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SMALLWOOD CIRCLE DRAINAGE IMPROVEMENTS - 11-0057-EN AND EDGEWOOD AVENUE SANITARY SEWER IMPROVEMENTS - 10-0027-UT - CERTIFICATE OF LIABILITY INSURANCE (2)AC•Rbe CERTIFICATE OF LIABILITY INSURANCE `/-- DATE(MM /DD/YYYY) 6/30/2014 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. 110 Carillon Parkway St. Petersburg FL 33716 CONTACT Laurie Sack NAME: IA / /CNN0.Extl: (727) 391-9791 I A/C.No.:(727)393 -5623 EMAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:Westfield Insurance Company 24112 INSURED Rowland, Inc. 6855 102nd Avenue Pinellas Park FL 33782 INSURERB:Admiral Insurance Company 24856 INSURER C : INSURER D : ,IMM , , ', 7/1/2014 INSURER E : EACH OCCURRENCE INSURERF: X COVERAGES CERTIFICATE NUMBER•CL1463022101 • 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 /DD/YYYYI POLICY EXP IMM /DD/YYYY) LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL Damage LIABILITY OCCUR /Occur �- cHM1620435 ` ,IMM , , ', 7/1/2014 7/1/2015 EACH OCCURRENCE $ 1,000,000 X DAMAGE TO RENTED PREMISES (Ea occurrence) $ 500,000 CLAIMS -MADE X MED EXP (Any one person) $ 15,000 X $500 Prop PERSONAL BADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENII AGGREGATE LIMIT APPLIES PER POLICY I—I PF� n LOC PRODUCTS - COMP /OP AGG $ 2,000,000 T1 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS -OWNED c541620435 7/1/2014 7/1/2015 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 $ X BODILY INJURY (Per person) SCHEDULED AUTOS BODILY INJURY Peraccident ( ) $ NON PROPERTY DAMAGE (Per accident) $ _AUTOS Medical payments $ 5,000 A X UMBRELLA LIAB EXCESS LIAB _ OCCUR CLAIMS -MADE (1411620435 7/1/2014 7/1/2015 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS Y I N N / A I TORY I M U- S I I0T E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ below E.L. DISEASE - POLICY LIMIT $ B Contractors Pollution Liability FEIECC1597901 7/1/2014 7/1/2015 Ea. Occur /Claim /Pollution 1,000,000 Aggregate Limit 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: Smallwood Circle Drainage Improvement Project. Certificate Holder is Additional Insured with respects to General Liability Automobile Liability and Pollution Liability per the terms, conditions and exclusions of the policy CERTIFICATE HOLDER CANCELLATION (727)562 -4755 karen.maldonado @MyClearwat City of Clearwater 100 S Myrtle Avenue 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 Kelly Petzold /SHAW ACORD 25 (2010/05) INS025 (201005).01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD