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CERTIFICATE OF LIABILITY INSURANCE (436)H� " CERTIFICATE OF LIABILITY INSURANCE Page 1 of 1 08/3 /2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. HOLDER. THIS BY THE POLICIES AUTHORIZED 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 Willis of Florida, Inc. c/o c/o 26 Century Blvd. P. O. Box 305191 Nashville, TN 37230 -5191 . CONTACT NAME: FAX A/C NO.EXT): 877- 945 -7378 888 - 467 -2378 E -MAIL ADDRESS: Certificates@willis.com INSURER(S)AFFORDING COVERAGE NAIC # INSURER A: Liberty Mutual Insurance Co. 23043 -091 INSURED Kimmins Contracting Corp. 1501 E. 2nd Avenue Tampa, FL 33605 I INSURER B: Liberty Mutual Insurance Company 23043 -004 INSURER C: National Union Fire Insurance Company of 19445 -005 INSURER D: OCCUR INSURER E: GEN'L INSURER F: PERSONAL &ADV INJURY • -- --- - -• -- - -- r.w r.wn rvanvrocn. 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 ADD'L INSRD SUBF WVD POLICY NUMBER TB2651285761Qr33; POLICY EFF (MM/DD/YYYY) g\/30/2013 POLICY EXP (MM/DD/YYYY) 8/30/2014 LIMITS EACH OCCURRENCE $ 1,000,000 A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY PREM PREMISES (EaEocccurence) $ 300,000 $ 5,000 CLAIMS -MADE X OCCUR MEDEXP(Anyoneperson) GEN'L PERSONAL &ADV INJURY $ 1,000,000 $ 2,000,000 $ 2,000,000 $ GENERAL AGGREGATE AGGREGATE POLICY X LIMIT APPLIES PER: JECT n LOC PRODUCTS - COMP/OP AGG B AUTOMOBILE X X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _AUTOS X _AUTOS SCHEDULED NON -OWNED AS2651285 61a23 8/30/2013 8/30/2014 C OMBINEDS INGLELIMIT $ 2,000,000 BODILY INJURY(Per person) $ BODILY INJURY(Per accident) $ PROPERTY DAMAGE (Per accident) $ $ C X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 8E15805666 8/30/2013 8/30/2014 EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10, 000, 000 DED X RETENTION$ 10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) fyes,describeunder DESCRIPTION OF OPERATIONS below N/A WC7651285761013 8/30/2013 8/30/2014 X WCSTATU- OTH- TORY LIMITS ER EL EACH ACCIDENT $ 1,000,000 E. L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach Acord 101, Additonal Remarks Schedule, if more space is required) RE: John Lewis Zemina - Qualifier License # CGC061458 Workers Compensation Coverage: includes USL &H CANCELLATION 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 City of Clearwater P.O. Box 4748 Clearwater, FL 34618 -4748 ACORD 25 (2010/05) Co11:4198622 Tp1:1694145 Cert:'0295265 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD