CERTIFICATE OF LIABILITY INSURANCE (525)Client#: 10
ACORDT. CERTIFICATE OF LIABILITY
INSURANCE
9/11/2014)
TYPE OF INSURANCE
PRODUCER
Construction Underwriters, Inc
4168 Southpoint Pkwy - Ste 305
Jacksonville, FL 32216
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
Milton J. Wood Fire Protection, Inc.
MJW Consolidated, Inc.
3805 Faye Road
Jacksonville, FL 32226
INSURER A: Amerisure
19488
INSURER B: Commerce & Industry
19410
INSURER C: XL Specialty Insurance Company
24554
INSURER D:
10/01/15
INSURER E:
$1,000,000
S
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
1NSR
LTR
ADD'L
INSRC
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MM/DD/YY)
POLICY EXPIRATION
DATE (MM /DD/YY)
LIMITS
A
GENERAL
X
LIABILITY
COMMERCIAL GENERAL LIABILITY
GL2024552
XCU Included
Ongoing /Comp Ops
Contractual Liab
10/01/14
10/01/15
EACH OCCURRENCE
$1,000,000
PREMISES ERENTED ncel
$500,000
CLAIMS MADE X OCCUR
MED EXP (Any one person)
$10,000
X
Blnkt Addl Insd
PERSONAL 8 ADV INJURY
$1,000,000
X
Blnkt WOS
GENERAL AGGREGATE
$2,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER:
POLICY n 78, n LOC
PRODUCTS - COMP /OP AGG
$2,000,000
7
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
$1,000 Comp Ded
CA2032133
RECEIVED
SEP
OFFICIAL RECORDS
10/01/14
18 2014
COR ®S AN
nFPT
10/01/15
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
X
DAMAGE
(Per accident)
$
X
$1,000 Coil Ded
GARAGE
LIABILITY
ANY AUTO
MASLOW
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
AUTO ONLY: AGG
$
B
EXCESS /UMBRELLA LIABILITY
BE15805674
Follow Form
Excess Over:
GL/Auto /Empl Lia
10/01/14
10/01/15
EACH OCCURRENCE
$10,000,000
)—(1 OCCUR CLAIMS MADE
AGGREGATE
$10,000,000
—1
DEDUCTIBLE
RETENTION $
$
$
$
WORKERS COMPENSATION AND
LIABILITY
ANY PROPRIETOR/PARTNER /EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
WC
WC STATU- 10TH-
TORY I IMITS ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
$
C
C
C
OTHER Installation
Rented Equip
Riggers Liab.
UM00023933MA13A
UM00023933MA13A
UM00023933MA13A
10/01/14
10/01/14
10/01/14
10/01/15
10/01/15
10/01/15
$2Mill($1MilITempSte)
$1Mill /$2Mill
$1Mill($500kTempSite)
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Certificate Holder is listed as an Additional Insured.
CERTIFICATE HOLDER
CANCELLATION
City of Clearwater
100 South Myrtle Avenue
Clearwater, FL 33756 -5520
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL fin DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2001/08) 1 of 1
#S95503/M95404
RLG
0 ACORD CORPORATION 1988