Loading...
EAST ADVANCED POLLUTION CONTROL FACILITY MOTOR CONTROL UPGRADES (01-0057-UT) - CERTIFICATE OF LIABILITY AGREEMENT (2)'°`� ° ® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 5/13/2014 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 Stahl & Associates Insurance Inc. 91 Lake Morton Drive P 0 Box 3608 Lakeland FL 33802 CONTACT Michele Crifasi NAME: PH NN Ott. (863) 688 -5495 FAX No (863) 688-4344 E -MAIL michele .crifasi @stahlinsurance.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :Westfield Insurance Company 24112 INSURED Leedy Electric East LLC 520 Prairie Industrial Pkwy Mulberry FL 33860 -9585 INSURER B :FCCI Insurance Company 10178 INSURER C :Columbia Casualty Company 31127 INSURERD: $ 1,000,000 INSURER E : $ 100,000 INSURERF: $ 1, 000 COVERAGES CERTIFICATE NUMBER:14 /15 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 INSR SUB WW VD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY �± ^'"te n CWP0184731 t' l a ? ^ ' f �, 1/17204 1/1/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 1, 000 ( CLAIMS -MADE X OCCUR PERSONAL & ADV INJURY $ 1,000,000 X Contractual Liability GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 7 POLICY I l PRO JECT - n LOC $ AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS _ CWP0184731 . - - - W 1/1/2014 1/1/2015 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 $ BODILY INJURY (Per person) BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ Medical payments $ 1,000 A X UMBRELLA LIAB EXCESS LIAB �X OCCUR CLAIMS -MADE CWP0184731 1/1/2014 1/1/2015 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 $ DED X RETENTION $ 1,000,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/ N N N/A 001WC14A58959 1/1/2014 1/1/2015 X I TORY LIMI WC STATUT- S OTH- ER E.L. EACH ACCIDENT $ 1,000,000 $ 1,000,000 $ 1 , 000 , 000 E DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT C A Professional Liability Rented & Leased Equipment CE0288376097 CWP0184731 5/10/2014 1/1/2014 5/10/2015 1/1/2015 Limit/Ded Per Claim $5,000 1,000,000 Limit/Deductible 100,000/500 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Clearwater P 0 Box 4748 Clearwater, FL 33758 -4748 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 S DePianta /CRIFAS 4 -. ACORD 25 (2010/05) INS025 (201005).01 ©1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and Togo are registered marks of ACORD