The URL can be used to link to this page

LANDSCAPE IMPROVEMENTS PHASE 2 GULF TO BAY BOULEVARD FROM SKYVIEW AVE TO KILMER AVE - 11-0048-PR(A) - CERTIFICATE OF LIABILITY INSURANCEA�OR�® v CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1/2/2014 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 PrimeGroup Insurance Services, Inc. 5402 W. Laurel St. Suite 220 Tampa FL 33607 -1726 CONTACT Patty King #E131203 NAME: y g IA/C. No.Ext): (813) 890 -0415 ( No): (813)685 -4311 ADDRESS:pking @primegroupins.cora INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:FCCI Commercial Insurance 33472 INSURED Pine Lake Nursery & Landscape, Inc. 2122 Henley Road Lutz FL 33558 -8330 INSURER B :National Trust Insurance 20141 INSURER C :Zenith Insurance Company 13269 INSURERD: $ 1,000,000 INSURER E : $ 300,000 INSURER F: $ 10,000 :CL141212385 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 AINSR SUBR SWVD POLICY NUMBER POLICY EFF (MM DDY/YYYY) POLICY EXP JMM/DD //YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY GL0010648 4 q- .�r-a,4 '" 1.� 1 Iiir� _, i,_ ,.__.: °— 7/1/2013 7/1/2014 EACH OCCURRENCE $ 1,000,000 DAMAGE PREM SESO(Ea occur RENTED $ 300,000 MED EXP (Any one person) $ 10,000 CLAIMS -MADE X OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ Included GEN'L AGGREGATE LIMIT APPLIES PER: 7 POLICY S:T ri LOC 1 1 JF $ B UTOMOBILE AUTOMOBILE X _ LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ SCHEDULED AUTOS NON - OWNED" AUTOS " " ( . ; s ; CAO0 `i$ 4 "7Iij2013 ,...:..-.C..;,- �V w J ` ,`�„ __° 7/1/2014 COMBINED SINGLE LIMIT (Ea accident) $ 1, 000 , 000 $ BODILY INJURY (Per person) BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ PIP -Basic $ 10,000 A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE UMB0011101 4 7/1/2013 7/1/2014 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 $ DED X RETENTION$ 10,000 C 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 2068 772408 1/1/2014 1/1/2015 X WC STATU- TORY I IMITS OTH- FR E EACH ACCIDENT $ 1,000,000 $ 1,000,000 $ 1 , 000 , 000 E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT A Inland Marine Contractors Equipment CM0005570 4 7/1/2013 8/1/2013 Scheduled Equipment $272, 000 $500 Ded DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Re: Landscape Improvements Phase 2. Gulf to Bay Blvd from Skyview Avenue to Kilmer Avenue. Project No. 11- 0048 -PR (A). Certificate Holder is included as Additional Insured per written agreement with Insured. City of Clearwater P.O. Box 4748 Clearwater, FL 33756 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 E Ellsasser #A077187/C---7 $1-- ACORD 25 (2010/05) INS025 (201005).01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD