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CERTIFICATE OF LIABILITY INSURANCE (577)1 ® AC Rb CERTIFICATE OF LIABILITY INSURANCE 40.------ . DATE (MWDD/Y YY) 10/29/2014 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 Bowen, Miclette & Britt of Florida LLC 1020 N. Orlando Avenue Suite 200 FL 32751 CONTACT Jamie Greene NAME: PHONE N ) 407- 647 -1616 FAX 407 - 628 -1635 (Maitland E-MAIL ADDRESS: certificates @bmbinc.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : North River Insurance Co. 21105 INSURED BANDESCONS Bandes Construction Co., Inc. 1368 Spalding Rd Ste C Dunedin FL 34698 INSURER B :Hartford Insuance Company of the SE 38261 INSURER C :Hartford Casualty Ins. Co. 29424 INSURER D $1,000,000 INSURER E : INSURER F : X 1232810751 ION 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 C X COMMERCIAL GENERAL LIABILITY Y Y 21UENQT7076 11/2/2014 11/2/2015 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $300,000 MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE POLICY OTHER: X LIMIT APPLIES jECT PER: LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP /OP AGG $2,000,000 $ C AUTOMOBILE X %( LIABILITY ANY AUTO AUT OWNED HIRED AUTOS X SCHEDULED NON -OWNED AUTOS Y Y 21 UENQT7076 11/2/2014 11/2/2015 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE Y Y 5811034788 11/2/2014 11/2/2015 EACH OCCURRENCE $7,000,000 AGGREGATE $7,000,000 DED X RETENT ON $0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABIUTY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A y 21WBQT9698 8/29/2014 8/29/2015 X STATUTE OTH 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 (ACORD 101, Additional Remarks Schedule, may be attached It more space is required) The following policy provisions and/or endorsements form part of the policies of insurance represented by this certificate of insurance. The terms contained in the policies and /or endorsements supersede the representations made herein. Electronic copies of the policy provisions and /or endorsements listed below are available by emailing: certificates @bmbinc.com When required by written contract, those parties listed in said contract, including the certificate holder, are added as an additional insured with respect to the general liability, auto liability and urylifet6 liability as afforded by the policy and /or endorsements. The general liability, auto See Attached... CITY OF ED CERTIFICATE HOLDER tCR CANCELLATION fvU O 2014 RISK MAN City of Clearwater AGEMENT Public Works Administration 9173 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 r ACORD 25 (2014/01) 1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACc'Re AGENCY CUSTOMER ID: BANDESCONS LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Bowen, Miclette & Britt of Florida LLC NAMED INSURED Bandes Construction Co., Inc. 1368 Spalding Rd Ste C Dunedin FL 34698 , POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE liability, and umbrella certified herein are primary and non - contributory to other insurance available, but only to the extent required by written contract. When required by written contract, waiver of subrogation, with respect to the general liability, auto liability, worker's compensation and umbrella is granted to those parties listed in said contract, including the certificate holder. Re:Clearwater Signage and Wayfinding Downtown District (09- 0085 -ED). RECEIVED CITY OF CI FARWATFP NOV 0 6 2014 RISK MANAUEMEN1 9173 ACORD 101 (2008/01) m 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 21 UENQT7076 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - OPTION I This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Designated Project(s) Or Location(s) Of Covered Operations: *Blanket; when required by written contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations, A. With respect to those person(s) or organization(s) shown in the Schedule above when you have agreed in a written contract or written agreement to provide insurance such as is afforded under this policy to them, Subparagraph f., Any Other Party, under the Additional Insureds When Required By Written Contract, Written Agreement Or Permit Paragraph of Section II — Who Is An Insured is replaced with the following: f. Any Other Party Any other person or organization who is not an insured unde- Paragraphs a. through e. above, but ony with respect to liability for "bodily injury', 'property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (1) In the performance of your ongoing operations for such additional insured at the project(s) or location(s) designated in the Schedule; (2) In connection with your premises owned by or rented to you and shown in the Schedule; or Form HS 24 80 07 13 (3) In connection wit's "your work" for the additional insured at the project(s) or location(s) designated in the Schedule and included within the "products - completed operations hazard ", but only if: (a) The written contract or written agreement requires you to provide such coverage to such additional insured at the project(s) or location(s) designated in the Schedule; and (b) This Coverage Part provides coverage for "bodily injury" or "properly damage" included within the "products - completed operations hazard ". The insurance afforded to the additional insured shown in the Schedule applies: (1) Only if the "bodily injury" or "property damage" occurs, or the "personal and advertising injury" offense is committed: (a) During the policy period; and (b) Subsequent to the execution of such written contract or written agreement; and © 2013, The Hartford (Includes copyrighted material of Insurance Services Office, Inc., with its permission.) Page 1 RtEIVED CITY OF CL_EARWATER NOV 0 6 2014 RISK MANAGEMENT (c) Prior to the expiration of the period of time that the written contract or written agreement requires such insurance be provided to the additional insured. (2) Only to the extent permitted by law; and (3) Will not be broader than that which you are required by the written contract or written agreement to provide for such additional insured. With respect tc the insurance afforded to the person(s) or organizations) that are additional insureds under this endorsement, the following additional exclusion applies: This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failu -e to render, any professional architectural, engineering or surveying services, including: (1) The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orcers, designs or specifications; or (2) Supervisory, inspection, architectural or engineering activities. The limits of insurance that apply to the additional insured shown in the Schedule are described in the Limits Of Insurance section. How this insurance applies when other insurance is available to the additional insured is described in the Other Insurance Condition in Section IV — Commercial General Liability Conditions, except as otherwise amended below. B. With respect to insurance provided to the person(s) or organization(s) that are additional insureds under this endorsement, the When You Add Others As An Additional Insured To This Insurance subparagraph, under the Other Insurance Condition of Section IV — Commercial General Liability Conditions is replaced with the following: Page 2 of 2 When You Add Others As An Additional Insured To This Insurance (a) Primary Insurance When Required By Contract This insurance is primary if you have agreed in a written contract or written agreement that this insurance be primary. If other insurance is also primary, we will share with all that other insurance by the method described in Paragraph (c) below. This insurance does not apply to other insurance to which the additional insured in the Schedule has been added as an additional insured. (b) Primary And Non•Contributory To Other Insurance When Required By Contract This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (i) The additional insured in the Schedule is a Named Insured under such other insurance; and (ii) You have agreed in a written contract or written agreement that this insurance would be primary and would not seek contribution from any other insurance available to the add tional Insured in the Schedule. (c) Method Of Sharing If all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach, each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares. we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. All other terms and conditions`in the policy remain unchanged. RECEIVED CITY OF CI FARWATER NOV 062014 RISK MANAGEMENT 9173 Form HS 24 80 07 13