CERTIFICATE OF LIABILITY INSURANCE (607)HAZE &SA -01
CDIXON
4 C RL7
_--- CERTIFICATE OF LIABILITY INSURANCE
DATE (MM /DDIYYYY)
3/21/2014
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
Ames & Gough
8300 Greensboro Drive
Suite 980
McLean, VA 22102
CONTACT NAME:
HONE
Exo: (703) 827 -2277 FAX No): (703) 827 -2279
,
E-MAIL
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: Transportation Insurance Company A(XV)
20494
INSURED
Hazen & Sawyer, P.C.
498 Seventh Avenue
New York, NY 10018
INSURER B:
!;
INSURER C :
INSURER D :
$
INSURER E :
$
INSURER F :
•
t..0 V CIWIJ co %.-Gm I rr Iv" ..- ..vn.v.-...
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 POLIC ES 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
INSD
SUER
WVD
POLICY NUMBER
IMM DD //YYYY)
(MM /DD //YYYY)
LIMITS
COMMERCIAL GENERAL LIABILITY
!;
EACH OCCURRENCE
$
DAMAGE TO RENTED
PREMISES (Ea occurrence)
$
CLAIMS -MADE
OCCUR
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
GE
'L AGGREGATE
POLICY
OTHER:
LIMIT APPLIES
JECT
PER:
LOC
PRODUCTS - COMP /OP AGG
$
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED
AUTOS
HIRED AUTOS
SCHEDULED
AUTOS
NON-OWNED
AUTOS
ti
COMB
(Ea accti EDtj SINGLE LIMIT
$
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
$
UMBRELLA LIAB
EXCESS UAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
$
DED
RETENT ON $
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y/N
ANY PROPRIETOR /PARTNER /EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
PER
STATUTE
OTH-
ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE POLICY LIMIT
$
A
Professional Liab.
AEH008231489
03/29/2014
03/29/2015
Per Claim /Aggregate 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: RFQ #07 -10 - Reverse Osmosis Water Treatment Plant.
VCR I Ir I\+N IL r7VLYGrc
City of Clearwater
ATTN: City Project Manager
PO Box 4748
Clearwater, FL 337584748
- . ° ----- ---
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
- - - -- - -- - - -- -- ..........
.11 -° -'-•- -- -- _.-..I
ACORD 25 (2014/01)
The ACORD name and logo are registered marks of ACORD