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EAST WRF GENERATOR AND MARSHALL ST WRF LAB ELECTRICAL IMPROVEMENTS - 11-0025-UT - CERTIFICATE OF LIABILITY INSURANCEACC7RC]r CERTIFICATE OF LIABILITY INSURANCE �� DATEJMMfDDIi YYYY3/25/2015 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, It the certiilcate holder is an ADDITIONAL INSURED, the po8cy(iee) must be endorsed, It 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 S1HLE INSURANCE GROUP, INC. P. 0. BOX 180398 LTAMDNTE SPRINGS FL 32716 Or Certificate Department +E 407- 889 6490 PI+� PAx 407- 389 -3580 E4MA 1- . Certificates @sihle.com INSU 8 AFFORDINGCOVARAOE HAIC 0 *MRERA. -FFVA Mutual Iris CO 10385 INSURED BLSMI -1 INSURER R; B L Smith Electric, Inc. 29252 US Hwy 27 Dundee FL 338384285 MISURERC: MED EXP am pmoN INSURYRD: INSURER E - PERSONAL 8 ADV INJURY S 9ISURSTR P GENERAL AGGREGATE $ VnIFMMAP-=Q !- COTfL -11' -A TC L1115a MVft. nI iiKrinas. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURER NAMED AECNE FOR THE POLICY PERIOD INDICATED, 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 HEREIN 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 POlJCY r1Ua16ER P Y FF POLICY E7IP COMMERCIALOENERAL LIABIUTY CLAWS4MCE 171 OCCUR EACH OCCURRENCE 5 CAMAGETORENIED PREMISES JES g MED EXP am pmoN S PERSONAL 8 ADV INJURY S GENIL AGGREGATE LRAn' APPLIES PER: POUCY JPECT F1 IAC OTHER: GENERAL AGGREGATE $ PRODUCTS- C0MPADPAGG S S AUTOMOBILE LIABILITY ANY AUTO ALL OWNED IV�ILED ED HIREDAUTOS AUTOS IrK;LE My E8 aoCfdO S BODILY INJURY (Per Person) S BODILY INJURY (PeracaldenQ S W- "room"S S UELLA LIAR EXCESS UA6 HCLAIMS-MADE OCCUR EACH OCCURRENCE S AGGREGATE $ DEp RETENTION S S A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTHERIEXECUnVE ❑ OFFICERNEMBER EXCLUDED? (Mandatory In NH) P edr d I OF OPERATIONS below NIA VC8400021850 V112016 411f2016 7S PER H- 1Jr ER E.L. EACH ACCIDENT S 1,000,00D E.L. DISEASE - EA EMPLOY§J 51,000,000 E -L. DISEASE - POLICY LIMIT I S 1,000 000 DESCRIPTION OF OFERATIONS ILOCATIONS I VEHICLES (ACM 101, AddHlonaI Ramatka Schedule, maybe attached M mom apace to raglAredl RE: East WRF Generator & Marshall Street WRF Lab Electrical Improvements (Project No. 11- D025 -UT). Blanket Waiver of Subrogation appiies as respects workers compensation when required by written contract. �.cn11r1a.n 1 � n�ur�;c 4AIYL.CLLR I IUJY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 10R;f THE EXPIRATION DATE THEREOF, NOTICE WILL HE DELIVERED IN Clffyy Of Clearwater S. Myrtle Avenue, Ste.200 r ACCORDANCE WITH THE POLICY PROVISIONS. G � ' � Clearwater FL 33756 TAUTHRE.PRESENTAIM C ®1988.2014 ACORD CORPORATION. All rights reserved, ACORD 25 t2014101) The ACORD name and logo are registered marks of ACORD SMIT -38 OP ID: BH (M MIDDYYY) CERTIFICATE OF LIABILITY INSURANCE F DATE 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(les) 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 Phone: 863- 967 -4454 CONTACT _NAME: Mulling Insurance Agency, Inc. Fax: 86361 -7592 PHONE — FA% P O Box 308 208 E Park Street _.MIND E :�: (A1C, Nal: Auburndale, FL 33823 -0308 ADDRESS: Mark E. Spann, CIC -- ]NSURER(S) AFFORDING COVERAGE NAIC # INSURER A: United Fire 8. Casualty 113021 INSURED B.L. Smith Electric, Inc. INSURER B 29252 US Hwy 27 - Dundee, FL 33838 -4285 INSURER C: INSURER D: INSURER E: r0VFRA[.FS r_FRTIFIr ATF MIIMRFR- oevlelnki All eneQro. 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 POLICY NUMBER POLICY EFF MM POLICY E%P MM DDIYYYY LIMITS GENERAL LIABILITY =a CURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR X 60419997 02124/2015 02124/2016 PREMISES (Ea !!N I ED $ 'IOQrOQ MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 { GENERAL AGGREGATE $ 2,000,00 GE NT AGGREGATE L I MIT APPLI ES PER: PRODUCTS - COMPIOPAGG $ 2,000,000 POLICY PRO LOG Emp Ben. $ 1,000,000 AUTOMOBILE LIABILITY CO eBI a�DnISINGLE LIMIT Jima $ 1,000,00 BODILY INJURY (Per person) S A ANY AUTO 60411997 02/24/2015 02124/2016 ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY (Per ( ) $ NON -OWNED HIRED AUTOS X AUTOS X PROPERTY DAMAGE Par accident $ Is UMBRELLA LIAS X OCCUR EACH OCCURRENCE $ 10,000,040 AGGREGATE $ 10,000,000 A EXCESS LIAB CLAIMS -MADE 60411997 02124/2015 02124/2016 DED I X I RETENTION$ 10000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIE%ECUTIVE OFFICERIMEMBER ExCLUDEO? ❑ NIA WCSTATU- I OTH- TOR LIMITS ER E.L. EACH ACCIDENT $ E. L. DISEASE -EA EMPLOYE S {Mandatary in NMI If yyees, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101, Addltfonal Remarks Schedule, If more space Is required) RE: CITY OF Clearwater East WRF Generator and Marshall St. WRE' Lab Electrical Improvements Project # 11- 0025 -UT City of Clearwater is included as additional insured per written contract. LHcR 1 In'ILN I C nLLUC(S L:AIVL:CLL.AI IUN CITYSPI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Clearwater ACCORDANCE WITH THE POLICY PROVISIONS. Engineering Department AUTHORIZED RE PRESENTATIVE Box 4748 Cl je� Clearwater, FL %,J 33758 cQ 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD