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SOUTH GULFVIEW BOULEVARD DRAINAGE IMPROVEMENTS - 11-0019-EN - CERTIFICATE OF LIABILITY INSURANCE STEVE-7 OIL ID: L5 CERTIFICATE LIABILITY -INSURANCE DATE(MWOOPfYYY) 07130/13 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE [TOES 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 CONTACT Rhone.72'7-461-6044 NAME: — — -- Brown&Brown of Florida,Inc. - -- 83 Park Place Blvd. Ste 101 Fax.727-442-7696 a�ie�'N E�: Na. P.O.Box 2456(337x7-2455) E-MAIL Clearwater,FL 33759 ADDRESS: Candida Lamberson,CIC,CRM INSURERIS)AFFORDING COVERAGE NAIC# INSURER A:SCOttsdale Insurance Co. 41297 INSURED Steve's Excavating&Paving, INsuRERs:FFVA Mutual Insurance Company 10385 Inc --- P.O.Box 303 INSURER c:General Ins Company of America 24732 Dunedin, FL 34697 INSURER O: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. NOTVATHSTANDING 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 ADDL SUBR POUCY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER. `I MM1007YYYY MMdOD(Y'YYY GENERAL LLA81LITY EACH OCCURRENCE $ 1,400,04 A X COMMERCIAL GENERA.LABILITY X BCS0028445 47128113 09105/13 PREMISES ow rrence-}—.._s 100,00 CLAIMS-MADE - OCCUR D EXP.(An+�ane persarap $. Exclude PERSONAL 8 AOV INJURY ...,_$ 1,000,00 GEN E RAL AGG RE EGATE S 2,000,00 GENL AGO REGATELEMITAPFILIES?ER. PRODUCTS-COMPIOPAGG 5 2,000,00 POLICY DK PRO` LOC Emp Ben. S 1M11 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT -._1,0,0000 aGCddent ._.., S C X ANY AUTO _ 24CC30852810 47128/13 07/2$114 BODILY INJURY(Per Person) S ALL O'+r.7JED SCHEDULED BODILY INJURY(Per ac�ddent) 5 P P DA AUTOS ALTOS N�'v-OVJfd"D ROERTY DAMAGE 5 X HIRED AUTOS ' X accidence_,__---- I � 5 UMBRELLA LIAR OCCUR EACH OCCURRENCE S 1,000,00 D E%LESS LIAEi �OLAIMS-MADE BE021163865 (77128113 09105113 AGGREGATE S 1,000,#100 DED X FREIENTION w 0 WORKERS COMPENSATION X V C STATU- Th- AND EMPLOYERS L€ABILITY - _ rDRYT.Ir�ITS ._. B AN 7 , ;r: ar �� Pc,x .IV- Y� WCS4a3tp2O3242013A 05175113 OW15114 Ei. EACH ACCIDENT � 1,00{1, 0 FXC�LJDEDD A I (Mandafaryr its NH) � E i. DISEASE EA EMPLOYEEl,$ 1,(140,40 If 4 5 aes mb,e u noor DESCRIPTION OF OPL::;R � ,,4S beln,,v E L DISEASE-POLICY LIMIT $ 1,000,00 I i DESCRIPTION OF OPERATIONS I LOCATIONS)VEHICLES{Attach ACORD 101,Additional Remarks SchedLu a,if more space is required) RE: South Gulfview Drainage Improvements 11-0019-EN City of Clearwater is an additional insured with regard to general liability arising from the work performed by the named insured, CERTIFICATE HOLDER CANCELLATION C ITYC-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Clearwater THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. P.07.Box 4746 Clearwater, FL 33756-5520 AUTHORIZED REPRESENTATIVE p 1988-2010 ACORD CORPORATION. All rights reserved. CORD 25(2010)05) The ACORD name and logo are registered marks of)ACCORD STEVE -7 OP ID: DG ,40[74001121:0' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DWYYYY) 08/02/13 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). PRODUCER Phone: 727 -461 -6044 Brown & Brown of Florida, Inc. Fax: 727 -442 -7695 83 Park Place Blvd., Ste 101 P.O. Box 2456 (33757 -2456) Clearwater, FL 33759 Candida Lamberson, CIC, CRM CONTACT FAX No): PHON O, Ext): MM/DDY� )- 09/05/13 E A DRISS' INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Scottsdale Insurance Co. 41297 INSURED Steve's Excavating & Paving, Sarnago & Sons Properties, Inc Inc P.O. Box 303 Dunedin, FL 34697 INSURER B : FFVA Mutual Insurance Company 10385 INSURERC:General Ins Company of America 24732 INSURER D : Commerce and Industry Ins Co '19410 INSURER E : AGCS Marine Insurance Co. 22837 INSURER F : • VV V GI N\7 CO VLF\ I n 1Ve1. ... .•v...v..•• 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 SUBR WVD - PoL l:R r- (MM /DD/YY EFF )_J 07/28/13 ° MM/DDY� )- 09/05/13 LIMITS A GENERAL LIABILITY X • • BCS0028445 .......- .�._.........._,.,.. - EACH OCCURRENCE $ 1,000,000 X GENERAL LIABILITY DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 COMMERCIAL CLAIMS -MADE X OCCUR MED EXP (Any one person) $ Excluded PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L PRODUCTS - COMP /OP AGG $ 2,000,000 AGGREGATE POLICY X LIMIT APPLIES j7 PER: LOC Emp Ben. $ 1M /1M C AUTOMOBILE LIABILITY 24CC30852810 07/28/13 07/28/14 Ea accidentSINGLE LIMIT $ 1,000,000 X X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AU NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ D X UMBRELLA LIAB EXCESS LIAB X $ OCCUR CLAIMS -MADE 0 BE021163965 07/28/13 09/05/13 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 DED X RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY PROPRIETOR/PARTNER /EXECUTIVE Y / N WC84000203242013A 05/15/13 05/15/14 X STTU- OTH- ER E.L. EACH ACCIDENT $ 1,000,000 ANY OFFICER/MEMBER EXCLUDED? in NH) N N / A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ E Contractors' Equipment MZI93021799 07/28/13 07/28/14 leased/ 250,000 Rented DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) RE: South Gulfview Drainage Improvements 11- 0019 -EN City of Clearwater is an additional insured with regard to general liability arising from the work performed by the named insured. GtK I II IUA I t 11ULUtK City of Clearwater P. O. Box 4748 Clearwater, FL 33756 -5520 CITYC -1 " ^' "' -- ..--^ 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) - . nn ...,..w .��`. ....•. The ACORD name and logo are registered marks of ACORD