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DRUID TRAIL WALKWAY - PHASE 3 - 04-0021-PR - CERTIFICATE OF LIABILITY INSURANCE (2)AC•RIi CERTIFICATE OF LIABILITY INSURANCE L.------ DATE(MM/DD/YYYY) 1/6/2014 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 FLOW. 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 Roe Insurance Inc. 9851 State Road 54 New Port Richey FL 34655 CONTACT NAME: 'PATIO. Extl: (727)376 -0030 I IAC No): (727)376 -2262 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC ft INSURER A:AutO Owners Insurance Co. 18988 INSURED Ram Excavating Inc 3349 Hannah Way E Dunedin FL 34698 -9456 INSURERB:SOUthern Owners Insurance Co. 10190 INSURER C : 1/30/2015 INSURER D: $ 1,000,000 INSURER E : $ 300, 000 INSURERF: ICLAIMS -MADE COVERAGES CERTIFICATE NUMBER:13 /14 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/YYYYI POLICY EXP (MM/DD/YYYY) LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY 4266278101 1/30/2014 1/30/2015 EACH OCCURRENCE $ 1,000,000 PRMMGE TO RENTED PREMISES (Ea occurrence) $ 300, 000 ICLAIMS -MADE OCCUR MEDEXP(Anyoneperson) $ 10,000 PERSONAL &ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: —I POLICY n IFt° n LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ A A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS — X X SCHEDULED AUTOS NON -OWNED AUTOS 4266278101 1/30/2014 1/30/2015 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 $ BODILY INJURY (Per person) BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ Uninsured motorist combined $ 100, 000 B X UMBRELLA UAB EXCESS LIAB _ OCCUR CLAIMS -MADE 4266278103 12/8/2013 12/8/2014 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ DED I X RETENTION$ 10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A INC STATU- I TORY LIMITS I r IOTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ B Leased and Rented Equip 20714467 12/8/2013 12/8/2014 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: DRUID TRAIL WALKWAY PHASE #3 PROJECT (04- 0221 -PR) CERTIFICATE HOLDER CANCEL (727)562-4575 maldonado@rayclearwater.com CITY OF CLEARWATER BUILDING DEPARTMENT 100 SOUTH 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 Josephine Mansur /JS ACORD 25 (2010/05) INS025 (201005).01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD