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CERTIFICATE OF LIABILITY INSURANCE (38) Client#: 6108 GRIMCRA3 ACORDm CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIVY) 10/12/06 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 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PRODUCER Suncoast Insurance Associates P.O. Box 22668 Tampa, FL \33622~2p68 813289-5200 - INSURERS AFFORDING COVERAGE Grimail Crawford, Inc. 1511 N Westshore Blvd Suite 1115 Tampa, FL 33607 COVERAGES INSURER A: United States Fidelity & Guaranty INSURER B: St. Paul Fire & Marine Insurance CO INSURER C: Hudson Insurance Company INSURER D: INSURER E: INSURED THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING AIjIY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MtY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH P L1CIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I'~M TYPE OF INSURANCE POLICY NUMBER Pgk!fl,~~5~ P~~fl ,'i::Jo~;WIN LIMITS A ~NERAL LIABILITY BK01231322 10/14/06 10/14/07 EACH OCCURRENCE $2AQ.0,000 _ X COM M ERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $2 000 000 - o CLAIMS MADE [X] OCCUR MED EXP (Anyone person) $10000 PERSONAL & ADV INJURY $2.000.000 , GENERAL AGGREGATE $4.000.000 n'L AGGR,Efil L1M IT APnS PER: PRODUCTS -COMP/OP AGG $4.000.000 POLICY X jr& LOC , ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $ I ---' ANY AUTO (Ea accident) - ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) - - HIRED AUTOS BODILY INJURY (Per accident) $ - NON-OWNED AUTOS - PROPERTY DAMAGE (Per accident) $ ~RAGE LIABILITY AUTO ONLY- EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ ricEss LIABILITY EACH OCCURRENCE $ :::1 OCCUR D CLAIMS MADE AGGREGATE $ $ ~ DEDUCTIBLE $ RETENTION $ $ . . IBI WORKERS COMPENSATION AND BW02178650 OS/22/06 OS/22/07 X we STATU- I IOJ~- EMPLOYERS' LIABILITY $1,000,000 E.L. EACH ACCIDENT E.L. DISEASE - EA EMPL OYEE $1,000,000 E.L. D,ISEASE - POLICY LIMIT $1,000,000 C OTHER AEE7137101 OS/29/06 OS/29/07 $1,000,000 per claim Professional $1,000,000 aggregate Liabilitv DeSCRIPTION OF OPERATlONSILOCATlONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Professional Liability is claims made and reported. RE: Engineer of Record - Mike Crawford CI;RTIFICATE HOLDER I I ADDITIONALINSURED"INSURERLETTER: CANCELLATION SHOULD ANY OF TH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Clearwater DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL30.-DAYSWRITTEN Engineer Dept; Attn: Susan Chase NOTlCETOTHE CERTIFICATE HOLDER NAMED TOTHE LEFT, BUTFAlLURE TODOSOSHALL Suite 220 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR PO Box 4748 REPRESENTATIVES. Clearwater, FL 33758-4748 AOl1.~ED REPR~TIVE I . ~ oJ,.. .a. ~ A ;;ORD 25-5 (7/97) 1 of2 #M132541 @ ACORD CORPORATION 1988 KEB 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). i I I 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 i 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. , I II AOORD2S-5(7/97)2 of 2 #M132541 II i Client#: 6108 GRIMCRA3 A'CORa:; CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYY) 10/12/06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Suncoast Insurance Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 226.68 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tampa, FL 33622.2668 813289.5200 INSURERS AFFORDING COVERAGE INSURED INSURER A: United States Fidelity & Guaranty Grimail Crawford, Inc. INSURER B: St. Paul Fire & Marine Insurance Co 1511 N Westshore Blvd INSURER c: Hudson Insurance Company I Suite 1115 INSURER D: I I I Tampa, FL 33607 INSURER E: CdVERAGES ~~.E POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING AIfJY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR M Y PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH P L1CIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I~~: TYPE OF INSURANCE POLICY NUMBER Pgk!fl/~J~g~~ p~~~J ('il!:!~m\N LIMITS A ~NERAL LIABILITY BK01231322 10/14/06 10/14/07 EACH OCCURRENCE $2.000000 eX COM M ERCIAL GENERAL LIAB ILITY FIRE DAMAGE (Anyone fire) $2.000.000 . I-- :=J CLAIMS MADE [i] OCCUR MED EXP (Anyone person) $10000 PERSONAL & ADV INJURY $2.000.000 . GENERAL AGGREGATE $4.000.000 GEN'L AGGREm L1M IT APPLIES PER: PRODUCTS -COM~OPAGG $4.000.000 I Il POLICY X j~~T n LOC ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) - - ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) - - HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) - - PROPERTY DAMAGE $ (Per eccident) ~GE UABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS UABILITY EACH OCCURRENCE $ ::J OCCUR D CLAIMS MADE AGGREGATE $ $ ~. DEDUCTIBLE $ .'.-. I II - - .- u_ - ..' . -RETENTION $ $ B WORKERS COMPENSATION AND BW02178650 OS/22/06 OS/22/07 X WC STATU- I IOJ~- EMPLOYERS' UABILITY $1,000,000 E.L. EACH ACCIDENT E.L. DISEASE - EA EMPL OYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1.000.000 C OTHER AEE7137101 OS/29/06 OS/29/07 $1,000,000 per claim Professional $1,000,000 aggregate liabilitv DesCRIPTION OF OPERATlONSlLOCATIONSNEHICLESJEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Professional Liability is claims made and reported. CERTIFICATE HOLDER I I AD DmONAL INSURED' INSURER LETTER: CANCELLATION SHOULD ANY OF TH E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION City of Clearwater DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TOMAIL:!O--DAYSWRJTTEN Engineering Department NOTlCETOTHE CERTIFICATE HOLDER NAMED TOTHE LEFT. BUTFAlLURE TO DOSOSHALL PO Box 4748, Ste 220 1M POSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON TH E INSURER,ITS AGENTS OR ! Clearwater, FL 33758-4748 REPRESENTATIVES. A~EDREPR~TIVE I ."..,. Ql., .a.. - A~ORD 25-5 (7/97)1 of 2 #M132541 KEB @ ACORD CORPORATION 1988 .... -.--"- 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). ! I i I 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. - ~~- .- ;il ACORD25-8(7/97)2 of 2 #M132541