FLORIDA GAS AND ELECTRIC CORPORATION - BID 04-08 - CERTIFICATE OF LIABILITY INSURANCE (5)'4` °R°� CERTIFICATE OF LIABILITY INSURANCE °ATErMM,°°",�",
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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 �R NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THh POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AI.ITHORIZED
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
NAME: Sh6rTj► SIIlltll
Northeast Underwriters ZI1C. PHONE �727� rJ21-4ZrJ3 F� No: �7Y7�5;i7-9455
4790 lst Street North E-""a�� ssmith@neu-ins.com
n�nRFSS�
St. Petersburg FL 33703
INSURED
Florida Gas & Electric Corp
Florida Gas Contractors, Inc.
PO Box 280
Dade City
FL 33526-0280
nAdmiral Insurance Com any
a:General Ins Co of America
c:St. Paul Fire � Marine Ins. Co
o:Ohio Casualtv
4732
4767
4074
COVERAGES CERTIFICATE NUMBER:CL131204374 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLIC�ES 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 '1NHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL 1� HE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1� OOO � OOO
X COMMERCIAL GENERAL LIABILITY DAMAGE T RENTED �
PREMISES Ea occurrence S 50 � 000
A CLAIMS-MADE ❑X OCCUR 00001592003 /1/2013 1/1/2014 MED EXP (Any ane person) $ 5, 000
10 ����� , PERSONAL & ADV INJURY $ 1� 000 � 000
�":��fi � GENERAL AGGREGATE $ _ Z� OOO � OOO
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2� OOO � OOO
X POLICY PRO- LOC i"'', �� p' r, a $
AUTOMOBILE LIABILITY �>." � COMBINED SINGLE LIMIT
Ea acciderrt 1 OOO OOO
B X ANY AUTO ����'� j �b ,,;p BODILY INJURY (Per person) $
ALL OWNED SCHEDULED �°�� � �"k�' "
4CC30 �,lD,J,� � �+� �� �,��3 /1/2014 BODILYINJURY(Peraccident) $
AUTOS AUTOS
NON-ONMED ""`"���}��; �; e�f��` ��°P r PROPERTY DAMAGE
HIRED AUTOS AUTOS ��`° �- 1 Per awiderrt $
Uninsuredmotoristcombined $ 1 000 000
X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 4� 000 � 000
C EXCESS LIAB CLAIMS-MADE
AGGREC�aTE $ 4, OOO, OOO
DED X RETENTION$ 10,00 UP12P3522613NF 1/1/2013 1/1/2014 $
WORKERS COMPENSATION WC STATU- OTH-
AND EMPLOYERS' LIABILITY y� N _
ANY PROPRIETOR/PARTNEWEXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBEREXCLUDED? � N�A -
(Mandatory In NH) E.L. DISEASE - EA EMPLOYE $
If yes, describe under -
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
D Inland Marine 1354743129 /31/2012 /31/2013 Deduc�ibie $1,000
Rented/Leased Equipment Ra�eased $250,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 701, Addftlonal Remarks Schedule, M more spaca Is requlred)
It is agreed the Certificate Holder is named as Additional Insured's with respect to General Lial�ility
and Commercial Auto Coverage.
CERTIFICATE HOLDER ceNCei � orinN
SHOULD ANY OF TI-FE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEL.IVERED IN
City of Clearwater ACCORDANCE WITH THE POUCY PROVISIONS.
Attn: City Clerk
PO BOX 4748 AUTHORIZED REPRESENTATIVE .
Clearwater, FL 34618-4748
°P ,��,�-....:
Ken Kijowski/SHERRY . �'�,e='.�.. -��aM..�..�, :
ACORD 25 (2010/OS) �O 1988-2010 ACORD CORPORATION. All righ#s reserved.
INS025 �ZO�oos�.oi The ACORD name and logo are registered marks of ACORD