Loading...
CERTIFICATE OF LIABILITY INSURANCE (579)rP52600280e2 S R ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 01/22/2015 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 M. E. Wilson Co., Inc. 300 W. Platt St. Ste 200 Tampa, FL 33606 Robin Moch INSURED Cox Fire Protection, Inc. 7910 Professional Place Tampa, FL 33637 -6746 1- 813 - 229 -8021 CONTACT NAME: Kelly Sutton PHONE EI k 813 - 349 -2233 1FAx ksutton@ewilson.coADDRESS_ LA/C,No 813 - 229 -2795 INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURERS) AFFORDING COVERAGE AmTrust International Underwriters Ltd PLAZA INS CO NAVIGATORS INS CO BRIDGEFIELD EMPLOYERS INS CO TRAVELERS PROP CAS CO OF AMER CRUM & FORSTER SPECIALTY INS CO NAIC 30945 42307 10701 25674 44520 COVERAGES CERTIFICATE NUMBER: 42827500 REVISION NUMBER: THIS INDICATED. CERTIFICATE EXCLUSIONS MDR LTR IS TO CERTIFY THAT THE POLICIES NOTWITHSTANDING ANY REQUIREMENT, MAY BE ISSUED OR MAY AND CONDITIONS OF SUCH - .._.... TYPE OF INSURANCE OF INSURANCE PERTAIN, POLICIES. AWL MSR MDR WVD LISTED BELOW HAVE BEEN TERM OR CONDITION OF ANY THE INSURANCE AFFORDED BY LIMITS SHOWN MAY HAVE BEEN __.. POLICY NUMBER ISSUED TO THE INSURED CONTRACT OR OTHER THE POLICIES DESCRIBED REDUCED BY PAID CLAIMS (MOUCYYYYI POLICYEXP IMMIDD/YYYY) NAMED ABOVE FOR THE POLICY PERIOD DOCUMENT WITH RESPECT TO WHICH THIS HEREIN IS SUBJECT TO ALL THE TERMS, LIMITS A GENERALLIABILITY X X X GEN'L COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X I OCCUR Contract. liab & XCU $5,000 PD ded AGGREGATE LIMIT APPLIES PER: POLICY I X JECOT- LOC PAL104203502 O1 /21 /15I 01/21/16 EACH OCCURRENCE PRM S RENTED PREMISES ( (E a a occurrence) MED EXP (Any one person) PERSONAL &ADVINJURY GENERALAGGREGATE PRODUCTS - COMP /OP AGG Design E & 0 $1,000,000 $ 100, 000 $ 5,000 I $1,000,000 $2,000,000 $2,000,000 $1,000,000 B AUTOMOBILELIABILITY X X ANY AUTO ALL AUTOS NEDI HIRED AUTOS SCHEDULED % -OWNED I AUTOS PALGMI1000942 -00 01/21/1$ 01/21/16 COMBINEDSINGLELIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) PIP $ 1,000,000 $ $ $ $10,000 C X UMBRELLALIAB EXCESS LIAR DED RETENT X IOCCUR i I CLAIMS -MADE ON $ None GA15EXC807123IC 01/21/1 01/21/16 EACHOCCURRENCE AGGREGATE $ 5,000,000 $5,000,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE Y / N OFFICERIMEMBER EXCLUDED? N l N/A (Mandatory In NH) II yes, describe under DESCRIPTION OF OPERATIONS below 83034862 08/01/14 08/01/15 x ARV MITS! _ ER I - - E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 E A F Equipment Floater Design Professional MO Poll /mold /fungus QT6604407X257TIL -15 IPAL104203502 CPL- 102566 01/21/1 01/21/1 01/21/1 01/21/16 01/21/16 01/21/16 Leased /Rented 75,000 Ea. Wrong. Act 1,000,000 5,000 deductible 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, R more space is required) *Florida Operations Only" Excess Liability policy follows over General Liab, Auto Liab, Employer's Liab, and Contractor's Design Prof. Liab. CERTIFICATE HOLDER CANCELLATION City of Clearwater P.O. Box 4748 Clearwater, FL 34618 USA 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) kbanke 42827500 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD P5260020002 AW °® CERTIFICATE OF LIABILITY INSURANCE DATE /2015"' 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 1- 813 - 229 -8021 N. B. Wilson Co., Inc. 300 W. Platt St. Ste 200 Tampa, FL 33606 Robin Koch CONTACT NAME: Rally Sutton PHONE 813 - 349 -2233 FAX WC. No. Ea): %lc. No): E-MAIL DDESS. ksuttonAaexilson.com INSURER(S) AFFORDING COVERAGE NAM: II INSURER A: AmTrust International Underwriters Ltd LIABILITY COMMERCIAL. GENERAL LIABILITY INSURED Cox Fire Protection, Inc. 7910 Professional Place Tampa, FL 33637 -6746 INSURERB: PLAZA INS CO 30945 INSURER C: NAVIGATORS INS CO 42307 INSURERD: BRIDGEFIELD EMPLOYERS INS CO 10701 IN SURERE: TRAVELERS PROP CAS CO OF AMER 25674 INSURER F: CRUM a FORSTER SPECIALTY INS CO 44520 VERAGES CERTIFICATE NUMBER: 42819926 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 INSR SUER MVO POLICY NUMBER POLICY EFF (MMEDD/YYYY1 POLICY EXP IMMIDDIYYYY) UNITS A GENERAL X LIABILITY COMMERCIAL. GENERAL LIABILITY PAL104203502 01/21/15 01/21/16 EACHOCCURRENCE $1,000,000 PREM E S l RENTED PREMISES (Ea occurrence) $ 100, 000 CLAIMS -MADE IX I OCCUR MED EXP (Any one person) $5,000 X X Contract. liab & ECU PERSONAL&ADVINJURY $1,000,000 $5,000 PD ded GENERALAGGREGATE $ 2,000,000 GEN'L AGGREGATE —1 POLICY LIMIT APPLIES X ,ialffr PER: LOC PRODUCTS - COMP/OP AGG $2,000,000 Design B & 0 51,000,000 B AUTOMOBLEUABIUTY X X ANY AUTO ALL OWNED AUTOS HIRED AUTOS X _ SCHEDULED AUTOS NON -OWNED AUTOS PALCd4I1000942 -00 01/21/15 01/21/16 CO MBINEDSINGLEUMR (Ea acadan0 $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per acadent) $ PROPERTY DAMAGE (Peraatiden) $ PIP $10,000 C X UMBRELLAUAB EXCESS UAB X OCCUR CLAIMS -MADE GA15EXC807123IC 01/21/15 01/21/16 EACHOCCURRENCE $ 5,000,000 AGGREGATE $5,000,000 DED , RETENTION $ NoIIe $ D WORKERSCOMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOWPARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS babes N / A 83034862 08/01/14 08/01/15 XI WCSTATU- TORY LIMITS 0TH - ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1, 000, 000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 B P A Equipment Floater Poll /mold /fungus Design Professional E&O QT6604407X257TIL -15 CPL - 102566 PAL104203501 01/21/15 01/21/15 01/21/15 01/21/16 01/21/16 01/21/16 Leased /Rented 75,000 5,000 deductible 2,000,000 Ea. Wrong. Act 1,000,000 DESCRIPTION OF OPERATIONS /LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is required) *Florida Operations Only Excess Liability policy follows over General Liab, Auto Liab, Employer's Liab, and Contractor's Design Prof. Liab. CERTIFICATE HOLDER CANCELLATION City of Clearwater P.O. Box 4748 Clearwater, FL 34618 I USA 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'r., ACORD 25 (2010/05) thanks 42819926 ®1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD P5260028002 ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 07/29/2014 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 1- 813 - 229 -8021 M. E. Wilson Co., Inc. 300 W. Platt St. Ste 200 Tampa, FL 33606 Robin /loch INSURED Cox Fire Protection, Inc. 7910 Professional Place Tampa, FL 33637 -6746 CONTACT Kelly Sutton NAME: INC PHONE : 813 - 349 -2233 (AIC. No. E; E-MAIL ADDRESS: INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : FAX 813 - 229 -2795 kautton@mewilson.com INSURERS) AFFORDING COVERAGE AmTrust International Underwriters Ltd OWNERS INS CO NAVIGATORS INS CO BRIDGEFIELD EMPLOYERS INS CO CRUM & FORSTER SPECIALTY INS CO TRAVELERS PROP CAS CO OF AMER NAIC 0 32700 42307 10701 44520 25674 COVERAGES CERTIFICATE NUMBER: 40855998 THIS INDICATED. CERTIFICATE EXCLUSIONS INSR LTR IS TO CERTIFY THAT THE POLICIES NOTWITHSTANDING ANY REQUIREMENT, MAY BE ISSUED OR MAY AND CONDITIONS OF SUCH TYPE OF INSURANCE OF INSURANCE PERTAIN, POLICIES. ADDL INSR LISTED BELOW HAVE BEEN TERM OR CONDITION OF ANY THE INSURANCE AFFORDED BY LIMITS SHOWN MAY HAVE BEEN SUBR: WVD POLICY NUMBER ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, REDUCED BY PAID CLAIMS. POLICY EFF POLICY EXP IMMIDDIYYYY) IMMIDDIYYYYI LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I X i OCCUR X I Contract. liab & XCU X 1 $5,000 PD ded GEN'L AGGREGATE LIMIT APPLIES PER POLICY X PRO - I j LOC PAL104203501 01/21/1 01/21/15 EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP /OP AGG Design E & 0 $ 1,000,000 $ 100,000 $ 5,000 $ 1, 000, 000 $ 2,000,000 $2,000,000 $1,000,000 B AUTOMOBILE X X { LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS I X SCHEDULED AUTOS NON -OWNED AUTOS 49- 711746 -00 01/21/14 01/21/15 COMBINEDSINGLELIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) PIP $ 1,000,000 $ $ $ $ 10,000 C X , UMBRELLA UAB EXCESS LIAB DED ; I RETENTION X $ OCCUR CLAIMS -M ADE None GA14EXC807123IC 02/28/14 01/21/15 EACH OCCURRENCE AGGREGATE $ 5,000,000 $5,000,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory In NH) If yes. describe under DESCRIPTION OF OPERATIONS below NIA 83034862 08 / O 1 / 11 08 / 01 / 15 WC STATU- 1 ,OTH- X TORY LIMITS ER E.L. EACH ACCIDENT - - E.L. DISEASE - EA EMPLOYEE E L DISEASE - POLICY LIMIT $1,000,000 $ 1,000,000 $ 1,000,000 E JP011 /mold /fungus F Equipment Floater A Design Professional E&O CPL- 101001 QT6604407X257TIL -14 PAL104203501 01/21/14 01/21/15 5,000 deductible 2,000,000 01/21/1 01/21/15 Leased /Rented 75,000 01/21/1 01/21/15 Ea. Wrong. Act 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) "Florida Operations Only" Excess Liability policy follows over General Liab, Auto Liab, Employer's Liab, and Contractor's Design Prof. Liab. CERTIFICATE HOLDER CANCELLATION City of Clearwater P.O. Box 4748 Clearwater, FL 34618 USA SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) MS004 40855998 ©1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD