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FIRE STATION 48 BUILDING RENOVATIONS - 07-0052-FI - CERTIFICATE OF LIABILITY INSURANCEA�!zO CERTIFICATE OF LIABILITY INSURANCE 8/29/2016 8/29/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. HOLDER. THIS BY THE POLICIES AUTHORIZED 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 Brown & Brown Insurance - Clearwater 83 Park Place Blvd., Suite 101 Clearwater FL 33759 CONTACT Linda Waldorf PHONE 727 - 461 -6044 FAX 727 - 442 -7695 (A /C. No, Ext)' IA/C No): E -MAIL ADDRESS: lwaldorf@bbpinellas.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :American Family Home Insurance Comp 23450 INSURED STEVE -7 Steve's Excavating & Paving, Inc. Sarnago & Sons Properties Inc. Sarnago & Sons Clearwater Recycling & Materials P.O. Box 303 Dunedin FL 34697 INSURER B :Westchester Surplus Lines Insurance 10172 INSURER C : EACH OCCURRENCE INSURER D INSURER E : CLAIMS -MADE INSURER F : OCCUR GES • rALYIVIVI• IMUITI LOGIN. 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 LIABILITY 88A5GL000039.Q -• s` CIF vp � st'�Cy, �' �, as, { t n t q czEp ,:j• J M `..0 r //^� pp s °a, "' "° " �� >r„ir'i'IiitL"s- i'°'s+,i.r• °�'s'Sq� r c;;.V$✓ 1-7/j, 8/2016 a "� tt; f b'•tr � i.a 7/28/2017 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR PREMISES (Ea occurrence) $100,000 GEN'L MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1,000,000 AGGREGATE POLICY OTHER: X LIMIT APPLIES JECOT 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 SCHEDULED AUTOS NON -OWNED AUTOS �,F� 88A5CA0 3H9e+ -- ' /28/2016 7/28/2017 EOa aBINED SINGLE LIMIT $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ PIP $10,000 UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENT ON $ $ 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 I STATUTE I I H ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ B Pollution Liability G27894550002 8/25/2016 8/25/2017 Per Occurrence 1,000,000 Aggregate 1,000,000 Deductible 10,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project -The Fire Station 48 Clearwater, FL. City of Clearwater is an additional insured per the terms of the policy. CERTIFICATE HOLDER CANCELLATION City of Clearwater PO Box 4748 Clearwater FL 33756 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 ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD '``PRO CERTIFICATE OF LIABILITY INSURANCE 7/27/2016 7/27/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. HOLDER. THIS BY THE POLICIES AUTHORIZED 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 Brown & Brown Insurance Clearwater 83 Park Place Blvd., Suite 101 Clearwater FL 33759 CONTACT NAME: Linda Waldorf PHONE (A /C. No Ext)• 727 461 -6044 FAX No): 727- 442 -7695 E -MAIL ADDRESS P Iwaldorf bb Inellas.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :American Family Home Insurance Comp 23450 INSURED STEVE -7 Steve's Excavating & Paving, Inc. Sarnago & Sons Properties Inc. Sarnago & Sons Clearwater Recycling & Materials P.O. Box 303 Dunedin FL 34697 INSURER B :Westchester Surplus Lines Insurance 10172 INSURER C : OCCUR INSURER D : INSURER E : PERSONAL 8 ADV INJURY INSURER F : GEN'L • THIS INDICATED. CERTIFICATE EXCLUSIONS INSR LTR IS TO CERTIFY THAT THE POLICIES NOTWITHSTANDING ANY REQUIREMENT, MAY BE ISSUED OR MAY AND CONDITIONS OF SUCH TYPE OF INSURANCE OF PERTAIN, POLICIES. ADDL INSD INSURANCE SUBR WVD LISTED BELOW HAVE BEEN TERM OR CONDITION OF ANY THE INSURANCE AFFORDED BY LIMITS SHOWN MAY HAVE BEEN POLICY NUMBER 88A5GL0000390 ISSUED TO CONTRACT THE POLICIES REDUCED BY POLICY EFF (MM /DDIYYYY) 7/28/2016 - THE INSURED OR OTHER DESCRIBED PAID CLAIMS. POLICY EXP (MM /DD/YYYYL 7/28/2017 nGVIJIVl\ IIMOIVIDICIN. NAMED ABOVE FOR THE POLICY PERIOD DOCUMENT WITH RESPECT TO WHICH THIS HEREIN IS SUBJECT TO ALL THE TERMS, LIMITS A x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) $1,000,000 $100,000 $5,000 CLAIMS -MADE X OCCUR PERSONAL 8 ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X WI: LOC PRODUCTS - COMP /OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY 88A5CA001w9$9 • - - - �.,,.. ,:.'.., '7/28/2016 , - - �� • ° 7/28/2017 COMBINED SIN(,LE LIMIT (Ea accident) $ 1,000,000 X %( ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ PIP $10,000 UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY N / A PER STATUTE OTH- ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? Y / N E.L. EACH ACCIDENT $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ B Pollution Liability G27894550001 8/25/2015 8/25/2016 Per Occurrence 1,000,000 Deductible 10,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project -The Fire Station 48 Clearwater, FL. City of Clearwater is an additional insured per the terms of the policy. ATE HOLDER CANCELLATION City of Clearwater PO Box 4748 • Clearwater FL 33756 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 ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD