oslo v12 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 policy(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 813-877-7799 NAMECONTACT ITALIANO INSURANCE SERVICES 813-877-8877 PHONE FAX P.O. Box 18425 AIC No Ext: AIC No: Tampa, FL 33679-8425 E-MAIL ADDRESS: PRODUCER CENT R-1 CUSTOMER ID#: INSURERS]AFFORDING COVERAGE NAIC# INSURED Central Florida Contractors INSURERA:Safeco Insurance Co of America 24740 Inc. &George Gomes INSURER B:SUM mltConsulting, Inc P.O. Box 3987 Seminole, FL 33775 INSURER C:The Ohio Casualty Group INSURER❑:The Ohio Casualty Group INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFYTHAT 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMIDDIYYYY MMIDDIYYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 D X COMMERCIAL GENERAL LIABILITY X BL053912671 05131/12 05/31/13 DAMAGE RENTED 100,000 PREMISES Ea occurrence $ � CLAIMS-MADE [XI OCCUR 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-COMPfOP AGG $ 2,000,000 X POLICY PRO LOC $ JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 A X ANY AUTO 01 C13460113 05131/12 05/31/13 (Ea accident} BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (Per accident) $ X NON-OWNED AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WC STATUS OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER B ANY PROPRIETORfPARTNERfEXECUTIVE YIN 83028647 03101/12 03/01/13 E.L.EACH ACCIDENT $ 500,000 OFFICERfMEMBER EXCLUDED? N I A (Mandatory in Ni E .DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 500,000 C The Ohio Casualty 53912671 05131/12 05/31/13 Equipment 25,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) City of Clearwater named as Additional Insured 2001 Sidewalk Contract #11-0012-EN CERTIFICATE HOLDER CANCELLATION CITYCLR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Clearwater/Engineering ACCORDANCE WITH THE POLICY PROVISIONS. Dept. 100 S. Myrtle Ave. Suite 220 AUTHORIZED REPRESENTATIVE Clearwater, FL 33756 QH) n ©1988-2009 ACORD-COOIIRPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD