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2009-2010 SANITARY SEWER AND MANHOLE REHABILITATION PROJECT - 09-0047-UT - CERTIFICATE OF LIABILITY INSURANCE (3) AC T DATE tNSM1DDYYY) 5(1!2014 4` ` €�1 s 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. It the certificate holder is an ADDITIONAL INSURED,the policytlesl must be endorsecL 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 lied of such endorsernent(s), CONTACT PRODUCER LocktDn Companies.LLC 1 Kansas City NAME: FXX 444 W 47tH Street Suite 9317 AI Q Et): A(C No, Kansas Cltyy MO 64112-1906 E-MAIL (816)96(1-9Q09 NAIL INSURER A: Zurich American Insurance Companj 1635 INSURED LAYNE INLiNER,LLC -INSURER B: 26 2531JEWETTLANE � INSURERC SANFORD FL 32771-1077 INSURER D: IN5W13g8 E: INSURER F COVERAGES I,AYINOI CERTIFICATE NUMBER: 10871760 REVISION NUMBER. XXX XXXX 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 TRIG TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR ADDL SUBR POLICY EFF POLICY EXP T TYPE OF INSURANCE iiJ $ 'IVD POLICY NUMBER _..1D�7!`r".'�"Y '�9fiht �Lbt4"YYY LI..te9f°E • GENERAL LIABILITY y Y GLO Sx817436-00 51112{}13 5/112014 EACH OCCURRENCE s 2,000,000 X COMMERCIAL GENERAL LIABILITY AMA TOtiRENTED 1 500�000 � CLAIMS-MADE N4 OCCUR ME EXP i8a one personj � 10,000 X CONTRACTUAL PERSONAL&ADV INJURY $ 2.000.000 X X.C,UCOVERAGE GENERAL AGGREGATE s 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGO $ 5,000,000 X PCLICY7 PERCT LOC $ • AUTOMOBILE LIABILITY Y Y BAP 5817437.00 5/1/2013 51112014 Ea�B.I d.,tSINGLE LIMIT $ 5,000,000 Ix ANY AUTO SODILY INJURY(Per person) s XXXXXXX AUTOSfNED M�SHFDVLED OSSODILY INJURY{Per accident $ XXXXX HIRED AUTOS pN&rN WNED PR r PERTY DAMAGE $ XXXXXXX sXXXXXXX UMBRELLA LIAR OCCUR EACH OCCURRENCE $ XXXXXXX EXCESS LIAR CLAIMS-MADE N "I APPLICABLE AGGREGATE S XXXXXXX DED RETENTION$ S WORKERS COMPENSATION _-. _"JC S T±'�T C�TH A AND EMPLOYERS'LIABILITY Y WC 5'817434-00(AOS) '5/112013 5/1/2014 X ,7 CRY LlrtiT Y t N WC 5817440-00(A"1) 5/1/2013 51I/2014 51000-000 ANY CERMIi 11,10M A;'sTNE=FZ'Ef?ECUTI'JE 1_ E L EAf,FE ACGI DENT A orrlGSwnaEMe�r3 r<xGLUOSO�I � NIA 5Tt71'GA17('=.�iC],Q 1,1V".A,lt,'°4') IMandalary In NH E.L.DISEASE.EA EMPL©YES 5,000,000 DE sCRI PTION CF OPERATIONS belo w El DISEASE•P+TUCV LIMIT 5,000,I)0{ DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES I(Attacrl ACORD 101,Additional Remarks Schedule,if more space is required) RE:2009-2010 SANITARY SEWER,AND MANIHOLE REHABILITATION PROJECT CONTRACT 094)04 -U'i JOB L+;st.• IION� V,'tl.KA'S LOCATIOIN'S,4LLARI A1I t, FL. OWNER,CON-IRACTOR,SUBCONTRACTORS,ACTORS,ENGI`EER,ENGINEER'S CONSULTANTS AND ALL O II R PERSONS OR ENTITIES IDENTIFIED IN THE SUPPLEMENTARY CONDITIONS ARE ADDITIONAL INSUREDS AS RESPECTS GENERAL.LIABILITY AND AUTOMOBILE LIABILITY COVERAGE, 4VHICI I. IS ON A PRIMARY BASIS,AND SUBROGATION IS WAIVED,ONLY AS REQUIRED BY CONTRACT,SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY,AS ALLOWED BY LAW, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10874760 AUTHORIZED REPRESENTATIVE CITY OF CL EARWATE.R 1001 SOUTH MYRTLE AVENUE CLEARWATER FL 33756-5526 ACORD 26(20101055) C) 9 11.2010 AC ORPORATION,All rights reserved The ACORD name and logo are registered marks of ACORD