CERTIFICATE OF LIABILITY INSURANCE (369)AICO/
RO" CERTIFICATE OF LIABILITY INSURANCE
V
DATE(MDD/YYYY)
MI
7/9/2015
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
Marsh & McLennan Agency, LLC Co Florida
2807 Edgewater Drive
Orlando FL 32804
CONTACT
NAME:
1 CCNNo. ); (407) 849 -0333 fANAC.No):(407) 425 -5694
E-MAIL
ADDRESS:
INSURERS) AFFORDING COVERAGE
NAIC S
INSURERA:Hartford Casualty Ins Company
29424
INSURED (407) 679 -5358
Reiss Environmental, Inc. & Reiss
Engineering, Inc
1016 Spring Villas Pt
Winter Springs FL 32708
INSURER B:Continental Casualty Company
20443
INSURER C : American Casualty Co of Reading
20427
INSURERD:Auto- Owners Insurance Company
18988
INSURERE:
CLAIMS -MADE
INSURER F :
OCCUR
CERTIFICATE NUMBER: Cert ID 48127
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
TYPE OF INSURANCE
ADM
INSD
SUER
WVD
POUCY NUMBER
POUCY EFF
(MMIDD/YYY1f)
POUCY EXP
(MNUDDIYYYY)
UNITS
C
X
COMMERCIAL GENERAL UABIUTY
2075095657
9/21/2014
9/21/2015
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE
X
OCCUR
�.zl. • •
PREMISES (Ea occurrence)
$ 1,000,000
MED ExP (Any one person)
$ 300,000
PERSONAL & ADV INJURY
$ 10,000
GENII
AGGREGATE
POLICY
OTHER:
X
LIMIT APPLIES
JECOT-
PER:
LOC
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OPAGG
$ 2,000,000
$
D
AUTOMOBILE
X
X
UABIUTY
ANY AUTO
ALL OWNED
AUTOS
HIRED AUTOS
X
_
SCHEDULED
AUTOS
NON -OWNED
AUTOS
4472389700
9/21/2014
9/21/2015
COMBINED SINGLELIMIT
(Ea accident)
$ 1,000,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident
( )
$
PROPERTY DAMA E
Per accident
$
$
B
X
■
UMBRELLA UAB
EXCESS LIAR
X
.
OCCUR
CLAIMS -MADE
2091445161
9/21/2014
9/21/2015
EACH OCCURRENCE
$ 2,000,000
AGGREGATE
$ 2,000,000
.
DED X RETENT ON $ 10 000
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
(Mandatory ER EXCLUDED? n
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N!A
21WE9420NY
9/21/2014
9/21/2015
PER OTH-
X STATUTE ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYE=
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
B
Professional Liability
Retention $25,000
AEH288355198
Claims Made
9/21/2014
9/21/2015
Per Claim 2,000,000
Aggregate 2,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H more space Is required)
Professional Liability - Knowledge Date 7/9/2011. $25,000 Deductible. City of Clearwater, as
Designated Organization, is an Additional Insured as respects General Liability. General Liability
is primary and non- contributory. All of the above is applicable when required by written contract
subject to the terms, conditions and exclusions of the policy.
CERTIFICATE HOLDER
CANCELLATION
City of Clearwater
Engineering, RFQ #34 -15
P.O. Box 4748
Clearwater FL 33758
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)
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