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2011 UNDERDRAINS PROJECT - 10-0016-EN - CERTIFICATE OF LIABILITY INSURANCE (4)ACORD CERTIFICATE \/ CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 6/17/2014 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 George H Odiorne Insurance Agency Inc PO Box 830 Brandon FL 33509 CONTACT Megan Manning NAME: g g Wt. Extl: (813) 685-7731 ai�c No): (813)685 -1823 AD DRIESS :mmanning @odiorneinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:FCCI LIABILITY COMMERCIAL GENERAL LIABILITY INSURED Adkins Contracting, Inc. PO Box 18 9 Ruskin FL 33575 INSURER B :FCB &I Fund [ , k r, GL001370K2 C:' INSURERC: 6/1/2015 INSURER D : $ 1,000,000 INSURER E : $ 100,000 INSURERF: $ 5,000 •14/15 Master All 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 SUBR wvn POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY1 LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY [ , k r, GL001370K2 C:' 6/1/2014 6/1/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 CLAIMS -MADE X OCCUR PERSONAL &ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GE X I POLICY f PF� fl LOC ` $ A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X _ X SCHEDULED AUTOS NON -OWNED AUTOS EE f ' / CA00212252 6/1/2014 6/1/2015 OMBINED(SSINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ PIP $ 10, 000 UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENT ON $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below YIN N NIA 10644942 4/5/2014 4/5/2015 X WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $ 500, 000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500 , 000 A Rented /Leased Equipment CM00080801 3/10/2014 3/10/2015 Limit 300,000 Deductible 1,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE 2011 Underdrain (10- 0016 -EN) City of Clearwater 100 S. Myrtle Ave. Clearwater, FL 33756 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 W Vildibill (C) /AIMEE e, ACORD 25 (2010/05) INS025 (201005) .01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD