CERTIFICATE OF LIABILITY INSURANCE (131)'```°R°� CERTIFICATE OF LIABILITY INSURANCE 8A17M2�1�
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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
certifcate holder in lieu of such endorsement(s).
PRODUCER NAMEACT 10E11]► PTEStOII
Christensen Group Insurance PHONE .(g52) 653-1000 F'�'X .(952)653-1101
11100 Bren Road West E �R�E :kpreston@christensengroup.com
INSURER 5 AFFORDING COVERAGE NAIC #
Minnetonka l�i 55343 iNSUReR n:Zurich American Ins . Co .
INSURED INSURERB:St63Cif83t Insurance Com an
CERES ENVIRONMENTAL SERVICES, INC. ETAL iNSUReRC:Starr Indemnitv & Liabilitv Co
6960 Professional Pkwy East INSURERE:
Sarasota E'L 34240 INSURERF:
COVERAGES CERTIFICATE NUMBER:2012-2013 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.
INTR TypE OF INSURANCE ADDL U R ppLICY NUMBER MML�DY EFF M�/DD E� LIMITS
GENERAL LIABILITY
EACH OCCURRENCE $ 1, 000 , 000
X COMMERCIAL GENERAL LIABILITY DAMA E T N D
PREMIS S Ea rr nce $ 300 � 000
A CLAIMS-MADE � OCCUR 05911870-����� /2012 /18/2013 MED EXP (Any one person) $ 10 , 000
PERSONAL 8 ADV INJURY $ 1� OOO � OOO
QI{(:` � � ZO � GENERALAGGREGATE $ 2,000,000
GEN'L AGGREGATE IIMiT APPLIES PER e��j�� PRODUCTS - COMP/OP AGG $ 2� 000 , O00
POLICY X PR� �OC $
AUTOMOBILE LIABILITY � B ,� ,��,i� �p E� aBciCeDtSINGLE lIM1T 2 000 000
A X ANY AUTO �������� �+�v` ��T � BODILY INJURY (Per person) $
ALL OWNED SCHEDULED 9313049-01 /18/2012 /18/2013 BODILY INJURY (Peraccident) $
AUTOS AUTOS
HIRED AUTOS NON-OWNED PROPERTY DAMAGE $
AUTOS Per acci nt
Auto Medica� Pa ments $ 5 000
X UMBRELLA LIAB pCCUR EACH OCCURRENCE $ 1, 000 , 000
C EXCESS LIAB CLAIMS-MADE AGGREGATE $ S� OOO � OOO
DED X RETENTION 10,00 ISCCCL01883512 /18/2012 /18/2013 $
A WORKERS COMPENSATION X WC STATU- OTH-
AND EMPLOYERS' LIABILITY Y� N
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1 OOO OOO
OFFICER/MEMBER EXCLUDED? � N � A
(Mandatory in NH) C9313050-01 /18/2012 /18/2013 E.L. DISEASE - EA EMPLOYE $ 1 �0� 00�
If yes, describe under E.L. DISEASE - POLICY LIMIT $ 1 000 000
DESCRIPT!ON OF C�P£f2ATIQNS be!ow
A Professional Li3b111t17 L05911870-00 8/18/2012 /18/2013 Each Condition/Claim $10 � 000 � 000
COntractors Pollution EC9266266-01 /18/2012 /18/2013 ClamsMadePOlicy Prof Liab
DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more space is required)
The City of Clearwater listed as additional insured
TE HOLDER
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Clearwater
RFP 25-11
Attn • City Clerk AUTHORIZED REPRESEN7ATIVE
P.O. Box 4748
Clearwater, FL 33758-4748 . �_
Tyler Simmons/KP ��'�
ACORD 25 (2010/05) O 1988-2010 ACORD CORPORATION. All rights reserved.
INS0251�ntnn5l n7 The Ar(1R�1 name anr! innn aro rcnie4ererl m�rlrc nf A!`nRll