Loading...
CERTIFICATE OF LIABILITY INSURANCE (322)HARVA -1 OP ID: KM Ate.- -- ° =` ' CERTIFICATE OF LIABILITY INSURANCE DATE 11 /10 /DD/YYYY) 11 /10/2014 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 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 RLl.El' L) Jackson, Collinsworth & Johnson Insurance Agency, LLC. CITY CF (- __`t -; ,. ?WATER 2208 Hillcrest Street Orlando, FL 32803 Mark E. Jackson t- j i `P, CONTACT NAME: Kristin McIntosh (aco,NN , Ext) :321-445 -1117 FAX No): 321-445 -1076 E -MAIL ADDRESS: cents @jcj- insurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A:RLI Insurance Company 13056 INSURED Harvard Jolly, Inc. RISK �v1�NAC;Fi`JtN1 y, 2714 Dr ML King Jr St. N. 917 5 St Petersburg, FL 33704 INSURER B : Travelers Casualty & Surety Co 19038 INSURER C : Commerce & Industry Insurance 19410 INSURER D : $ 1,000,000 INSURER E : INSURER F : X 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 INSD SUBR WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS B X COMMERCIAL GENERAL LIABILITY 6801709P725 11/08/2014 11/08/2015 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) 1 000 000 $ > > MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE POLICY OTHER: X LIMIT APPLIES jE 0 PER LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 $ B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS BA-1F692578 11/08/2014 11/08/2015 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ C X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE EBU063718182 11/08/2014 11/08/2015 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below - N / A PSW0001698 01/01/2014 01/01/2015 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Professional Liability RDP001114 06/30/2014 06/30/2015 Per Claim 3,000,000 Aggregate 3,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Architect of Record Agreement RFQ 14 -11 Professional Services. CERTIFICATE HOLDER CANCELLATION CLEA474 City of Clearwater tY P.O. Box 4748 Clearwater, FL 33758 -4748 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 /01eAle- ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD HARVA -1 OP ID: KM `t '' � CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/10/2014 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 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 Jackson, Collinsworth & Johnson Insurance Agency, LLC. 2208 Hillcrest Street Orlando, FL 32803 Mark E. Jackson CONTACT Kristin McIntosh (A/CNN ,E,rt) :321 -445 -1117 FAX 321 -445 -1076 E-MAIL ADDRESS: certs@jcj-insurance.com JCj- insurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:RLI Insurance Company 13056 INSURED Harvard Jolly, Inc. 2714 Dr ML King Jr St. N. St Petersburg, FL 33704 INSURER B: Travelers Casualty & Surety Co 19038 INSURER & Industry Insurance ry 19410 INSURER D : $ 1,000,000 INSURER E : INSURER F : X 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 ADM INSD SUBR WVD POUCY NUMBER POLICY EFF (MMIDD/YYYY) POUCY EXP (MMIDDIYYYY) LIMITS B X COMMERCIAL GENERAL LIABILITY 6801709P725 11/08/2014 11/08/2015 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR PAMAGFTORENTEO PREMISES (Ea occurrence) 1000000 $ > > GENII MED EXP (Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 AGGREGATE POLICY OTHER: X LIMIT APPLIES ECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 $ B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS BA- 1F692578 11/08/2014 11/08/2015 COMBINED SINGLE LIMIT (Ea adent) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ C X UMBRELLA UAB EXCESS UAB X OCCUR CLAIMS -MADE EBU063718182 11/08/2014 11/08/2015 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory In NH) if yes, describe under DESCRIPTION OF OPERATIONS below N / A PSW0001698 01/01/2015 01/01/2016 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Professional Liability RDP001114 06/30/2014 06/30/2015 Per Claim 3,000,000 Aggregate 3,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Architect of Record Agreement RFQ 14 -11 Professional Services. CERTIFICATE HOLDER CANCELLATION CLEA474 City of Clearwater P.O. Box 4748 Clearwater, FL 33758 -4748 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) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACOREI CERTIFICATE OF LIABILITY INSURANCE �,,,� DATE(MM /DD/YYYY) 10/09/2014 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 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 Mutual Insurance Inc 1900 1st Ave North PO Box 12350 St Petersburg FL 33713 RAMP. ACT Mitchell Marsh ext 2214 PHONN yr +). (727) 896 -0006 FAX N,).(727) 821 -7483 E-MAIL 44, mmarsh @mutualinsuranceinc.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Auto Owners Insurance Co 18988 INSURED Harvard Jolly, Inc. & Tercilla, Courtemanche Architects, Inc. 2714 Dr MIk Jr St N St Petersburg FL 33704 -2722 INSURER B : RECEIVED OCT 14 � t �t� p ��' Vb1014�. REEMRDS INSURERc: INSURER D : $ INSURER E : $ INSIIRFR F : $ REVISION 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 /NCR SUBR wvn POLICY NUMBER POLICY EFF nYY (MMmIYYI POLICY EXP (MM/nnIYVYY) LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY RECEIVED OCT 14 � t �t� p ��' Vb1014�. REEMRDS / 2014 C� � ��_ ANE, EACH OCCURRENCE $ DAMAGE TO RENTED PRFMISFS (FR nrrurrenne) $ MED EXP (Anv one person) $ CLAIMS -MADE OCCUR PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP /OP AGG $ GEN'L AGGREGATE I POLICY LIMIT APPLIES PER: PRO- I I LOC $ A AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED NON -OWNED AUTOS X �� "yE sr 967711700( W r1 iz aire11/08/2015 COMBINED; INGLE LIMIT (Fa arcident _$ $ 1,000,000 BODILY INJURY (Per person) BODILY INJURY (Per accident) $ 1,000,000 PROPERTY DAMAGE ( P ) $ 1,000,000 $ UMBRELLA LIAB EXCESS LIAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under fFSCRIPTION OF OPFRATIONS below Y I N N / A I TO WC v LIMITS I I ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES Attach ACORD 101 Additional Remarks Schedule, if more space Is required Cancellation Terms: 30 days notice of cancellation except for 10 days notice for non payment of premium. The City of Clearwater is an additional insured as per the Commercial auto policy with a waiver of subrogation in favor of the additional insured. 30 days notice of cancellation. ■GR 11r IVM 1G r1VGYGJN City of Clearwater Attention: City Clerk PO Box 4748 Clearwater I FL 337584748 "•---- --•"_" 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) Fax: ( ) - ©1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD