The URL can be used to link to this page

TROPIC HILLS STORMWATER OUTFALL PROJECT - PHASE III - 11-0040-EN - CERTIFICATE OF LIABILITY INSURANCE OP ID: L5 ,acoRO" CERTIFICATE OF LIABILITY INSURANCE DATE(M14/1YYY) `-� 05/14/13 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). CONTACT PRODUCER Phone: 727-461-6044 NAME: Brown&Brown of Florida,Inc. Fax:727-442-7695 PHONE FAX 83 Park Place Blvd.,Ste 101 A/c No Ext: (A/C,No): P.O.Box 2456(33757-2456) E-MAIL Clearwater,FL 33759 ADDRESS: PRODUCER STEVE-7 Candida Lamberson,CIC,CRM CUSTOMER ID#7 INSURER(S)AFFORDING COVERAGE NAIC# INSURED Steve's Excavating& Paving, INSURERA:Scottsdale Insurance Co. 41297 dba Sarnago&Sons Recycling INSURER B:FFVA Mutual Insurance Company 10385 Inc P.O. Box 303 INSURERC:General Ins Company of America 24732 Dunedin„ FL 34697 INSURER D:Commerce and Industry Ins Co 19410 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 DDL UBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY X X BCS0028445 07/28/12 07/28/13 DAMAGE TO RENTED 100 000 PREMISES Ea occurrence $ , CLAIMS-MADE Fir-1 OCCUR MED EXP(Any one person) $ Excluded X Broad form PERSONAL&ADV INJURY $ 1,000,000 property damage GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000 RO POLICY X J CT LOC Emp Ben. $ 1M/1M AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) C X ANY AUTO 01C162480510 07/28/12 07/28/13 BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ X HIRED AUTOS (Per accident) X NON-OWNED AUTOS $ UMBRELLA LIAB I X OCCUR EACH OCCURRENCE $ 1,000,000 X EXCESS LAB CLAIMS-MADE AGGREGATE $ D BE021163965 07/28/12 07/28/13 DEDUCTIBLE $ X RETENTION $ 0 $ WORKERS COMPENSATION Y/N X STATUS- OTH- AND EMPLOYERS'LIABILITY TORWC Y LIMIT ER B ANY PROPRIETOR/PARTNER/EXECUTIVE X WC84000203242013A 05/15/13 05/15/14 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Tropic Hill Stormwater Outfall ProJect - Phase 3 Project Certificate holder is an additional insured with regard to Bodily Injury or Propertyy Dampge arising from the work performed by the named insured per form CG2037 07/04. Waiver of Subrogation in favor of certificate holder applies in regards to general liability and workers compensation CERTIFICATE HOLDER CANCELLATION CITY-20 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Clearwater THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 4748 100 S. Myrtle Avenue, Ste 220 Clearwater, FL 33758-4748 AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD