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FIBER OPTIC CABLE INSTALLATION, CONDUIT BORING & FIBER MAINTENANCE SERVICES, PROPOSAL #09-13 - CERTIFICATE OF LIABILITY INSURANCE (4)'°`� ° CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/Y CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 12/2/2015 5 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 Stahl & Associates Insurance, Inc. 250 International Parkway NAME: T Tammy Dooley PHONE (Q07) $33-$998 FAX N (407)633 -3909 EMAIL . tammy.dooley @stahlinsurance.com Suite 128 Lake Ma Mary FL 32746 INSURERS AFFORDING COVERAGE NAIC # INSURER AAmeri sure Insurance Co 19488 INSURED Precision Contracting Services, Inc. 15834 Guild Court INSURER B:Amerisure Mutual Ins CO 23396 INSURERC:XL Specialty Insurance Co. 37885 INSURER D: INSURER E ,Jupiter FL 33478 INSURER F: wmv�r�. 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 SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM /DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTS PREMISES Ea occurrence $ 50,000 A CLAIMS -MADE � OCCUR X L2090669 2/31/2015 2/31/2016 MED EXP Any one person) $ 5,000 X Blanket Add' 1 Insured' S PERSONAL 8 ADV INJURY $ 1,000,000 X GL Extension Endorsement GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY NERD SINGLE LIMIT Ee aB 11000,000 X BODILY INJURY (Per person) $ A ANY AUTO BODILY Per accident ( ) $ ALL OWNED SCHEDULED AUTOS AUTOS 026011 2/31/2015 2/31/2016 HIRED AUTOS X NON -OWNED AUTOS X PROPERTY DAMAGE Per accident $ X UMBRELLA LIAB X IOCCUR EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 B EXCESS LIAB CLAIMS -MADE DIED I X I RETENTION$ -0 $ U2026018 2/31/2015 2/31/2016 A WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N E.L. EACH ACCIDENT $ 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? D (Mandatory in NH) N/A 0202602810 2/31/2015 2/31/2016 E.L. DISEASE - EA EMPLOYE $ 500,000 If yes, describe under E.L. DISEASE - POLICY LIMIT 1 $ 500,000 DESCRIPTION OF OPERATIONS below C Contractors Equipment UM00027863MA15A 2/31/2015 2/31/2016 Leased /Rented Equipment: $300,000 Installation Floater: $300,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Certificate holder is included as an Additional Insured as respects general liability per the Blanket Additional Insured endorsement CG7048 as required per written contract. City of Clearwater 100 South Myrtle Avenue Clearwater, FL 33756 VMFVVIMLLFi I Ium 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 Bowles /DOOLEY' "!" 111+VKU L9 (LUTU /UO) ©1988 -2010 ACORD CORPORATION. All rights reserved. INS025 (201005).01 The ACORD name and logo are registered marks of ACORD