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BYRAM DRIVE CHANNEL EROSION CONTROL IMPROVEMENTS - 13-0009-EN - CERTIFICATE OF LIABILITY INSURANCEBIOMASS -01 JFAVA ' 10. R CERTIFICATE OF LIABILITY INSURANCE �► —�-"'� DAT9 /9 /2 D /YYYY) 9/9/2015 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 ASSOCIATES AGENCY, INC. 11470 N 53rd St Temple Terrace, FL 33617 CONTACT NAME: BONN Ext : (813) 988 -1234 FAX (A/C, No): (813) 988 -0989 ADDRESS: E -MAIL agent@associatesins.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:Southern Owners Insurance Co 10190 INSURED INSURERB:AUTO OWNERS INSURANCE CO. 18988 Bio Mass Tech Inc INSURERC: FCCI INSURANCE CO. 10178 INSURERD:Catlin Insurance Company (UK) Ltd 20767942 15212 State Rd 52 Land O Lakes, FL 34638 INSURER E : DAMAGE TO RENTED PREMISES Ea occurrence INSURER F: X MED EXP (Any one person) COVERAGES CERTIFICATE NUMBER: 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 INSD SUBR WVD POLICY NUMBER POLICY EFF MM /DD /YYYY POLICY EXP MM /DD /YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE 1XII OCCUR 20767942 09/16/2015 09/16/2016 DAMAGE TO RENTED PREMISES Ea occurrence 300 000 $ , X MED EXP (Any one person) $ 10,000 Contractual Liab. PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY JjECT [::] LOC PRODUCTS - COMP /OPAGG $ 2,000,000 $ OTHER I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ B ANY AUTO 4776794200 09/16/2015 09/16/2016 ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE Y/N 001 -WC1 5A-611 11 01/01/2015 01/01/2016 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 OFFICER /MEMBER EXCLUDED? ❑ (Mandatory in NH) N /A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 D Equipment Floater IMI- 690418 -0916 09/16/2015 09/16/2016 Rented /Leased Equip 250,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: BYRAM DRIVE CHANNEL EROSION CONTROL IMPROVEMENTS I #13- 0009 -EN. City of Clearwater is an additional insured with regard to the general liability. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014/01) © 1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Clearwater THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 100 South Myrtle Avenue Clearwater, FL 33756 AUTHORIZED REPRESENTATIVE ACORD 25 (2014/01) © 1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD