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EAST ADVANCED POLLUTION CONTROL FACILITY MOTOR CONTROL UPGRADES (01-0057-UT) - CERTIFICATE OF LIABILITY AGREEMENTA`cc•R°® CERTIFICATE OF LIABILITY INSURANCE 6ii2i2o1"3") 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). PRODUCER Stahl Associates Insurance Inc. 91 Lake Morton Drive 0 Box 3608 Lakeland FL 33802 CONTACT Peggy Dittmann NAME: g� PHONE (863) 688-5495 u Fax (863) 688 -4344 IA/C. No. Extl: (A/C. Nol: E-MAIL eggy.dittman @stahlinsurance.corn ADDRESS: peggy.dittman@stahlinsurance.com INSURER(S)AFFORDINGCOVERAGE NAIC# INSURERA:Westfield Insurance Company 24112 INSURED Leedy Electric East LLC 520 Prairie Industrial Pkwy Mulberry FL 33860 -9585 INSURER B :FCCI Insurance Group 4740 INSURER C :Columbia Casualty 31127 INSURERD: $ 1 , 000, 000 INSURER E : $ 50 , 000 INSURERF: $ 1, 000 COVERAGES CERTIFICATE NUMBER:13 /14 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 LTR TYPE OF INSURANCE ADDL INSR SUER VD POLICY NUMBER POLICY EFF JM /Y M /DDYYY) POLICY EXP (MM /DD/YYYYI LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY / CWP018473' , ,,. ' ! /1/2013 1/1/2014 EACH OCCURRENCE $ 1 , 000, 000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 50 , 000 MED EXP (Any one person) $ 1, 000 CLAIMS -MADE X OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER ]----C-1 POLICY n JECT n LOC PRO- $ A AUTOMOBILE _ X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON-OWNED AU O ��A:; ,. Ca c a..,ti-,..,, t a a G ff `ro sa�� j'., r, j CWP0184�33 "" �- ° ,_> d 1/1/2013 1/1/2014 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 $ BODILY INJURY (Per person) BODILY INJURY (Per accident) $ PROPERTY DAMAGE P $ Medical payments $ 1,000 A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CWP0184731 1/1/2013 1/1/2014 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 $ DED I I RETENTION $ NONE B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? n (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 001WC13A58959 1/1/2013 1/1/2014 WC STATU- X I TORY I IMITS [OTH- I ER E.L. EACH ACCIDENT $ 1,000,000 $ 1,000,000 E.L. DISEASE - EA EMPLOYE c $ 1,000,000 E.L. DISEASE - POLICY LIMIT C A Professional Liability Rented & Leased Equipment CE0288376097 CWP0184731 5/10/2013 1/1/2013 5/10/2014 1/1/2014 Limit /Ded per Claim $5,000 1,000,000 Limit/Deductible 100,000/500 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Clearwater P 0 Box 4748 Clearwater, FL 33758 -4748 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE S DePianta /CRIFAS ACORD 25 (2010/05) INS025 (201005).01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD