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EAST WTF DEWATERING PUMP STATION REHABILITATION - 10-0031-UT - CERTIFICATE OF LIABILITY INSURANCE ACO CERTIFICATE OF LIABILITY INSURANCE 6/27/2012 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 INSURERl AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(iesJ 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(sJ. PRODUCER CONTACT Michele Crifasi NAME: HOE Stahl Herndon & Associates Inc. A1cN No,I (863)688-5495 FAX No: (863)688-4344 91 Lake Morton Drive EMAIL .michele.crifasi @stahlherndon.com P 0 BOX 3608 INSURER(S)AFFORDING COVERAGE NAIL# Lakeland FL 33802 INSURERA AmerlSUre Insurance Co INSURED INSURER American Guarantee & Liab RTD Construction Inc INSURERC: PO BOX 2439 INSURERD: INSURER E: Zephyrhills FL 33539-2439 INSURERF: COVERAGES CERTIFICATE NUMBER:12/13 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 TYPE OF INSURANCE INSR WVD POLICY NUMBER MMIDD YYYY MMIDD YYYY LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 100,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ee o.curronce $ A CLAIMS-MADE R OCCUR X CPP2083199 6/30/2012 6/30/2013 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000 Fx-] POLICYF—] PRO- LOC $ JECT AUTOMOBILE LIABILITY (Ea e cideDtSINGLE LIMIT 1,000,000 A X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED X 083197 6/30/2012 6/30/2013 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident PIP-Basic $ 10,000 X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 10,000,000 B EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DED I X I RETENTION$ 10,000 kUC926628802 6/30/2012 6/30/2013 $ A WORKERS COMPENSATION VVC STATU- OTH- AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER ANY PROPRIETORfPARTNERfEXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICERfMEMBER EXCLUDED? ❑ NfA 6/30/2012 6/30/2013 (Mandatory in 1 2083198 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 f yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) RE: East APCF Dewatering Pump Station Rehabilitation (10-0031-UT) City of Clearwater is listed as an additional insured with respects to the General liability, Auto & Umbrella (follow form) policies. Waiver of subrogation applies in favor of City of Clearwater on the General liability, Auto & Workers Compensation policies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Clearwater ACCORDANCE WITH THE POLICY PROVISIONS. 100 South Myrtle Avenue 3rd Floor AUTHORIZED REPRESENTATIVE Clearwater, FL 33756 Gerald Powell/CRIFAS ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005)01 The ACORD name and logo are registered marks of ACORD Acc• �® CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 6/28/2013 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 Stahl Associates Insurance Inc. 91 Lake Morton Drive P 0 Box 3608 Lakeland FL 33802 CONTACT Michele Crifasi NAME: PHONE (863) 688 -5495 I FAx (863)688 -4344 IA/C. No. Ertl: (AlC. Nol: E -MAIL michele .crifasi @stahlinsurance.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER AAmerisure Insurance Co LIABILITY COMMERCIAL GENERAL LIABILITY INSURED RTD Construction Inc PO Box 2439 Zephyrhills FL 33539 -2439 INSURER B :North River Insurance Co CPP20831990101 EGL0002137 Poll Aggregate/$1,000,000 Ea Poll Incid /$1,000,000 INSURER CMt. Hawley Insurance Co 6/30/2014 1/01/2014 INSURER D AGCS Marine Insurance Co $ 1,000,000 INSURER E : $ 100, 000 INSURERF: $ 5 , 000 IFICATE NUMBER:13 /14 all 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 SUBR WVD POLICY NUMBER POUCY EFF (MMIDDIYYYY) POUCY EXP (MM /DD/YYYYI LIMITS A C GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X Y CPP20831990101 EGL0002137 Poll Aggregate/$1,000,000 Ea Poll Incid /$1,000,000 6/30/2013 1/01/2013 6/30/2014 1/01/2014 EACH OCCURRENCE $ 1,000,000 PREMISES (Ea RENTED $ 100, 000 MED EXP (Any one person) $ 5 , 000 1 CLAIMS -MADE X OCCUR PERSONAL & ADV INJURY $ 1,000,000 X Contractual Liability GENERAL AGGREGATE $ 2,000,000 X Pollution Liability PRODUCTS - COMP /OP AGG $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 7 POLICY n JFST PI LOC $ A AUTOMOBILE X _ X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED NON -OWNED AUTOS X Y CA20831970105 6/30/2013 6/30/2014 (CEOMBB,IINEDtSINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ PIP -Basic $ 10,000 B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 5811019047 6/30/2013 6/30/2014 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 $ DED I X I RETENTON$ 10,000 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE Y / N OFFICER/MEMBEREXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A Y NC2083198 6/30/2013 6/30/2014 I TORY IMITS I rut E.L. EACH ACCIDENT $ 1,000,000 $ 1,000,000 $ 1,000,000 E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT D Rented /Leased equip (4X193043175 6/30/2013 6/30/2014 Limit w$5,000 Deductible 600,000 DESCRIPTION OF OPERATIONS ! LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: East APCF Dewatering Pump Station Rehabilitation (10- 0031 -UT) City of Clearwater is listed as an additional insured with respects to the Gene Umbrella (follow form) policies. Waiver of subrogation applies in favor of City' General liability, Auto & Workers Compensation policies. 1 Auto & `_on the ^ �? 7 ,I : " L 0 20 City of Clearwater 100 South Myrtle Avenue 3rd Floor Clearwater, FL 33756 I 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 Gerald Powell /CRIFAS _ � ACORD 25 (2010/05) INS025 (201005).01 -2010 ACORD CORPORA l ION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACG °® CERTIFICATE OF LIABILITY INSURANCE 6�2e�2o13 ") 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 Stahl & Associates Insurance Inc. 91 Lake Morton Drive P 0 Box 3608 Lakeland FL 33802 CONTACT Michele Crifasi PHONN Est): 688 -5495 I .Not: (863)688 -4344 E-MAIL michele.crifasi@stahlinsurance.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER AAmerisure Insurance Co LIABILITY COMMERCIAL GENERAL LIABILITY INSURED RTD Construction Inc PO Box 2439 Zephyrhills FL 33539 -2439 INSURER B North River Insurance Co INSURER C :Mt . Hawley Insurance Co •(MMIDD/YYYY) 6/30/2013 1/01/2013 INSURERDAGCS Marine Insurance Co EACH OCCURRENCE INSURER E : X INSURERF: $ � 000 COVERAGES CERTIFICATE NUMBER•13 /14 all 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 SUBR WVD POLICY NUMBER POLICY EFF POLICY EXP IMM /DD/YYYY) LIMITS A C GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY OCCUR X CPP20831990101 EGL0002137 Poll Aggregate/$1,000,000 Ea Poll Incid /$1,000,000 •(MMIDD/YYYY) 6/30/2013 1/01/2013 6/30/2014 1/01/2014 EACH OCCURRENCE $ 1 , 000, 000 X DAMAGE TO RENTED PREMISES PREMISES (Ea occurrence) $ � 000 CLAIMS -MADE X MED EXP (Any one person) $ 5, 000 X Contractual Liability PERSONAL & ADV INJURY $ 1,000,000 X Pollution Liability GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY n 7PR n LOC PRODUCTS - COMP /OP AGG $ 2,000,000 n $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS CA20831970105 6/30/2013 6/30/2014 COMBINED SINGLE LIMIT (Ea accident ) $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X _ X PROPERTY DAMAGE (Per accident) $ — PIP -Basic $ 10,000 B X UMBRELLA LIAB EXCESS UAB X OCCUR CLAIMS -MADE 5811019047 6/30/2013 6/30/2014 EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10, 000, 000 DED I X IRETENTON$ 10,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS Y.. N N/A WC2083198 6/30/2013 6/30/2014 I WC STATU- I 0TH - TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000,000 N E.L. DISEASE - EA EMPLOYEE\ $ 1,000,000 $ 1,000,000 below E.L. DISEASE - POLICY LIMIT D Rented /Leased equip t.DCI93043175 6/30/2013 6/30/2014 Limit w$5,000 Deductible 600,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) City of Clearwater is listed as an additional insured with respects to the Gen iii,liability if required by written contract. s'.., t�f' •W H s3 Co C7P1C1U CERTIFICATE HOLDER C City of Clearwater Public 100 S Myrtle Ave Clearwater, FL 33758 N° p t Y•r VUihYN P�y✓ l' X51 CANCELLATION 4i i L u,a 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 Gerald Powell /CRIFAS ACORD 25 (2010/05) INS025 (201005).01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Acl�°, R°i CERTIFICATE OF LIABILITY INSURANCE DATE ) 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 Stahl & Associates Insurance Inc. 91 Lake Morton Drive P 0 Box 3608 Lakeland FL 33802 CONTACT Michele Crifasi NAME: ?ANNo. Extr. (863) 688 -5495 I,No): (663) 608 -4344 E-MAIL ADDRESS: michele .crifasi @stahlinsurance.cora INSURER(S) AFFORDING COVERAGE NAIC # INSURER AAmerisure Insurance CO LIABILITY COMMERCIAL GENERAL LIABILITY INSURED RTD Construction Inc PO Box 2439 Zephyrhills FL 33539 -2439 INSURER B :North River Insurance Co CPP20831990101 EGL0002137 Poll Aggregate/$1,000,000 Ea Poll Incid/$1 , 000 , 000 INSURER C Mt . Hawley Insurance Co 6/30/2014 1/01/2014 INSURER D AGCS Marine Insurance Co $ 1,000,000 INSURER E : 100 000 $ r INSURERF: COVERAGES CERTIFICATE NUMBER:13 /14 all 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 SUBR WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP IMM /DD/YYYY) LIMITS A C GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X CPP20831990101 EGL0002137 Poll Aggregate/$1,000,000 Ea Poll Incid/$1 , 000 , 000 6/30/2013 1/01/2013 6/30/2014 1/01/2014 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) 100 000 $ r CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5, 000 X Contractual Liability PERSONAL & ADV INJURY $ 1,000,000 X Pollution Liability GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2 , 000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER 7 POLICY 1 1 PEo n LOC $ A AUTOMOBILE X _ X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ X _ SCHEDULED AUTOS NON -OWNED AUTOS CA20831970105 6/30/2013 6/30/2014 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ PIP -Basic $ 10,000 B X UMBRELLA LIAB EXCESS UAB X OCCUR CLAIMS -MADE 5811019047 6/30/2013 6/30/2014 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10, 000, 000 $ DED I X RETENTION$ 10,000 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? I - (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A PIC2083198 6/30/2013 6/30/2014 r I p YTAMITSI I0T LT E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1, 000,000 D Rented /Leased equip m:4193043175 6/30/2013 6/30/2014 Limit w$5,000 Deductible 600, 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space Is required) City of Clearwater is listed as an additional insured with respects to the General liability if required by written contract. CERTIFICATE HOLDER C ANCELLATION City of Clearwater 100 S Myrtle Ave Clearwater, FL 33758 SHOULD ANY OF THE ABOVIEstei/SCRISIBe PoLiCeStietANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Gerald Powell /CRIFAS �- ACORD 25 (2010/05) INS025 (moos) 01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AC•Rbw CERTIFICATE OF LIABILITY INSURANCE �� DATE(MM/DD/YYYY) 6/28/2013 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 Stahl & Associates Insurance Inc. 91 Lake Morton Drive P O Box 3608 Lakeland FL 33802 CONE: CONTACT Michele Crifasi PHONN Ems): (863) 688 -5495 ((A/C. Not: (863) 688-4344 E-MAIL michele.crifasi @stahlinsurance.com ADDRESS INSURER(S)AFFORDINGCOVERAGE NAIC# INSURER A :Amerisure Insurance Co LIABILITY COMMERCIAL GENERAL INSURED RTD Construction Inc PO Box 2439 Zephyrhills FL 33539 -2439 INSURER B :North River Insurance Co OCCUR PER: LOC INSURER C Mt. Hawley Insurance Co Y INSURERDAGCS Marine Insurance Co _(MM/DD/YYYY) 6/30/2013 1/01/2013 INSURER E : EACH OCCURRENCE INSURER F: X COVERAGES CERTIFICATE NUMBER:13 /14 all 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 = R WVD POUCY NUMBER POUCY EFF POLICY EXP (MM /DD/YYYY) LIMITS A C GENERAL LIABILITY COMMERCIAL GENERAL Liability o LIABILITY OCCUR PER: LOC X Y CPP20831990101 EGL0002137 Poll Aggregate/$1,000,000 Ea Poll Incid /$1, 000 , 000 _(MM/DD/YYYY) 6/30/2013 1/01/2013 6/30/2014 1/01/2014 EACH OCCURRENCE $ 1, 000, 000 X DAMAGE RENTED PREMISES ( (Ea occurrence) $ 100, 000 I CLAIMS -MADE X MED EXP (Any one person) $ 5,000 X Contractual Pollution AGGREGATE LIMIT Liability APPLIES I1 PERSONAL &ADV INJURY $ 1,000,000 X GENERAL AGGREGATE $ 2,000,000 GEN'L —1 PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY [ 1 I $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS -OWNED X Y CA20831970105 6/30/2013 6/30/2014 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 _ X BODILY INJURY (Per person) $ SCHEDULED AUTOS BODILY INJURY (Per accident) $ X — X NON PROPERTY DAMAGE (Per accident) $ _AUTOS PIP -Basic $ 10,000 B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 5811019047 6/30/2013 6/30/2014 EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10, 000, 000 DED I X I RETENTION $ 10,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS Y / N N/A y WC2083198 6/30/2013 6/30/2014 j I TORY IM U- 1 I T E.L. EACH ACCIDENT $ 1,000,000 N E.L. DISEASE - EA EMPLOYEE $ 1,000,000 below E.L. DISEASE - POLICY LIMIT $ 1, 000 , 000 D Rented /Leased equip t4X193043175 6/30/2013 6/30/2014 Limit w$5,000 Deductible 600 , 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) The City of Clearwater is listed as an additional insured with respects to the General liability if required by written contract and with respects to the Auto liability. Waiver of subrogation applies in favor of City of Clearwater on the General liability, Auto & Workers Compensa Jl'i CERTIFICATE HOLDER CANCELLATION City of Clearwater 100 S Myrtle Ave Clearwater, FL 33758 SHOULD ANY OF THE ABOVE coatibitikkiudiairaiailLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Gerald Powell /CRIFAS ACORD 25 (2010/05) INS025 (201005).01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AR °' CERTIFICATE OF LIABILITY INSURANCE sA2ei2o1Y3 ) 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 Stahl & Associates Insurance Inc. 91 Lake Morton Drive P 0 Box 3608 Lakeland FL 33802 CONTACT Michele Crifasi PHONN .Erztt: (863) 688 -5495 =No); No); (863)688 -4344 ADDRE SS: michele•crifasi @stahlinsurance.com ADDRE INSURER(S)AFFORDINGCOVERAGE NAIC# INsuRERA:Amerisure Insurance Co LIABILITY COMMERCIAL GENERAL LIABILITY INSURED RTD Construction Inc PO Box 2439 Zephyrhills FL 33539 -2439 INSURER B North River Insurance Co CPP20831990101 EGL0002137 Poll Aggregate/$1 , 000 , 000 Ea Poll Incid /$1, 000 , 000 INSURER C :Mt . Hawley Insurance Co 6/30/2014 1/01/2014 INSURER D AGCS Marine Insurance Co $ 1, 000, 000 INSURER E : $ 100, 000 INSURERF: I CLAIMS -MADE X OCCUR COVERAGES CERTIFICATE NUMBER:13 /14 all 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 SUBR WVD POLICY NUMBER POUCY EFF (MM /DD/YYYY) POUCY EXP IMM /DD/YYYY) LIMITS A C _7 A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X Y CPP20831990101 EGL0002137 Poll Aggregate/$1 , 000 , 000 Ea Poll Incid /$1, 000 , 000 6/30/2013 1/01/2013 6/30/2014 1/01/2014 EACH OCCURRENCE $ 1, 000, 000 DAMAGE aENTED PREMISES ( (Ea occurrence) $ 100, 000 I CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5, 000 X X GEN'L Contractual Liability Pollution Liability AGGREGATE LIMIT APPLIES PER: POLICY [ 1 jF ? n LOC PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 $ AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS X Y CA20831970105 6/30/2013 6/30/2014 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ PIP -Basic $ 10,000 B X UMBRELLA LIAB EXCESS UAB X OCCUR CLAIMS -MADE 5811019047 6/30/2013 6/30/2014 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED I X I RETENTION$ 10,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A Y 2083198 6/30/2013 6/30/2014 I TORY LATU- I I0T E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1, 000 , 000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 D Rented /Leased equip 14X193043175 6/30/2013 6/30/2014 Limit w$5,000 Deductible 600,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Project: Northeast Water Reclamation Facility Clarifiers 1 -4 Rehabilitation Bid# 10- 0023 -UT City of Clearwater is listed as an additional insured with respects to the General liability, Auto & Umbrella (follow form). Waiver of subrogation applies in favor of City of Clearwat neral liability, Auto & Workers Compensation policies. ;i.tlf- ,, JUL Oa 261 :s CERTIFICATE HOLDER CANCELLATION City of Clearwater 100 South Myrtle Avenue 3rd Floor Clearwater, FL 33756 C:-- !Ci ^'r L RECD e I S ,01\r, SHOULD � L D IN THE ED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Gerald Powell /CRIFAS ACORD 25 (2010/05) INS025 (201005).01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD