FIBER OPTIC CABLE INSTALLATION, CONDUIT BORING & FIBER MAINTENANCE SERVICES, PROPOSAL #09-13 - CERTIFICATE OF LIABILITY INSURANCEACORO� w►rE �M�uDwrvvn
� CERTIFICATE OF LIABILITY INSURANCE 4/18/2013
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 IPOLICIES
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 certHicate 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 RaTeII H311
NAME: .
Stahl & Associates insurance, =I1C. P�NE .(407) 833-8998 FAX .(407)833-3909
250 InteZ'national Parkway '�"�'�� .karen.hall�stahliasuraace.com
SU1 t@ �.2 S INSURER S AFFORDING COVERAGE NAIC p
Lake Mary FL 32746 iNSUReRnAmerisure Insurance Co 19488
INSURED INSURERBA�EY'1S11Z'@ Mutual Ins Co 3396
Precision Contracting Services, Inc. INSURERC: _
15834 Guild Court INSURERD:
ter FL 33478
COVERAGES CERTIFICATE NUMBER:�•12122116496 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLIGY PERIOD
INDICATED. NOTIMTHSTANDING 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 TNE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMiTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR 7ypE OF INSURANCE ADDL SUBR pp�ICY NUMBER MMIDDY �F MMILDD �P UMITS
LTR
GENERALLIABILITY EACHOCCURRENCE $ 1.00U�OOO
X COMMERCIAL GENERAL LIABILITY DRMMAGETO RENT�E D�e $ _ 5U, OOO
A CLAIMS-MADE �OCCUR L2026017 /1/2013 /1/2014 MEDEXP(Anyoneperson) $ 5,000
X Blanket Additonal insd's PERSONAL8ADVINJURY $ 1, 000, 000
X GL ExtEaBiOa Endoraemeat GENERALAGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ �� OOO � OOO
POLICY X PR� LOC $
AUTOMOBILELIABILITY EOM�BI�NdeDtSINGLELIMIT ], 000 000
A X ANY AUTO BODILY INJURY (Per person) $
ALLOWNED SCHEDULED 2026011 /1/2013 /1/2014 gODILYINJURY(Peraccident) $
AUTOS AUTOS PROPERTY DAMAGE $
NON-0WNED Per accident
X HIREDAUTOS X AUTOS -
$
X UMBRELLALIAB X OCCUR EACHOCCURRENCE $ 4.,000,000
B EXCESS LIAB CLAIMS-MADE AGGREGATE $ 'f � OOO � OOO
DEO X RETENTION -� 2026018 /1/2013 /1/2014 $
A WORKERS COMPENSATION X WC STATU- OTH-
AND EMPLOYERS' LW&LITY
ANYPROPRIETOR/PARTNER/EXECUTIVE Y�N E.L.EACHACCIDENT $ $OO OOO
OFFICER/MEMBER EXCIUDED? � N�A C2026028 2/31/2012 2/31/2013
(Mandatory in NH� E.L. DISEASE - EA EMPLOYE $ 500, OOU
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ $OO � OOO
B COntraCtOrS 73quipmeIIt PP2026016 /1/2013 /1/2014 LeasedlRentedEquipment: $50,000
Instauation Floatec $10 0, 0 0 0
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Atlditional Remarks ScF�edule, i► more space is requiretl)
Certificate holder is iacluded as aa Additional Iasured as respects general liability per the Blanket
Additioaal Insured endorsemeat CG7048 0304 if required per writtea coatract.
City of Clearwater
100 South Myrtle Avenue
Clearwater, FL 33756
ACORD 25 (2010/U5)
INS025 r�mnn�� m
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIWERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
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O 1988-2010 ACORD CORPORATION. All rights reserved.
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