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2013 STORMWATER REPAIRS PROJECT - 12-0040-EN - CERTIFICATE OF LIABILITY INSURANCE (4)'`�`-c ° 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 Linda Waldorf PHONE (A/c, No Est). 727 461 -6044 FAX Nor 727- 442 -7695 E -MAIL ADDRESS: Iwaldorf bb p 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 : EACH OCCURRENCE INSURER D INSURER E : CLAIMS -MADE INSURER F : OCCUR • r« V wrvrl ItumDCrc: 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 MA`bHAVE BEEN REQUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMa!R POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 88A5GL0000390 _- ::...... .: 7/28/2016 .. . 7/28/2017 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $100,000 MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1,000,000 GE 'L AGGREGATE POLICY OTHER: X LIMIT APPLIES 78: PER: LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP /OPAGG $2,000,000 A AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X — SCHEDULED AUTOS NON-OWNED 88A5CA0000189 7/28/2016 7/28/2017 (Ea accident) BI D 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 PER STATUTE OTH- l ER E.L. EACH ACCIDENT $ 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 / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Ref: 2013 Stormwater Repair, 12- 0040 -EN Certificate holder is an additional insured with regard to Bodily Injury or Property Damage arising from the work performed by the named insured per form CG2037 04/13. ICATE HOLDER CANCELLATION City of Clearwater PO Box 4748 Clearwater FL 33758 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