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CERTIFICATE OF LIABILITY INSURANCE (220) ACC>ROP CERTIFICATE OF LIABILITY INSURANCE - DATE(fJYfd7rC�btYS'YY)/14;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 terse 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 ONTACT Ni chae7.a Bernier d NAME: George Eidson Agency Inc dba Eidson PHONEichaele dsonisassranoe.c Not; G Ss4 Insurance s E (407)849-0333 l407la2s- , E.C. Eox 540209 E•N1AIL , I A�cRess: i 2807 Edgewater Dr �a�o� R 11 0 014 1 7 6 Orlanr?o F 32854 _ INSUS A FOROIAtCs CO}dERAGE NAIC# PdSUREL IrsSURRA Atrerican Casualty Ccsu an 20427 NSUR€RB Auto-Owl ers Insurance 8988 Reiss Environmental, Inc. & Reiss Engineering, INSURERC:Continental Casualt 044 L116 Spring Vitas Pt, INSURERD13rid efielcd. Em 21oyers Ins Co 10701 INSURER�: Winter Springs EL 32708 NSURER F COVERAGES CERTIFICATE 1UMBER:12/13 GL; Auto, WC REVISION DUMBER: 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, EvCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLA'rMS, POLICY EFF POLICY EXP _ LTR, TYPE OF INSItRANCE _ P $ PO, ry NID�RHER ENlC7C7r'Y!fYY PA IC7[1'YYYY:. LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1..000,,000 COMMERCIAL GENERAL LIABILITY � i A E h _.. PREMISES Eac w_ re war �: 300,000 5195557 9/21/ 012 /21J2p13 A CLAIMS-MADE OCCUR I NEb€hP a y one person) g 10,000 2 PERSONAL&ACV INJURY S 11000,000 ®? GENERAL AGGREGATE $ 21000,000 �GEN'L AG GREGATE LIMIT APP LIFEE PER j PRCDU,'TS COMPIOP AGG 1$ 21000,000 POLIC't 1 RR� LOC ` F.a9S{g,nTiCdE§ILE LIABILITY CONIB8 NED SINGLE LIMIT rp a s ident} $ 1,0 0 0,0€I 0 ANu t BuDILYIN�UY;Peras�4723 1 �,ALL GN,fNIED AUTOS ;— _9r 2ei2 (_9/2013 $ BODILY INJURY'Persc�Ident} SCHECULED AUTOS r �X HIRED AUTOS _ PROPERTY DAMAGE $ (,Peracclden.)NON-OWNED AUTOS PiPBasic $ 10,000 _ Medical payrnants $ 5 Q 0 0 X UMBRELLA LIAR {} CUc 'EACH OCCURRENCE $ 11000,000 EXCESS LIAR C.AkItiAS'1AC7E AGGREGATE $ 1,.0©0,000 DEDUCTIBLE U I REII INlirrl* S 10,000 P091445:!61 J9/21/2012 9/21/2013 a i WORKERS COMPENSATION VdC S� TU- CTaf- - AN0 EMPLOYERS'LIABILITY �C VIN ]"V/C ANY PRCPR;"70RfPARTNERIEXEC;UTIVE Iw f . § >OFFICEa MEMSER EXCI-I-IDED7 'NIA 1 ''�L EACH AC,CIDEN_T is �.. DO C a (f+fia.ndatary raI NH) 63049095 '9/21/20312 9/21/2013 if gs,dos r e u nd, f E L DiSFASE-EA EMPLOYEE $ 1,000,000 DESGRIPT ON OF GPEP�TIONS teirw E.L.DISEASE-POLICY LIMIT_', $_____I,_Ooo,000 C' professional Liability- Ex2Btl3S5198 /9/2012 i /9/20'13 LabaityEs hClam: $2,000,000 Claims Made Coverage Dee1, $10,000./F.e±ro: Ala LiabiLly-Aggragate $2,000,040 DESCRIPTION OF OPERATIONS f LOCATIONS(VEHICLES (Attach ACORD 101,Additions it Remarks Schedule,if more space Is required) I( f 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. Attn. Engineering P.O. Sox 4748 AUTHORIZED REPRESENTATIVE Clearwater, FL 33758--4748 t Michaela Bernier/C'LIS - ACCRC 255(2009/09) _ - IN 025l2:uaca) The ACORO name and Inrin era r0nicfcara l.„ t9$$-2A f' AM�CII�U C}R}�ORA7l(�R, All rights salved.