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REVERSE OSMOSIS PLANT NO 1 - PLANT EXPANSION - 09-0018-UT - CERTIFICATE OF LIABILITY INSURANCE (4)HARNROS-01 TBO�RTZ V�i F (MM/DD NYYYI CERTIFICATE OF LIABILITY INSURANCE 12121/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS FCERTIFICATE 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 INSUIRER(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 riot confer rights to the �_certificate holder in lieu of such endorsement(s). PRODUCER Roberts Insurance Group, LLC 211 South Nokomis Avenue Venice, FL 34285 INSURED Harn Ro Systems, Inc. 310 Center Court Venice, FL 34285 PHONE F EMAIL ADnRcss,7 Tr.,ir-ey@robertsi,nsurancegroup.cc INSURER(S) AFFORDING COVERAGE -INSURER A-Allied P & C Insurance Company INSURER B FCCI INSURFR C; INSURER D INSURER F M'Surz7r, r NAIL 0 WEEF COV ERAGES CERTIFICATE NUMBER; REVISION NUMBER: S TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD ICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED 14EREIN IS SUBJECT TO ALL 'THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES- LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS LTR TYPE OF INSURANCE F'aucy u -,'Ar poucf Exii POLICY NUMBER _._:51APPDWyy1 Yy) tMWDD1YYYY) LIMITS Kx7c'MMERCLAL GENERAL, LIABILITY I _4 "' I EACH OCCURRENCE $ 1,000,0 CLAAMS-MADE X] OCCUR PGLD05954655517 10101/2015 10/0112016 1 D-AMTGE TO RE_WTT-,T 100,0 7 ,PREMISES �41 Ll ��XVI (Any ur� pom�.i) ' S 1E RSONAL 11 AIIV INJURY $ 1,000, GEN1 AGGREGATE LIMITAPP(JES PER GENERAL. AGGREGATE. $ 2,00�01. ] PRO- POLICY JFCT "k-1 WC PRODUCTS COMPIOP AGG $ 2,000: OTHER, AU OMOBILE LIABILITY COMBINEID-S—INGLEUMIT (F 1-1c tL S 1,000, A I. ALL ANY AU-1 0 CPO' 029-C-1-M YAZ5954655517 101014015 1010112016 BO D ILY IINJ I I R Y (Per person) $ ALL OWNED SCHEDULED J� AUTOS AUTOS I BODILY INJURY (Per ac6dent) NON-OWNED J J —FROf �� LR T Y _6A _MA(!C__ HIRED AUTOS AUTOS Per a qlden ') — -GH OCCURRENCE X UMBRELLA LIAB X .. UR I-AL 6000 4E X C E SS 1. 11 A 11L L A I ms mm) I,, ACPCAp6 0"446556 H J 1010112015 1 10/01/20116 ACriH V 1F +± J F 1) 1. RE ,N' ION$ �5,000,000 WORKERS COMPENSATION ri D FJ -- S AND EMPLOYERS'LIARII.ITY X STATUTE CR Y�N I --- B ANY PROPRIL:l'QRAIARiINLRIC--Xll',�U�-IVE 001-WC-16A-60864 0110112016 0110112017 E L I-, A(,� I ACCIDLN 11 1,000, I OFRCER/MEMBER ExcLaJDE ©? NIA (Mandatory in NH) 0, DIESGRIPTION OF OPERATIONS Belo. E L MS[,rASL -POLICY I,imrr 1,000, 11010112015 10/01)2016 Contr E $$ 1,254, If y S. descrvbo mde� L I DISFASE - EA EMill OYFF A Equipment Floater P5944655517 quip DESCRIPTION OF OPERATIONS I LOCATIONS! VEHICLES (ACORD 101, Adtlitional Remarks Schedule, may be attached if more space is requireal CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVMWNS, City of Clearwater Engineering Dept Attn Robert Fahey AUTHORIZED REPRESENTATIVE Utility Engineering Mngr 100 South Myrtle Avenue #220 ACORD 25 (2014101) CC) 1988-.2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD