CERTIFICATE OF LIABILITY INSURANCE (178)Client #: 137132
14ENERCONSER
ACORDTM CERTIFICATE OF LIABILITY INSURANCE
DATE (MM DATE /DDIYYYY)
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
J. Smith Lanier & Co.- Atlanta
11330 Lakefield Drive
Bldg 1, Suite 100
Duluth, GA 30097
CONTACT
NAME:
PHONE 770 476 -1770 FAX 770 4764651
(A/C, Ext): (A/C, No >:
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURERA: Chartis Specialty Insurance Co.
26883
INSURED
Enercon Services, Inc.
500 Town Park Lane Ste. 275
Kennesaw, GA 30144
INSURER B : Sentinel Insurance Co., LTD
11000
INSURER C : Markel Insurance Company
38970
INSURER D Hartford Fire Insurance Co.
19682
INSURER E :
$ 25,000
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.
LTR
TYPE OF INSURANCE
ADDL
INSR
SUBR
W VD
POLICY NUMBER
POLICY EFF
JMM /DD/YYYY)
07/01/2013
-,
1
�!;;'' ,�i
'y
POLICY EXP
(MM /DD/YYYY)
07/01/2014
LIMITS
EACH OCCURRENCE
$1,000,000
A
GENERAL
X
LIABILITY
COMMERCIAL GENERAL LIABILITY
24204154
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ii I_ ri
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° F? j a
PREMISES (CpEa occurrence)
$ 300,000
MED EXP (Any one person)
$ 25,000
CLAIMS -MADE
X
OCCUR
PERSONAL & ADV INJURY
$1,000,000
GENERAL AGGREGATE
$2,000,000
PRODUCTS - COMP /OP AGG
$2,000,000
GE
'L AGGREGATE
POLICY
X
LIMIT APPLIES
j� a
PER:
LOC
D
AUTOMOBILE
X
X
LIABILITY
ANY AUTO
ALL OWNED
AUTOS
HIRED AUTOS
X
SCHEDULED
AUTOS
NON -OWNED
AUTOS
20UENJ�AI9063.
'�
V' f ,
07/01/2013
, -)
'fir -
07/01/2014
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
$
A
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
24204393
07/01/2013
07/01/2014
EACH OCCURRENCE
$11,000,000
AGGREGATE
$11,000,000
$
DED
RETENTION $
B
WORKERS COMPENSATION
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
Y /N
N / A
20WEAE9351
07/01/2013
07/01/2014
X
WCSTATU-
TORY LIMITS
OTH-
ER
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE - EA EMPLOYEE
$1,000,000
E.L. DISEASE - POLICY LIMIT
$1,000,000
C
A
Professional Liab
Pollution Liab
13EOSE20001
24204154
04/18/2013
07/01/2013
04/18/2014
07/01/2014
$5,000,000
$1,000,000
DESCRIPTION OF OPERATIONS ! LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space s required)
Certificate Holder is named as additional insured as per written contract, subject to the provisions and
limitations of the policy. Waiver of subrogation applies per written contract, liability policies are
written on primary basis. Separation of insured applies
CERTIFICATE HOLDER
CANCELLATION
City of Clearwater
Attn: City Clerk
PO Box 4748
Clearwater, FL 33758
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
ACORD 25 (2010/05) 1 of 1
#S1950075/M1948175
9 8- 010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
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