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FIRE STATION 48 LOGAN STREET APPROACH - 13-0005-FI - CERTIFICATE OF LIABILITY INSURANCESTEVE -7 OP ID: S7 4WR°� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 07/28/14 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 Phone: 727 -461 -6044 Brown & Brown of Florida, Inc. Fax: 727-442-7695 83 Park Place Blvd., Ste 101 7 -442 -7695 P.O. Box 2456 (33757 -2456) Clearwater, FL 33759 Sean Tobe CONTACT PHONE FAX (A /C. No. Ext): (A /C, No): E-MAIL INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Gemini Insurance Company 10833 INSURED Steve's Excavating & Paving, Inc P.O. Box 303 Dunedin, FL 34697 INSURER B: Zenith Insurance Company 13269 INSURER C : General Ins Company of America 24732 INSURER D : Commerce and Industry Ins Co 19410 INSURER E : $ 100,000 INSURER F : COVERAGES CERTIFICATE 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 SUER WVD POLICY NUMBER POLICY EFF (MMIDD/YYYY) POLICY EXP (MM/DOIYYYY) LIMITS A GENERAL X LIABILITY _ COMMERCIAL GENERAL LIABILITY X VGGP0012 ECEI!/ED� JUL 3 0 2014 OFFICIAL 7/28/14 AND 07/28/15 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: POLICY J!'?f LOC PRODUCTS - COMP /OP AGG $ 2,000,000 Emp Ben. $ 1M/1M C AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS - "'� �j�� p��.S 24CC30852820 -" SR��"�T `D /18/14 07/28/15 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) ( ) $ PROPERTY DAMAGE (Per accident) $ $ D X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE BE016491272 07/28/14 07/28/15 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ DED X RETENTION $ 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If Es, describe under D DESCRIPTION OF OPERATIONS below Y / N N / A 2126638601 05/31/14 05/31/15 WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Job -The Fire Station 48 Logan St Approach, Clearwater, FL. City of Clearwater is an additional insured per the terms of the policy. ATE HOLDER CANCELLATION CITYC -1 City of Clearwater P. O. Box 4748 Clearwater, FL 33756 -5520 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 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD