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CERTIFICATE OF LIABILITY INSURANCE (236)A� " CERTIFICATE OF LIABILITY INSURANCE 9/4/2013 rr) 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 - CONTACT Michele Crifasi NAME: Stahl & Associates Insurance Inc. PHONE (863) 688 -5495 ra. No): (863) 688 -4344 91 Lake Morton Drive AE-MAIL DDRESS: michele.crifasi @stahlinsurance.com P O Box 3608 INSURER(S) AFFORDING COVERAGE NAIC # Lakeland FL 33802 INSURERA:American Guarantee & Liability PRaENTED PREEMIMI E SES S (RENTED Ea occurrence) INSURED CLAIMS -MADE INSURER B Auto Owners Insurance Co 18988 Johnsons Excavation & Service Inc INSURERC:Bridgefield Employers Ins Co 10701 1706 Trapnell Rd INSURER D:OWners Insurance Co '32700 Contractual Liability INSURER E :American Safety Indemnity Co $ 2,000,000 Plant City FL 33566 -4936 INSURERF: $ 2,000,000 ERTIFICATE NUMBER:13 /14 • 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 POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP IMM /DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X GT-094797820],n ^ -7 �- _3/22/2013 $1,000 -. ( -. e 3/22/2014 EACH OCCURRENCE $ 1 , 000, 000 PRaENTED PREEMIMI E SES S (RENTED Ea occurrence) 100 000 $ r CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 X X BI 6 PD Deductible PERSONAL 8 ADV INJURY $ 1,000,000 Contractual Liability GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER —I POLICY 13► 1 781, Ti LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ B AUTOMOBILE X X LIABILITY ANY AUTO ALL OW NED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS 60 96407700' - " ' '' '-' Experience Mod Rate . 90 it. //2013 3/22/2014 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ Medical payments $ 5,000 A X UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE AEC924225101 3/22/2013 3/22/2014 EACH OCCURRENCE $ 3,000,000 AGGREGATE $ 3,000,000 DED I I RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? DI (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 083027268 3/22/2013 3/22/2014 X I TORY IM TS I I ER E.L. EACH ACCIDENT $ 1, 000, 000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 $ 1,000,000 E.L. DISEASE - POLICY LIMIT D E Rented & Leased Equip Pollution Liab /Ded $5,000 72531842 TBD 3/22/2013 9/06/2013 3/22/2014 96/2014 Limit/Deductible 150,000/1,000 Aggregate/Ea Incidental 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Clearwater is named as additional insureds. ATE HOLDER CANCELLATION City of Clearwater P O 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 Marc Wilder /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