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EAST ADVANCED POLLUTION CONTROL FACILITY MOTOR CONTROL UPGRADES (01-0057-UT) - CERTIFICATE OF LIABILITY AGREEMENT (3)A� °R °I CERTIFICATE OF LIABILITY INSURANCE DATE ) 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 INCNW txt): (863) 688 -5495 I A/C. 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 Group � �.y bra, CWP0184731 L �� 4ti w ` - 'h �� 1Jb� ( - c4 & a C ECMAII V � '� /�''- CWP0184731 INSURER C :Columbia Casualty 1/1/2015 1/1/2015 INSURERD: $ 1,000,000 INSURER E : $ 100,000 INSURERF: CERTIFICATE NUMBER:14 /15 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 WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY � �.y bra, CWP0184731 L �� 4ti w ` - 'h �� 1Jb� ( - c4 & a C ECMAII V � '� /�''- CWP0184731 r^ 014 € l ,) ��. ITT ) 1/1/2014 1/1/2015 1/1/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 1, 000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 7d POLICY n PRO- n JECT PRODUCTS - COMP /OP AGG $ 2 , 000 , 000 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 A — AUTOMOBILE X X LIABILITY ANY AUTO ALL ONED AUTOS W HIRED AUTOS X SCHEDULED AUTOS NN -OWNED AUTOS 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 $ 4,000,000 AGGREGATE $ 4,000,000 DED X ( RETENTION $ 1,000,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below �, / N N / A 001WC14A58959 1/1/2014 1/1/2015 WC STATU- I TORY LIMITS I ER E.L. EACH ACCIDENT $ 1,000,000 $ 1,000,000 E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ 1,000,000 C A Professional Liability Rented & Leased Equipment CE0288376097 CWP0184731 5/10/2013 1/1/2014 5/10/2014 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) ER CANCELLATION City of Clearwater 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 S DePianta /CRIFAS ACORD 25 (2010/05) INS025 (201005).01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD