CERTIFICATE OF LIABILITY INSURANCE (29)
PRODUCER .
Lockton Companies
444 W. 47th Street, Suite 900
Kansas City Mo 64112-1906
(816) 960-9000
DATE (MMlDDIYY)
ACORDTM CERTIFICATE OF LIABILITY INSURANCE 12/31/2007 12/22/2006
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
ED
MASTEC NORTH AMERICA, INC.
A TTN: MAUREEN POPOVICH
7221 DR. MARTIN LUTHER KING JR BLVD E
TAMPA FL33619
INSURED
1059807
INSURERS AFFORDING COVERAGE
CECOMPANY
COVERAGES - RE OR 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.
INSR 'F~PiH)FINSURANC~ ..... .. P6LiGV_R ~~ICY EFFECTIVE POLICY EXPI~~?N "'lIMITS'
.'. ", ....... T - . ....-
GENERAL LIABILITY EACH OCCURRENCE $ 2 000 000
-
A X COMMERCIAL GENERAL LIABILITY HOOG21714914 12/31/2006 12/31/2007 FIRE DAMAGE (Anv one fire) $ 500 000
[ CLAIMS MADE [K] OCCUR MED EXP I Anv one Derson \ $ 25 000
- PERSONAL & ADV INJURY $ 2 000 000
- GENERAL AGGREGATE $ 10000000
GEN'L AGGREGATE LIMIT APn PER PRODUCTS.COM~OPAGG $ 4 000 000
"I Ti1 PRO-
POLICY JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $ 3,000,000
A .K.. ANY AUTO ISAH08224389 ] 2/31/2006 ] 2/31/2007 (Ea accident)
- ALL OWNED AUTOS BODILY INJURY
$ XXXXXXX
SCHEDULED AUTOS (Per person)
-
.K.. HIRED AUTOS BODILY INJURY XXXXXXX
$
.K.. NON-OWNED AUTOS (Per accident)
- PROPERTY DAMAGE $ XXXXXXX
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ XXXXXXX
=1 ANY AUTO NOT APPLICABLE OTHER THAN EA ACC $ XXXXXXX
AUTO ONLY, AGG $ XXXXXXX
EXCESS LIABILITY EACH OCCURRENCE $ XXXXXXX
~ OCCUR D CLAIMS MADE NOT APPLICABLE AGGREGATE $ XXXXXXX
=1 0 UMBRELlA I $ XXXXXXX
DEDUCTIBLE FORM !I: XXXXXXX
RETENTION $ $ XXXXXXX
A WORKERS COMPENSATION AND, ',' ~ WLRC44451SH& ._--~. - ]2/31/2006- 12/3 ]/2009 -X IWC STATU- I . ..lgJH. - , .,
A EMPLOYERS' LIABILITY SCFC4445]89A (WI) ] 2/31/2006 ]2/3]/2007 ] 000 000
E.L. EACH ACCIDENT $
I E.L. DISEASE - EA EMPLOYEE $ ] 000 000
E.L. DISEASE - POLICY LIMIT $ ] 000 000
OTHER
DESCRIPTION OF OPERA nONS/LOCA nONSNEHICLESJEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
THE CITY OF CLEARWATER IS SPECIFICALL YINCLUDED AS AN ADDITIONALINSURED ON LIABILITY INSURANCE COVERAGE DESCRIBED
ABOVE. BID NO. 29-06
CERTIFICATE HOLDER I ! ADDITIONAL INSURED' INSURER LETTER: CANCELLATION
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 ~ DAYS WRITTEN
A TTN: 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
REPRESENT A nVES.
AUTHORIZED REPRESENTATIVE /2 .-.A ~.. ~. ...tt1It..
F'7' -
ACORD 25-S (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
n
THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING