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CERTIFICATE OF LIABILITY INSURANCE (398)Client#: 1509400 68GEORGYOU ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 2/10/2014 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 BB &T- Landrum Yaeger 3375 -B Capital Circle, NE PO Box 14099 Tallahassee, FL 32317 CONTACT NAME: Scott Jay (A/CNN , ). 850 386 -2143 FAX 888 328 -1326 (A/C, No): a- MAIL sjay @bbandt.com INSURERS) AFFORDING COVERAGE NAIC # INSURER A : Westfield Insurance Company 24112 INSURED George F Young of Florida Inc George F Young Inc 299 Dr Martin Luther King Jr St N Saint Petersburg FL 33701 INSURER B : X INSURER C PREMISES (EaEoocrtEi pence) INSURER D: INSURER E: CLAIMS -MADE INSURER F : OCCUR COVERAGES CERTIFICATE NUMBER: 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 ADDLSUBR INSR WVD POLICY NUMBER POUCY EFF ,JMM/DD/YYYYUMM/DD/YYYYL 02/10/2013 ;J F; POUCY EXP 02/28/2014 LIMITS EACH OCCURRENCE $1,000,000 A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X X CMM5700700 E � -1 0 .t °iii (� a 7 Gt -o !Ci�g3 1` rt0 RD'S PREMISES (EaEoocrtEi pence) $ 300,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $10 000 X PD Ded: $1,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE 7 POLICY X LIMIT APPLIES Ter- PER: LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ A AUTOMOBILE X X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X X SCHEDULED AUTOS NON WNED AUTOS -0 X X J CMI�I� . W iVCS a 2013 02/28/2014 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CMM5700700 02/10/2013 02/2812014 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 DED X RETENT ON $0 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A VVC RYTLIM TS I ERH E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E . DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) General Liability *** Additional Insured status is granted with respect to General Liability if required by written contract per endorsement "Additional Insured - Owners, Lessees or Contractors - Automatic Status When Required in Construction Agreement With You" CG2033 (07/04). (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION City of Clearwater Attn: City Clerk P.O. 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 ACORD 25 (2010/05) 1 of 2 #S11839237/M11838730 ©1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NS9 Additional Insured status including Completed Operations is granted with respect to General Liability if required by written contract per endorsement "Additional Insured - Owners, Lessees, or Contractors - Automatic Status When Required in Construction Agreement - Completed Operations" CG7087 (01/05). Blanket Waiver of Subrogation applies with respect to General Liability per endorsement "Waiver of Transfer of Rights of Recovery Against Others To Us" CG2404A (05/09). Per Project Aggregate and Per Location Aggregate applies. 30 Day Notice of Cancellation with 10 Day Notice of cancellation for non - payment applies. ***Auto*** Blanket Additional Insured applies with respect to Auto Liability per endorsement "Business Auto Expand Endorsement" CA7068 (08/11). Blanket Waiver of Subrogation applies with respect to Auto Liability per endorsement "Business Auto Expand Endorsement" CA7068 (08/11). Umbrella Coverage is Excess of General Liability, Auto and Worker's Compensation Coverage. City of Clearwater Project #13 -0004 -EN and PO #ST109373 KCA Project No. 6201207.02 KCA Task Work Oder #2 Design of Island Estates 4 Bridges: #155513, #15514. #15515, & #15516 City of Clearwater is named as Additional Insured with respects to General Liability and Auto Liability. A Waiver of Subrogation applies. SAGITTA 25.3 (2010/05) 2 of 2 #S11839237/M11838730