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SID LICKTON PARK SITE CIVIL CONTRUCTION - 12-0024-PR-A - CERTIFICATE OF LIABILITY INSURANCE (2)ALTOCON -01 JWAGNER -e-1`;,:� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDmrn) 8/24/2016 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). i PRODUCER ,.m Florida Insurance Center, Inc. %.... -+ � " 414 N Alexander St Plant City, FL 33563 I( � ') ) v� J L i I li °!SSA CONTACT NAME: Judy Wagner, AAI, AU, AIS, CPIW E FAX (A/C, No. Ext): (A/C, No): EMAIL wa ner/�toridainsurancecenter.com ADDRESS: j g v„ INSURER(S) AFFORDING COVERAGE NAIC # SURER A : United Fire & Casualty Company 13021 i �;vf'!4C� A N; INSURED EE �^°yyt ! Ads tW ! .63' [�',.t�`dvL A TVE 4>.f t C i? r Alto Construction Co., Inc. 4102 Causeway Blvd Tampa, FL 33619 -5124 SURER B : Travelers Property & Casualty 25674 INSURER C : 08/31/2017 INSURER D : $ 1,000,000 INSURER E CLAIMS -MADE INSURER F : OCCUR CERTIFICATE NUMBER: • 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 POLIC ES 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 X X 60480883 08/31/2016 08/31/2017 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 GEN'L AGGREGATE POLICY OTHER: X LIMIT APPLIES JECT X PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 $ A AUTOMOBILE X X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS H Damag ys SCHEDULED AUTOS NON -OWNED AUTOS X X 60480883 08/31/2016 08/31/2017 EOa aBI ED SINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) ( ) $ PROPERTY DAMAGE (Per accident) $ PIP $ 10,000 B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE ZUP71M6410216NF 08/31/2016 08/31/2017 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED X RETENT ON $ 0 $ 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 PERTUTE I I ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A A Leased /Rented EQ Installation Floater 60480883 60480883 08/31/2016 08/31/2016 08/31/2017 08/31/2017 Limit: 202,800 Limit: 50,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Certificate holder is named as an additional insured with a waiver of subrogation with regards to the general and auto liability coverage. Coverage is primary and non - contributory as per written contract. Project: Sid Lickton Pk - Site Civil Construction 12- 0024 -PR -A Certificate holder is named as an additional insured with a waiver of subrogation with regards to the general and auto liability coverage. Coverage is primary and non - contributory to any other insurance. The Umbrella follows the form of the above policies. CERTIFICATE HOLDER City of Clearwater Engineering Office Rm #220 100 S. Myrtle Ave 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 REPVRESSENNTTATIVE ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD