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STORMWATER OUTFALL PIPE CLEANING - 13-0045-EN - CERTIFICATE OF LIABILITY INSURANCEACORO® CERTIFICATE OF LIABILITY INSURANCE ■■•■--- 8/1/2015 DATE(MM /DD/YYYY) 7/23/2014 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 PRESENTATIVE 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 Lockton Companies 444 W. 47th Street, Suite 900 Kansas City MO 64112 -1906 (816) 960 -9000 CT CONTACT FAX (NC, No, Ext): I (A/C, No): E -MAIL ADDRESS: INSURER'S) AFFORDING COVERAGE NAIC # INSURER A : Zurich American Insurance Company 16535 INSURED LAYNE INLINER, LLC 426 2531 JEWETT LANE SANFORD FL 32771 -1677 INSURER B : American Zurich Insurance Company 40142 INSURER C 8/1/2015 INSURER D : $ 2,000,000 INSURER E : CLAIMS -MADE OCCUR X INSURER F : $ 500,000 COVERAGES LAY • • 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 INSD SUBR VVVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP /MM /DD/YYYYI LIMITS A x COMMERCIAL GENERAL LIABILITY y y GLO 5817438 -01 8/1/2014 8/1/2015 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE OCCUR X DAMAGE TO RENTED PREMISES (Ea occurrence) $ 500,000 X S'ONTRACT1 TAT , MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 2,000,000 X X.C.I J COVFRAGE GENERAL AGGREGATE $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 3 POLICY❑ JECT LOC OTHER PRODUCTS - COMP/OP AGG $ 5,000,000 $ iv AUTOMOBILE — LIABILITY ANY AUTO AUTOS OWNED HIRED AUTOS ^— — — SCHEDULED NON -OWNED AUTOS Y Y BAP 5817437 -01 JUL 8/1/2014 31 2014 8/1/2015 COMBINED SINGLE LIMIT (Ea accident) $ 5,000,000 BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident PROPERTY DAMAGE (Per accident) $ $ XXXXXXX UMBRELLA LIAB EXCESS LIAB _ OCCUR CLAIMS -MADE NOT APPLICABLE EACH OCCURRENCE $ )00X000( AGGREGATE $ XXXXXXX DED I I RETENTION $ $ B A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) If yes, tlescdbe under DESCRIPTION OF OPERATIONS below N/A Y WC 5817439 02 AOS) WC 5817440 -02 WI)) STOPGAP(ND,O ,WA,WY) 8/1/2014 8 /1/2014 8/1/2014 8/1/2015 8/1/2015 8/1/2015 PER OTH- X I STATUTE I I FR E.L. EACH ACCIDENT $ 5,000,000 E.L. DISEASE - EA EMPLOYEE $ 5,000 000 E.L. DISEASE - POLICY LIMIT $ 5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: STORMWATER OUTFALL PIPE CLEANING ( #13- 0045 -EN) — VARIOUS LOCATIONS, CITY OF CLEARWATER; CITY OF CLEARWATER IS INCLUDED AS AN ADDITIONAL INSURED AS RESPECTS GENERAL LIABILITY AND AUTOMOBILE LIABILITY IF REQUIRED BY SIGNED, WRITTEN CONTRACT. WAIVER OF SUBROGATION APPLIES IF REQUIRED BY SIGNED, WRITTEN CONTRACT AND WHERE ALLOWED BY LAW. 30 DAYS NOTICE OF CANCELLATION APPLIES. 12927606 CITY OF CLEARWATER 100 SOUTH MYRTLE AVENUE CLEARWATER FL 33756 CANCELLATION 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 ACORD 25 (2014/01) ©9 8 -2014 ACCitilif ORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD