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CERTIFICATE OF LIABILITY INSURANCE (347)
A RD CERTIFICATE OF LIABILITY INSURANCE ;A9�20 s""Y) 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 Northeast Underwriters Inc. 4790 1st Street North St. Petersburg FL 33703 CONTACT Stephanie Young �PpH/ONE Ede (727) 521 -4253 I A/C. No): (727)527 -9455 pDDREss;syoung @neu- ins.com INSURER(S) AFFORDING COVERAGE NAIC # INsuRERA:Ohio Security Insurance Company 24082 INSURED Fge Engineering Inc PO Box 280 Dade City FL 33526 INsuRERB:Bridgefield Casualty Ins Co 10335 INSURERC:Travelers Cas & Surety Co of A 31194 INSURER D: $ 2,000,000 INSURER E : $ 300,000 INSURERF: ERTIFICATE NUMBER :14 -15 • 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 SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MMIDD/YYYY) LIMITS A GENERALLU161L1TY X COMMERCIAL GENERAL LIABILITY BZS56195218 7/27/2014 7/27/2015 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 300,000 � CLAIMS -MADE 17 I OCCUR MED EXP (Any one person) $ 15,000 PERSONALE. ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X1 POLICY n jF O- n LOC PRODUCTS - COMP /OP AGG $ $ AUTOMOBILE — LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ _ SCHEDULED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED 1 RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below y / N N / A 19611020 9/21/2013 9/21/2014 WC STATU- 10TH- I TORY LIMITS I I ER E.L. EACH ACCIDENT $ 100,000 $ 100,000 E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ 500, 000 C Errors and Omissions 105677527 9/22/2013 9/22/2014 $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) The certificate holder is hereby named as additional insured, as per written contract, in regards to the general liability policy. CANCELLATION City of Clearwater Engineering, RFQ #34 -15 PO 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 Ken Kijowski /SMY ACORD 25 (2010/05) INS025 (9n1nr15101 © 1988-2010 ACORD CORPORATION. All rights reserved. That annum name and Inn^ are rani¢ +marl marIrc ^f art rum