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CERTIFICATE OF LIABILITY INSURANCE (2) PRODUCER . Lockton Companies 444 W. 47th Street, Suite 900 Kansas City Mo 64112-1906 (816) 960-9000 ACORDTM CERTIFICATE OF LIABILITY INSURANCE 12/31/2006 D;;~~;~~D;;;;) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR C V P CIE EL INSURED 1059807 MASTEC NORTH AMERICA, INC. A TTN:MAUREEN POPOVICH 7221 DR. MARTIN LUTHER KING JR BLVD E TAMPA FL 33619 INSURERS AFFORDING COVERAGE ACE AMERICAN INSURANCE COMPANY COVERAGES - INSIJRERISI AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. "IN]: H, ITPE-oF.;NSURANCE-- ,. . '.. . POL.,"'V ~1I11"U:II:R . _ .'cii';!2Y EFFECTIVE P..aI,J~Y EXPIRATION LIMITS - GENERAL LIABILITY EACH OCCURRENCE $ 2 000 000 r-- A X COMMERCIAL GENERAL LIABILITY HDOG21727659 12/31/2005 12/31/2006 FIRE DAMAGE..lAI}Y one fire) $ 100 000 I CLAIMS MADE [X] OCCUR MED EXP (Anyone person) $ 25 000 - PERSONAL & ADV INJURY $ 2 000 000 - GENERAL AGGREGATE $ 4 000 000 ,gr AGGRIil ~I~'~ APflPER PRODUCTS - COMP/OP AGG $ 4 000 000 POLICY X JEl?T LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT r-- $ 3,000,000 A ~ ANY AUTO ISAH08016616 12/31/2005 12/31/2006 (Ea accident) ALL OWNED AUTOS BODILY INJURY r-- $ XXXXXXX SCHEDULED AUTOS (Per person) f-- -X- HIRED AUTOS BODILY INJURY XXXXXXX $ X NON-OWNED AUTOS (Per accident) - PROPERTY DAMAGE $ XXXXXXX (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ XXXXXXX ==i ANY AUTO NOT APPLICABLE OTHER THAN EA ACC $ XXXXXXX AUTO ONLY: AGG $ XXXXXXX EXCESS LIABILITY EACH OCCURRENCE $ XXXXXXX :J OCCUR D CLAIMS MADE NOT APPLICABLE AGGREGATE $ XXXXXXX ==j 0 UMBRELLA $ XXXXXXX DEDUCTIBLE FORM 'I: XXXXXXX RETENTION $ $ XXXXXXX -- -- .~.-- , . -.'--- - -'12/31/2()05 -.---- "12/31/2006 .' xlYo,IeSfATlt"1 I~~H- .....n .' ..n A WORKERS COMPENSATION AND WLRC44447137 A EMPLOYERS' LIABILITY SCFC44447149 (WI) 12/31/2005 12/31/2006 I 000 000 E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ I 000 000 E.L. DISEASE - POLICY LIMIT $ I 000 000 OTHER DESCRIPTION OF OPERA TIONS/LOCA TIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS THE CITY OF CLEAR WATER IS SPECIFICALLY INCLUDED AS AN ADDITIONAL INSURED ON LIABILITY INSURANCE COVERAGE DESCRIBED ABOVE. BID NO. 29-06 HOLDER I I ADDITIONAL INSURED' INSURER LETTER: .ATION 2633021 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF CLEARWATER DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ..11L. DAYS WRITTEN ATTN: CITY CLERK PO BOX 4748 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL CLEARWATER FL 33758 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE /0 ~~.4 L~ .-ttIL I ACORD 25-5 (7/97) For questions regarding this certificate, contact the number listed in the 'Producer" section above and specify the client code 'MASTE-1', @Ae"'O~ CORPORATION 1988 MASTE 1 JI THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. 00 ~~ ~ I~ : ~ ~ OFFICIAL RECORDS AND LEGISLATIVE SRVCS DEPT 'I