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TROPIC HILLS STORMWATER OUTFALL PROJECT - PHASE III - 11-0040-EN - CERTIFICATE OF LIABILITY INSURANCE (2) STI*VEw7 OR ID.L5 CERTIFICATE OF LIABILITY INSURANCE DATE(MMI(7DNYYY) X1713011 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 pollcy(ies)must be endorsed. If SUBROGATION IS WAIVED, sub}ect 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 endorsements . PRODUCER CONTACT Phone: NARiE;,_ Brown&Brown of Florida,Inc. — — - - -- 83 Park Place Blvd.,Ste 101 Fax;727 2-76 5 ° Ext FAX No): P.O.Bon 2456(33757.2456) E-MAIL Clearwater,FL 33759 ADDRESS: _ - ___--- Cand'ada Lamberson,CIC,CRM iNSURER(S)AFFORDING COVERAGE NAIC x INSURER A: Insurance Co.. 41297 -� ---------------- — — -- — INSURED Steve's Excavating&Laving, INSURER a:FFVA Mutual Insurance Company 10,386 Inc ---- --- -- — _ P.O.Box 303 INSURER c General Ins Com an of America 24732_ Dunedin,FL 34697 INSURER D:Commerce and Industry Ins Co 19410 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER. REVISION NUMBER: THIS I$TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DDL UBR _ POLICY EFF POLICY EXP _ LTR TYPE OF INSURANCE POLICY NUMBER ,MMfDDrryYY MM0DPYYYY LIMITS I GENERAL LIABILITY -. ;: EACH OCCURRENCE i$ 1,000,00 DAMAGE A X COMMERCIAL GENERAL LIABILITY .X X BCS0028445 07128113 09105113 ,.PREMISEES kRENTED cccurt6nco'.. $ 100,00 CLAIMS•MADE . I OCCUR s M E D EX (Any one person) $ Exclude c PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GE.N'LAGGREGATE LIMIT APPLIES PER, -CoMPICP AGO S 2,000,00 POLICY X PRO- cac Emp Ben. ----- $ 11 AUTOMOBILE LIABILITY i COMBINED SINGLE LIMIT Ea acs sentX �. _s—. 1,000,00 C X ANY AUTO 24CC30852810 07128113 07128114 BODILY INJURY(Per person) S ALL 0ANED SCHEDULED ED BODILY INJURY(Per accident) S - AUTOS ,SL �... 110 114-0 ATi D PROPERTY DAMAGE ... .------- -------- X HIRED AUTOS ! Per accident -- UMBRELLA LEAD. X 001" P L ,.i ,vURRE IOC. ;; 1,000,00 0 X_EXCESS LIAR Cu'q Cu' MS MAF)E i BE021163966 0712II113 09105113 AGGREGATE 1,000,000 WORKERS COMPENSA'nON ---- TORY LATU t£R�- AND EMPLOYERS'LIABILITY ( _ ANY PROPRtETORIPARTNERIEXECLTIVE Y X I C84000203242013A 05115113 05115114 E L EACH ACCIDENT $ 1,000,00 OF'FICER,TAEMBER EXCLUDED? NIA --- (Mandatory In NH) � E L DISEASE-EA EMPLOYEE;$ 1,000,00 If yyes ducrto under DESCR'PT10.14 OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORO Iof,Additional Remarks Schedule,If more space is mquiredI Tropic Hill Stormwa;ter Outfall Project: - Phase 3 Project. Certificate holder is an additional insured with respect to general lability arising from work performed by the roamed insured.. Waiver of Subrogation applies in favor of the certificate holder with regards to ~general liability and workers compensation. CERTIFICATE HOLDER CANCELLATION CITYC-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CI of Clearwater THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. P.U. Box 4748 100 S. Myrtle Ave,Suite 220 - Clearwater,FL 33756-5520 AUTHORIZED REPRESENTATIVE Cp71988-2010 ACORD CORPORATION. All rights reserved. ACORD 26(2010105) The ACORD name and logo are registered marks of ACORD STEVE-7 OP ID, D A4CC?MEP` CERTIFICATE OF LIABILITY 708102113( tw�acCatYYYr) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE: HOLDER. THIS CERTIFICATE DOES PICT 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 INSURERIS), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT. If the certificate holder is an ADDITIONAL INSURED,the pollcy)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 Veto of such endorsement(s). PRODUCER Phone,727-461-6044 NAME CT Brown&Brown of Florida,Inc. PHONE FAx 83 Park Place Blvd.,Ste 101 Fax.727 2-7695 AC No, E ;...u,_, IBC,Nit: P.O.Box 2466(33787-2466) E-MAIL s. Clearwater,FL 33759 ¢ w Can ida Lamber on,CIC,CIRM _ INSUREWS1 AFFORDING COVERAGE _ fiAIC INSURER A!Scottsdale Insurance Co. 141297 m. _ INSURED Steve's Excavating&Paving, -.. INSURE'R.B.FF A Mutual Insurance Company 110385 Sernago&Sons Properties, Inc INSURER c:General Iron Company of America 124732 Inc - ..� �.. . ._P.O.Eon 3fe3 INSURER D Commerce end lrtd4si Iron Co 19410 � � . . Dunedin, FL 34597 INSURER E:AGCY Marine Insurance Co. 122837 INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN 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 Af)t]L SUR I m.. IPOLI EW' ( -_OY EXP - LIMITS L TR TYPE OF INSURANCE POLICY NU'rutSER. GENERAL LIABILITY - EACH OCCURRENCE. $ 9,11170, 0.. DAMAGE TO RENTED -'-- -- A X I COMMERCIAL GENERAL LIABILITY X BCS0028445 ( 07128/13 09/08113 PREMISES IEra accurrenceL 1 - - 100,00 CLAWS-MADE [OCCUR MED EXP IAny raise person) _$ Excluded _ I PERSONAL&ADV INJURY $--- 1,000,00 _- GENERAL AGGREGATE $ 2 00,0,00 GEN'L AGGREGATE LIMIT APPLIES PER- PRODUCTS•COMPPOP AGG i 1 ...2,000,00 POLICY� I PRO- jECj � LOC t IErn den, $ /� AUTOMOBILE LIABILITY - - - COMBINED SINGLE LIMIT' 1,000,004 Eta accadent) �w C AN'AUTO 2 07128113 1 07128114 BODILY INJURY{Per person} } ALL OWNED SCHEDULED S BODILY INJURY IPer accident),3 AUTOS ALTOS NON-OWNED � PROPERTY DAMAGE HIRED AUTOS AUTOS r accident) UMBRELLA LIAB ' X OCCUR � ; I EACh4 OCCURRENCE $ 1,000,00 D EXOESS LIAR CLAIMS-MADE BE021163965 07/28113 09106113 AGGREGATE $ 1,000,00 -...- WtIRKEF'r5C @IvIFEISATICYN ... ( WCSTATCJ- iarhi- AND EMPLOYERS'LIABILITY � SS7RY LIMITS °R ANY PROPRIETORPARTNFIREXECUTI Y[I r ' C840002032 2013, � OffI6f93 O6}7 /I4 i_E-L EACrIAcaIaENT � s 1,0m,00 {3PPICE MEMBER EXCLUDED? ? _ -.... (Mandatsrsy in NH) ( E.L.DISEASE-EA EMPLOYEE! $ 1,000,.00 If es,describeunrter O[LSCRIPTION OF OPERATIa.NS below E.L DISEASE POLICY LIMIT !$. 1,000,00''. E IContractors' 1NZI93021799 07/28113 07128114 Ileasedl 250,00 Equilao ent Rented DESCRIPTION OF OPERATIONS I LOCATIONS t VEMICLES (Attach ACORD I01,Additional Renawk5 Srhedule5 It rnrare space Is required r �' Tropic ail l St c�rrrtl�ra er fDut all Project - Phase Project. t Certificate holder is an additional insured with respect to general liability arising from work performed by the named insured. Waiver of Subrogation applies in favor of the certificate holder with regards to general liability and workers compensation. CERTIFICATE MOLDER CANCELLATION CIT YC61 SHOULD ANY OF THE ABOVE DESCRIBER POLICIES BE CANCELLED BEFORE E EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Clearwater ACCORDANCE WITH THE POLICY PROVISIONS. P.0. Box 4748 100 S. Myrtle Ave,Suite 220 AUTHORIZED REPRESENTATIVE Clearwater',FL 3375n5520 _ a4i��_ __ __ - 1988-2010 ACCRC CORPORATION, All rights reserved. ACCRA 25(2010105) The ACCRC name and logo are registered marks of ACCRD