CERTIFICATE OF LIABILITY INSURANCE (574)0411�12014 14:50 9414853835 y� x ���� GIFFORD HEIDEN INS PAGE 01/01
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.a►cvfR�• CEI�TiFICA�`� OF L,IABILITY INSUFtANC� pATE�MMioplYYYY)
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THIS C�RTIFICAI'� 15 ISSUED A8 A MATTER OF (NFpRMATION ON�,Y AND C�NF�RS NO RIGliTS UPON THE CER7i�ICATE HOL�ER. TNIS
CERTIFICATE DO�S NOT AFFIRMATIVELY OR NEGATIV�LY AINEND, FJC'IEND OR AI.'f�R THE CdVERAGE A�FqRDED BY TFIE i�O1,ICIES
BELOW. THis CER7iFicn� OF INSUr�e►NCE pOES MaT CONSTITUr� A GON7�.acT BETwE�N THE 153uiN� INSUR�R(S), AuTHORI2ED
REpRES�NfATIVE OR PRODUCER, AND TH� C�RiI�ICAT� HOLDER.
fMPpRTAMT; If the cartl8cat8 hofdar Is an ADDITIDNAL IN5UR�17, tha poliCy(ies) m�t be endorsad. If SUBROGATIpN I$ WAIV�d, subJecC to
the ternlg �1�d eor�ditipns of the polioy, cert8ifn policie� may requlra �n endorsement A slatement on thfs certlflCAte daes not confer rights to the
aertlflcate holder In Ileu of such endorsemenNs}.
pRODUCER �,+�
Gif�ord•Heldon Ins Ina 947
P, o. �oX a2s
venice, Ft 3a284
Russ Gifford
n; Briqqefreld Gasuaftv Ins
iNBUREb WlBiams Testing, I.�,C,
2446 i 9th Street
3arasata, FL 34254
COVERAG�S CERTIFICATE NUMB�R: R�VI510N NUMB�R:
THIS IS 70 C�RTIFY'fHAT THE POLICIES pF IN3URANCE L15TED BELOW HAVE BEEN fSSUED TO TW� INSURED NAMED A80V� FOR TWE POLICY pEitl�Q
INDICAT�D, N07WITH3TANDINt3 ANY REQUIREMEN7, T�RM OR CONDITION OF ANY CQNTRACT OR OTHEI2 DQCUMENT WITH RESpEGT TO WWIpH THIS
C�RTIFICAT� MAY qE ISSUED pR MAY PERTAIN, TH� INSUF'tANC� AFFORbED eY THE PbuCf�S DESCRIB�D HEREIN IS SUBJECt TO ALL THE TERMS,
EXCLUSIONS qNp CDN�ITIpN3 OF SUCN POLIGIE3. LIMITS SWpWN MAY WAVE 9�EN REDUCEA BY PAID CI,AIMS.
�NS TYpE 6P �NSURANCE
PQI.iCY MUMBER � F PO P u�
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D�8CRIP F TIONS I I.OGA710N5 f VEWICLES (Altash ACOkD 707, AtleNtlonnl Ramerks Seheduln, If moro tp�te Ia rnqu�ro�
P�a ecti N�me: 2409-2010 8anitary Sewer 6 ManhoXe Rehabi,ii.tation Pxoject -
ar Sanitiar�r Semgr Treneh].ess Rsconstrucfiion
Project Numb�z�; 09-OQ47-VT
fax 1-727�582-Q5']6
CERTIFICATE HOLD�17 neure� � wr�n.�
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SHOUiA ANY OF THE ABOVE DESCRIBEp POLICtE3 BE CANCELLEd ��FORE
ClTY OF CLFr�1RWATER-pEWELOpMENT T�'�E �xpIR,4TtoN oa7E THEReo�, ntarcE uw�,�, e� o�uVER�o ia
qCCORDANCe WITH TME p061CY PRDVISfONS.
SVC DEPT.
FAX: t72��rJs2+4rJ7s p11THpRt�p R6PRESENTATIvE
700 S. MYftT�,� AVE �
CL�ARWATER, FL 33756 �
41988-x010 ACORD GORPURATION. A!I rights reserved.
ACORD 25 (2010/05) T'he ACORD namo and loga arm reglstered marks of ACORD
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