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SMALLWOOD CIRCLE DRAINAGE IMPROVEMENTS - 11-0057-EN AND EDGEWOOD AVENUE SANITARY SEWER IMPROVEMENTS - 10-0027-UT - CERTIFICATE OF LIABILITY INSURANCE (3)e '9 ° CERTIFICATE OF LIABILITY INSURANCE i 2oi2o ' I 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. 'no 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 Lassiter -Ware Insurance of Tampa Bay 4401 West Kennedy Blvd Suite 200 Tampa FL 33609 NAMECONTA CT Barbara Benton FF911310 Eatl: (800) 845 -8437 FAcX IpIC. Not: (888) 883 -8680 ADDREEMAIL SS: barbarab €lassiter -ware. colt INSURERS) AFFORDING COVERAGE NAIC S INSURER A Amerisure Mutual Insurance Co. 23396 INSURED Rowland, Inc. 6855 102nd Avenue North Pinellas Park FL 33782 rntrroAr•�c •+----- - -- - .....- -- - - - - slums Amerisure Insurance Companies 19488 INSURER C Ad= ral Insurance Company EACH OCCURRENCE ,24856 INSURER D INSURER E 5 300,000 INSURER F: CLAIMS -MADE i- ir•IL.M i r NllaaMI- M'•1 5--16 _._.-- ... _ __ -- --- _ - port iLini re.munum. 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. INS TR TYPE OF INSURANCE AWL I(ySR SUBR wvo POLICY NUMBER POLICY EFF IMMICDIYYYY) POLICY EXP IMMIDDIYXYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X X CPP2062751 7/1/2013 7/1/2014 EACH OCCURRENCE I: 1,000,000 DAMAGE TO RENTED PREMISES (Eeowwarre ncel 5 300,000 CLAIMS -MADE X OCCUR. MED EXP IAny ono parson) 5. 10,000 X X GEN'LAGGREGATE 7 XCU Included' PERSONAL & ADV INJURY S 1,000,000 Contractual Liability LIMIT APPLIES PER POLICY I x I 1,7g LOC GENERAL AGGREGATE S 2,000,000 PRODUCTS - COMP/OP AGO $ 2,000,000 $ 13 AUTOMOBILE X 3( X LIABILITY ANY AUTO ALL OWNED }ftREDAUTpS. PIP. $10,000 SCHEDULED AUTOS NON.ONMEO AUTOS X CA2.062748 7/1/2013 7/1/2014 {Ea COMBBIINED d SINGLE LIMIT S 1,000,000 5 BODILY INJURY (Per person) BODILYINJURV i Peraccden accident) S PROPERTY DAMAGE (Per accldenn 4 Medic.* Payments S 5,000 A X UMBRELLA LIAB EXCESS UAS X OCCUR CLAIMS -MADE X 002062749 7/1/2013 7/1/2014 EACH OCCURRENCE 5 _ 5,000,000 AGGREGATE $ 5,000,000 DED I IRETENTON5 S WORKERS COMPENSATION AND EMPLOYERS' LIAaL TY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE u OFFICERIMEaMSER EXCLUDED? (Mandatory In NH) tf yYea, describe older DESCRIPTION OF OPERATIONS beow N 1A I TORY 1 AMU S I 10TH- E.L. EACH ACCIDENT S E.L DISEASE. EA EMPLOYEE I E.L DISEASE • POLICY UNIT S C Contractor's Pollution X FEIECC1597900 7/1/2013 7/1/2014 S4,ODOODO Each Occurrence 34,000,000 Opera! Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 191, Additional Remark Schedule, if more space b required) Re Smallwood Circle Drainage Improvement Project. rcn'TIrIn A Tr 11/11 .. r. CANCELLATION City of Clearwater 100 S. Myrtle Avenue Clearwater, FL 33756 ACORD 25(2010/05) INS025 rn11Of, i Tha AI;t1Rr1 name and Irwin era ream PP w$ marten of 6 N SDn 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 Dana Snyder /BARBAB 01988 -2010 ACORD CORPORATION. All rights reserved.