The URL can be used to link to this page

CERTIFICATE OF LIABILITY INSURANCE (797) �+c ffi CERTIFICATE OF LIABILITY INSURANCE DATE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY ARID 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=iesy 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). CONTACT PRODUCER NAME: FAIL Marsh USA Inc. PHONE _ IUC Nn 1564 Sawgrass Corporate Pkwy,Suite 306 E-AAAIL Sunrise,FL 33323 D RESS: INSURERS AFFORDING COVERAGE NAIL# 1050 8554 All'GAWUP 1516 INSURER A:Liberty Mutual Fire Insurance Company 23035 INSURED INSURER B:LM Insurance Corporation 33600 Waste Pro USA,Inc, 19437 2101 W.SR 434,Suite#305 INSURER C:Lexington Insurance Company Longwood,FL 32779 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-004016411-01 REVISION NUMBER:1 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- IN R A l�}L 5USR POLICY EFF POLICY EX P LIMITS LTR TYPE OF INSURANCE Wvp POLICY NUMBER fMWDDfYYYYI FMMIDDIYYYYI A X COMMERCIAL GENERAL LUNBILITY T132-621.093760-905 1112712645 11122J2016 EACH OCCURRENCE $ i,000,000 DAMAGE TWRffWTTU CLAIMS-MADE El OCCUR PREMISES(Ea occurrence $ 500,000 MED EXP{Any one pemonl S 5,060 PERSONAL&ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY PRO- �LOC PRODUCTS-COMPIOP AGG $ 2,004,004 S OTHER. COMBINED SINGLE LIMIT A AUTOMOBILE LIABILITY S2.621-€!93780-095 11122/2015 1112212016 Ea accident $ I'CW00 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS x AUTOS PROPERTY aar ciden OANtAGE $ C X UMBRELLA LIAR OCCi1R 018423515 111222015 11/2212016 EACH OCCURRENCE $ 5,000,606 EXCESS LIAR CLAIMS-MADE AGGREGATE $ 5,OD0,000 DED I I RETENTION$ $ B WORKERS COMPENSATION WA562DO93780045(AOS) 111222615 1i122J2016 XT R H- AND EMPLOYERS LIABILITY YIN ANY PROPRIETORIPARTNE MEAL"TIVa N IR E L EACH ACCIDENT $ 1,000,000 OFFICERIMEMAER EXCLUDES 7 (Mandatory inNH) EL DISEASE-EA EMPLOYEE $ 1,000,000 Ir yes,describe under 1,060,000 DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT J$ B Workers Compensation EW562N09378W55(FL) I V2212015 11/2212016 Employers Liability: 1,000,000 SIR: 5011,060 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACONO Jul,rAdditional Remarks Schedule,may be attached it more space is required) RECEIVED ED SEP 2 2016 CERTIFICATE HOLDER GALS AnUIN CANCELLATION Clearwater Gas System SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 406 N Myrile Ave THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Clearwater,FL 33755 ACCORDANCE W"THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Juan Hemandez C 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2094101) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER 10. 185458554 ��-�--�- LOC#: Lauderdale AC4 RC7� ADDITIONAL REMARKS SCHEDULE Page Z of 2 AGENCY NAMED INSUREf7 Marsh USA Inc, Waste Pro USA,Inc. 2101 W,SR 434,Suite##305 POLICY NUMBER Longwood,FL 32779 CARRIER :sAtc coos EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM 15 A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE. Certificate of Liability Insurance Coniracto(s Poilukan Liability: Carrier.AIG Specialty Insurance Company Policy Number PLC2300207 Dates:01I0112016.011OV2017 Lirpts:$5,000'000 oeductibla:$250,000 Storage Tank Liabitty Limit:$1.000.000 ACORD 101 [2008101] ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORN