CERTIFICATE OF LIABILITY INSURANCE (212)Client#: 2962 SDIENVI3
ACORDTM CERTIFICATE OF LIABILITY INSURANCE °s;2;;20�2 "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 �s 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 NAME:
ISU Suncoast Insurance Assoc PHONE g13 289-5200 F'°'X
P.O. Box 22668 �A L° EXt : ac, No :$13 289-4561
ADDRESS:
Tampa, FL 33622-2668
CUSTOMER ID #:
813 289-5200
INSURED
S D I Environmental Services, Inc.
3816 W Linebaugh Avenue #200
Tampa, FL 33618
INSURER(S) AFFORDING COVERAGE
iNSUReRa: Endurance American Specialty In
iNSUReR s: Travelers Indemnity Company
�NSUReRC: Travelers Casualty 8 Surety Co
�NSUReR o: Charter Oak Fire Insurance Comp
INSURER E :
NAIC #
41718
194
615
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.
TYPE OF INSURANCE DDL UBR POLICY EFF POLICY EXP LIMITS
LTR POLICY NUMBER MM/DD MM/DD
A GENERAL LIABILITY ECC101013105 09/02/2011 09/02/201 EACH OCCURRENCE $� ��0 00�
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED
PREMISES Ea occurrence $5��00�
CLAIMS-MADE � OCCUR MED EXP (Any one person) $rJ��O�
X BI/PD Ded:5�000 PERSONAL & ADV INJURY $� �OOO�OOO
GENERALAGGREGATE $Z,OOO,OOO
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $� ,OOO,OOO
POLICY PR� LOC $
p AUTOMOBILELIABILITY BA2562L1�C� I9IZO�2 O%I29IZO�3 COMBINEDSINGLELIMIT
ANY AUTO C �Ea accident) $1 000 000
BODILY INJURY (Per person) $
ALL OWNED AUTOS
SCHEDULED AUTOS JUN 2 8 201 BODILY INJURY (Per accident) $
PROPERTY DAMAGE $
X HIRED AUTOS (Per accident)
X NON-OWNED AUTOS O�FIC��1L (YG:JtiJR✓ ry,� $
R DEP7 $
B �( UMBRELLA LIAB X OCCUR CUP6416Y764 06/30/2012 06/30/201 EACH OCCURRENCE $� ��0 ��0
EXCESS LIAB CLAIMS-MADE AGGREGATE $'I OOO OOO
DEDUCTIBLE $
X RETENTION � OOOO $
C WORKERSCOMPENSATION UB7082Y944 09/01/2011 09/01/201 X WCSTATU- OTH-
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVEY� N E.L. EACH ACCIDENT $� �OOO�OOO
OFFICER/MEMBER EXCLUDED? ❑ N/A
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $� �0�0�000
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $�,OOO�OOO
A Professional ECC107013105 09/02/2011 09/02/201 $1,000,000 per claim
Liabili $2,000,000 annl a r.
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (AtWch ACORD 101, Additlonal Remarks Schedule, if more space is required)
Professional Liability coverage is written on a claims-made and reported basis.
City of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Attn: Ci Clerk THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
tY ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 4748
Clearwater, FL 33758-4748 AUTHORIZED REPRESENTATIVE
oL� � Ot9--oc.A ,�t,r-----
� 1988-2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S391954/M391950 AGB