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.