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MISSION HILLS RAW WATER MAIN - 14-0038-UT - CERTIFICATE OF LIABILITY INSURANCEA�RIY CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DDYYY) /Y 10/20/2015 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 Sihle Insurance Group, Inc. 2653 McCormick Drive Clearwater FL 33759 CONTACT PHONE FAX (AIC,N Fst) 727 -531 -6800 (A/C. No): 727 -531 6855 Ira scolaro ADDRFSC9 sihle.com @ INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :Westfield Insurance Group 24112 INSURED CASTCON -04 Castco Construction, Inc. 9001 126th Ave. North Largo FL 33773 INSURER B 6/7/2015 INSURER C : EACH OCCURRENCE INSURER D INSURER E : CLAIMS -MADE INSURER F : OCCUR COVERA • • ISO- .IVIVI. I. vnIo GrN• 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 LIABIUTY Y Y CWP3991686 6/7/2015 6/7/2016 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $150,000 X X XCU Included Contractual Liab MED EXP (Any one person) $1,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE POLICY OTHER: X LIMIT APPLIES ECT PER: LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 A AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON-OWNED CWP3991686 6/7/2015 6/7/2016 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 CWP3991686 6/7/2015 6/7/2016 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 DED X RETENTION$0 $ 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 PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: Mission Hills 144 - 003$ -U % CSX Transportation is included as additional insured with respects to general liability as required by written contract. Waiver of Subrogation is included on general liability as required by written contract CERTIFICATE HOLDER CANCELLATION CSX Transportation 500 Water Street Jacksonville FL 32202 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 REPRESE TIVE ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AC:ORE CERTIFICATE OF LIABILITY INSURANCE ‘.""'� DATE(MM/DD/YYYY) 10/16/2015 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 Sihle Insurance Group, Inc. 2653 McCormick Drive Clearwater FL 33759 CONTACT NAME: (AK' N . Ext). 727 -531 6800 FAX No)- 727 -531 -6855 21,2 scolaro sihle.com ADDRESS: gscolaro@sihle.com AFFORDING COVERAGE NAIC # INSURER A Westfield Insurance Group 24112 INSURED CASTCON -04 Castco Construction, Inc. 9001 126th Ave. North Largo FL 33773 INSURER B CWP3991686 INSURER C : 6/7/2016 INSURER D : $1,000,000 INSURER E : INSURER F : X • - - MCl/I011-IV rrlUMbtK: 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/YY YY) POLICY EXP (MM/DD/YYYYI UNITS A x COMMERCIAL GENERAL LIABILITY CWP3991686 6/7/2015 6/7/2016 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $150,000 X X XCU Included Contractual Liab MED EXP (Any one person) $1,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE POLICY OTHER: X LIMIT APPLIES 238i PER: LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 A AUTOMOBILE X %( UABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS CWP3991686 6/7/2015 6/7/2016 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA UAB EXCESS UAB X OCCUR CLAIMS -MADE CWP3991686 6/7/2015 6/7/2016 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 DED X RETENTION $0 $ 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 PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: Mission Hills t LA _003$ City of Clearwater is included as additional insured nsured with respects to general liability as required by written contract. Waiver of Subrogation is included on general liability as required by written contract. CANCELLATION City of Clearwater, Engineering Dept 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 REPRESS THE ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD