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TOWN POND FLOC REMOVAL PROJECT - 11-0008-EN - CERTIFICATE OF LIABILITY INSURANCE 168214 CERTIFICATE OF LIABILITY INSURANCE DAT6/16/D0/YYYY) 6/16/2012 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 CONTACT Jane Damon NAME: Commercial Lines—(972)588-6456 PHONE 972-588-6438 FAX 972-239-2919 A/C No Ext: A/C,No: Wells Fargo Insurance Services USA, Inc. E-MAIL wesar ADDRESS: jane.damon@welisfargo.com @ g 5151 Belt Line Road,Suite 200 INSURER(S)AFFORDING COVERAGE NAIC# Dallas,TX 75254 INSURERA: Chartis Specialty Insurance Company 26883 INSURED INSURER B Terra Renewal LLC INSURER C 1100 E Campbell Road INSURER D Suite 220 INSURER E Richardson,Texas 75081 INSURER F: COVERAGES CERTIFICATE NUMBER: 4476803 REVISION NUMBER: See below 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD MM/DD A GENERAL LIABILITY PROP4793877 05/03/2012 05/03/2013 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY General Liability& PREMISES Ea occurrence $ 300,000 CLAIMS-MADE OCCUR Pollution MED EXP(Any one person) $ 25,000 PERSONAL&ADV INJURY $ 1,000,000 X Pollution Liability GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X PECOT- LOC Pollution $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS APer accident A UMBRELLA LAB X OCCUR PROU4793903 05/03/2012 05/03/2013 EACH OCCURRENCE $ 2,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000 DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) The General Liability policy includes a blanket automatic additional insured endorsement that provides additional insured status to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status. As respects the coverage afforded the Additional Insured,this insurance is primary and non-contributory. CERTIFICATE HOLDER CANCELLATION City of Clearwater,FL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Municipal Services Building THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 100 S. Myrtle,3rd FL Clearwater, FL 33756 AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) (This certificate replaces certificate#4289557 issued on 5/3/2012)