CR 193 - GROVE CIRCLE AND BELCHER AREA SANITARY SEWER SYSTEMS - 13-0049-UT - CERTIFICATE OF LIABILITY INSURANCE - 13-0049-UT (2)DALL1CO-01 DELL EN
CERTIFICATE OF LIABILITY INSURANCE in �1- i"iMmm D-)-YY---Y-Y-)
1211712015
. . . ........ ......... ....... . . ...
'THIS CERTIFICATE IS ISSLEED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPONTHE CERTIFICATE HOLDER, THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EX'I OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTn,6TE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER,
------------ -------
1 11' the certificate holder is an ADDITIONAL INSURIED, the policy(ios), must be endorsed. If SUBROGAT!ON lS WAIVED, subject to
the terrris and conditions of the poky, certain policies omay requIre an endorsement, A, sliteniont an this certificate does notconfer Irigphrts to the
certfficale t"Aidor Pn flee of such en(Jorsernent(s),
PROI[X . ICER C1,6K 146-1- . . . . . ... ...... ............ . . . . ........... .... .. .......... . .. . ............. . ...
NAME: Linda Aflem
Florida Insurance Center, Irm. P 1 114 1 ONE 11 H 1 3) 1 7 1 54 -35 1 6' 1 l.fN�rr�r � 3450
414 N Alexander St N04, NO
E,MAh-
Plant City, FL 33563 ADDRES&
BNSURED
Dalhas 1 Corporation dba Dahas 'I Constrmflon &
Developmeni
dba Tampa 1 Tech inoWgy SOILAJOTIS
10328 E. Main Senn' 'I'.
"Thonoto sax ssa, Ft., 335S2
COVERAGES CERTIF�C�ATE NUMBER: REVISION NUMBER:
-------- - -------- . . . ......... . . .................. ....... .. .. . .. . — ------- I-- .. . . ... ........... . ........ 1-1-1-11-111, ......... . . . . . ..... . ................ .. I ---------------------------- . . . . . . . ............................. . . . ..... . . .............. . .... ............... . .. .................... . ................. . .... .
FI,flS NS R) "'EhHr r, Th/"'r TH �J:-2;2S, !NS1-,',),NC 1- L1S!'E.`D THE MSURED NAMED ABOVE FTY'k I'HE P01 ICY PERIOD
INDICATED NOT%AATHSTANDFNCA ANY REQUIREMEN 1, TERIM OR CONUTION OF ANY CON I I`ZACT OR 0 rHER D0,JIUMENP V,: J ire 1C,' �13
CER11RC'ATE MAY BE ISSUED OR, MAY PER, �AIN, THE', INSURANCE AFFORDED BY THE P011J(,,'IES DESCMBED HIERUN H3 SUBJECT 10 ALL THE, 1 ERMS,
EXCLIJS' ONS AND CONPI-MONS OF SUCI I POLICIES I IN1ITSSH0VVN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
Ran POIJCY EFr I POLICY rXP I
LIR TYPE OF INSURANCE INSI)TINVD POLWY NUMBER MVIDWYYYY) (MMIDDIYYYY�
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DESCRIP1 ION OF OPERA'T'IONS I LOCA1 Q NS i VEHICLES (AC'ORD 10 P, Addftlo"M Ro rnm*s Schoplift, may bo aflachod! Jr more space is, rtiquh udl
Project: C.R. 1953, Grove Circle aind Soldier Area Sanitary Sewer Systems Q13-1004 -UT) City of Clearwater is named as additional insured with regards to
gieneral liability as required by written contract All Policies are prinnary and non contrIbutory, Waiver of subrogation applLes.
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CEIFCA TE HOLIDER
.. ........ 11 1 . . ..... . ................................ . .... .
City of Clearwater Engineering Department
Attrr Construction Office SpecIafisl
IP 0 Box 4748
33758-4748
SHOULD ANY OF THE ABOVE DESCIRMED, POLICIES BE CANCELLED BEFORE
THIS EXPIRA1 'LON DATE nIERIEOF, NOT]CE WILL BE DELIVERED IN
ACCORDANCE WITH TFIE P01 ICY PROVISIONS.
ALITHDRIZED REPRESENrATIVI'",
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1) 1988-2014 ACORD CORPORATION. All rights reserved,
ACORD 25 (2014/01) "rho, ACORD narne and log gal are registered marks of ACORD
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DESCRIP1 ION OF OPERA'T'IONS I LOCA1 Q NS i VEHICLES (AC'ORD 10 P, Addftlo"M Ro rnm*s Schoplift, may bo aflachod! Jr more space is, rtiquh udl
Project: C.R. 1953, Grove Circle aind Soldier Area Sanitary Sewer Systems Q13-1004 -UT) City of Clearwater is named as additional insured with regards to
gieneral liability as required by written contract All Policies are prinnary and non contrIbutory, Waiver of subrogation applLes.
I
RT
CEIFCA TE HOLIDER
.. ........ 11 1 . . ..... . ................................ . .... .
City of Clearwater Engineering Department
Attrr Construction Office SpecIafisl
IP 0 Box 4748
33758-4748
SHOULD ANY OF THE ABOVE DESCIRMED, POLICIES BE CANCELLED BEFORE
THIS EXPIRA1 'LON DATE nIERIEOF, NOT]CE WILL BE DELIVERED IN
ACCORDANCE WITH TFIE P01 ICY PROVISIONS.
ALITHDRIZED REPRESENrATIVI'",
y
1) 1988-2014 ACORD CORPORATION. All rights reserved,
ACORD 25 (2014/01) "rho, ACORD narne and log gal are registered marks of ACORD