DREW STREET AND US 19 OVERPASS LANDSCAPE IMPROVEMENTS - 05-0004-EN - CERTIFICATE OF LIABILITY INSURANCEMOREL -2
OP ID: B8
'4� °R °R CERTIFICATE OF LIABILITY INSURANCE
DAT08 /06D/YYYY)
08/06/13
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 813 - 226 -1300
Brown & Brown of Florida, Inc. 813- 226 -1313
P. O. Box 173086
Tampa, FL 33672
Steve Ayers
NAMEACT Bernadette Perreault
PHONE g13 -472 -7022 FAX No):
(A/C. No, Ext):
813 -226 -1313
ADDRESS: bperreault@bbtampa.com
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: AUTO OWNERS INSURANCE
18988
INSURED Morelli Landscaping Inc.
4855 162nd Ave North
Clearwater, FL 33762 -3224
INSURERB:FCCI INSURANCE CO
10178
INSURER C : Southern Owners Insurance Co.
10190
INSURER D :
PREMISES (Ea occur ence)
INSURER E :
MED EXP (Any one person)
INSURER F :
•
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
SUBR
W VD
POLICY NUMBER
POLICY EFF
(MM /DD/YYYY)
POLICY EXP
(MM /DD/YYYY)
LIMITS
C
GENERAL
X
LIABILITY
COMMERCIAL GENERAL LIABILITY
20654637 '
08/06/13
08/06/14
EACH OCCURRENCE
$ 1,000,000
PREMISES (Ea occur ence)
$ 50,000
MED EXP (Any one person)
$ 5,000
CLAIMS -MADE
X
OCCUR
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP /OP AGG
$ 2,000,000
GEN'L
X
AGGREGATE
POLICY
LIMIT APPLIES
PRO
PER
LOG
Emp Ben.
$ none
A
AUTOMOBILE
X
_
X
LIABILITY
ANY AUTO
ALL OWNED
AUTOS
HIRED AUTOS
X
SCHEDULED
AUTOS
NON -OWNED
AUTOS
(
4216601101E
08/06/13
08/06/14
(Ea BINEDtSINGLE LIMIT
J__ 1,000,000
_
$
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
$
Per acEcRdentDAMAGE
$
$
A
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
4216601102
08/06/13
08/06/14
EACH OCCURRENCE
$ 2,000,000
AGGREGATE
$ 2,000,000
$
DED
X
RETENTION$ 10,000
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER /EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
Y / N
N / A
001 -WC 12A-47444
09/30/12
09/30/13
X
WC STATU-
TORY LIMITS
OTH-
ER
E.L. EACH ACCIDENT
$ 100,000
E.L. DISEASE - EA EMPLOYEE
$ 100,000
E.L. DISEASE - POLICY LIMIT
$ 500,000
C
IM Installation
Floater
20654637 -13
08/06/13
08/06/14
Inst Fltr 10,000
Ded $500
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule if more space Is required)
Landscaping
City of Clearwater
Public Works Administration
PO Box 4748
Clearwater, FL 33758
1
CLEARWA
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
&7'°C
ACORD 25 (2010/05)
1988-2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD