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MISSOURI AVENUE LANDSCAPE IMPROVEMENTS PROJECT NO 1 - CONTRACT NO AS063 - CERTIFICATE OF LIABILITY INSURANCE Client#: 1791116 69SMITHLAN TE'm ACORDT. CERTIFICATE OF LIABILITY INSURANCE DA 110512010"7yy' 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 SUBR6dAfION IS WAIVED,subject to the to 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 iu;Morrisseau BB&T Insurance Services,Inc. P I HbNE 0 u 1�,j z 888-632-8459 12485-28th Street North E'MAIL E rri eau@bbandt.com D Saint Petersburg,FL 33716 .................M __.w......................... 727 327-7070 INSURER(S)AFFORDING COVERAGE NAIC NAIC 9 INSURER A:American Interstate Insurance C 31895 INSURED INSURER B: Smith Landscape Services Inc 1293 Myers Road _LNSURERR, Brooksville,FL 34602 MSURILF! INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A50VE 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 POLICY NUMBER P MR-M-0- JMWQDNYM'A LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ RENTED ------ CLAIMS-MADE OCCUR a2-iriL- S?R:— -L- M y one person) $ LED ff��P 4 .......... . . ......... ( _ _______ ____ _ttRSC�N�L&,�RV 11!��IRY RV GEWL AGGREGATE LIMIT APPLIES PER� GENERAL A0GREGATE $ LICY JECT LOC PRODUCT m COMROP AGO $ PO PRO- OTHER: $ ......... �OM�Wffb-r5�GLr LIM.FC- AUTOMOBILE LIABILITY -Eq ao ANY AUTO BODILY INJURY(Per person} S ALL OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS — _ . __............................. NON-OWNED `i�dRERWI�l AGE $ HIRED AUTOS AUTOS ------------ -—--------------- ..................... ............................................. ............................ ..........-------I—-..........._..___._.._.__............ .............__'.___'_.____ UMBRELLA LIAB ---[C�CUR EACH OCCURRENCE $ ................... EXCESS LIAR MS:MADE G REC?LTC .......................A....................................... j._PE0_I_ RETENTIONS__..... S_. —------- PER A WORKERS COMPENSATION AVWCFL2546822016 1110112016 11/0`1/201 lklm=------X OT"" AND EMPLOYERS'LIABILITY YIN ANY PROPR�ETORJPARTNEPJEXECUTIVE[-�� OFFICE EMBER EXCLUDED? !�L._EACF!A0C;L1LLT11,,000,000 R/M NIA (Mandatory In NH) E.L.DISEASEEA EMPLOYEE. 9 yes r describe under DE,, —alPTION OF OPERATIONS Wow E.L.DISEASE-POLICY IMIT DESCRIPTION OF OPERA71ONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached It mom space Is required) Proprietors/Partners/Executive Officers/Members Excluded: Frank Smith,President Missouri Avenue Landscape Improvements Project#1 Contract#AS063 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Clearwater,Attn.Parks THE EXPIRATION DATE THEREOF, NOINCE WILL BE DELIVERED IN &Recreation ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 4748 Clearwater,FL 33758-4748 AUTHORIZED REPRESENTATIVE 0198 -2014 ACORD CORPORATION.All rights 0 ACORD 25(201 1) 1 of 1 The ACORD name and logo are registered marks of ACORD 17422101/ 17090942 KCJ 717' =(;41 14[of-Til I�Ill&�fff--Klj F.A 114 jW 0 10 DQ 141111*s]4�11111 U41111IJ4 J UU,Uf 111TI 4AA," U0 J1114cf.34 I t;I&�Kdq4z4tI;I[4f--'k 1 &ill JXI�f;a 1103 411WIMINT 'jkQ:90i4ail INSURED Smith 4andscape Services Inc. rL4SUR t_ER ................ ........... I'SU, 1293 Myers Road NSURER D, Brooksville,FL 34602 IIN�LUREFLR. 7&ROUIZAR"L INS' TYPE OF INSURANCE COMMERCIAL GENERAL LIABILITY cwm"ADr: OCCUR ....................... GEN'L AGGREGATE UMITAPP.LL WIIEW ::Lpoucy[XI Spea I LOC a ar rHER: AUTOMOBILE LIABILITY AWAUF0 ONIED S RULED AUTOS 0�qLy AROS ASOMM UMBRELLA LIAB ]5UR E C IM _MAOE ION S WICWRS CO P N MPLOYF .%S�NSATION f. A UABILITY y Z Contract#GO829.City of as me for me certcate holder, F THE ABOVE D015CRIBED LICIES BE CANCELLED BEPORE I I ON DATE THEI I�TICE WILL BE DELIVERED IN WITH THE POLICY 3 S' . CERTIFICATE OF LIABILITY INSURANCE 1011912016 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 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT CT BE EENI 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 right to the certificate holder In lieu of such endorsement(s)® PRODUCER NAIUEa Ashley 21nke OneSour Insuran ,L.LCf Adams RnanCial 1 u�613)759 1 _, _ _ __,... m_ .. ! *N®J..,_(677)3� 1821 m...._ 1614 S.Alexander Street,Suite 102oSS: ASh1ey.2Vnko osltlorida.Corn 1ISU SI.Ar FFORDING COBERAGE__..,. _ _.. ._ w NAIC#. ...,_ Plant _._ City .__--_....._____ ...._,_. . _._.. ..___ .,_,..__ _ .,,__,.Ft33563 WSURERA G.....r.a...n....a..da MsuranCS'Company . ._..._m '16870 _----.. -., ,... .,. INSURE) INSURER S I Smith Landscape Senlops,Inc. INSURER o 1253 Myers Load INSURER D INSURER.E o Brooksville FL 34602 COVERAGES CERTIFICATE NUMBER-BER- R ISVO NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN lSSUEID TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDMG ANY RE(DWREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VATH RESPECT TO MICH THIS CER"rIRCATE MAY BE ISSUED OR MAY PERTAIN), THE INSURANCE AFFORDED BY TI°IE POLICIES DESCRIBED HEREIN!IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. d E BNSU.,.NCE AC(1'L CTS _ m _ ._._.- ti E 1 d7I V_„00 ..,,., ... POLICY NUMBER ►dwool yyy ilimp yyY"y UMITS COMMERCIAL E L LIABILITY EDAACI�H 74 COL C C 1 RRENC I WTCi AC OrCUR CtlAW B'R EI4NV DES t rib egM . (_ I a..........— —.ED F-XP Q.AIp9y GP6BB# Y9" VI to :I ilr aaµ.l�+DV�NJ Ur�°Y �,.,... 4�'N i...A �� .... ...m " .. rE UW I drPFLIFS PER: � C�ENI RAd /A'�RCCiV 6E $ JET .-- ._ e GC1wNr POP AGO $ OTHER: $ AUTOMOBILE LIABILITY WA 39 ..b I �I I I $ 1,000,000 EVu acs uI�¢t ANY AUTO ItG&ULY VwURY(Per person) $ hA _,._ AFB 0e, BrE�IGBI..E(D CA011"1-1010265 02915920/6 02!1592017 DOU Y lr JUPY(Persaa,ddenq $ RR ED. ns ALL AAtn' EIU r� I AANACxG _ Eis AUTC$xi ' Airi r .. 10,000 ME D occuI EXCESS UA CLNMS-M ADE AG CLItli rCENrW $ RErrA1d $ PEED RETENTION$ $ WORKERS COMP "nON PER tl H AND EMPLOYERS"LIAauB„ITY YIN 9�6I di L ANY PROPR4ErOR/P ARTNB R�kdlE#•&=�;d.MVE I "'y NSA E.i EACH AdA 0ENT $ 0FRCER/MEMB5R k XCLtMEIA A f y _w o- _dr...,. (Mandatory In NH) E.L. b S F;A�SF EA EMPLOYEE $ Sf �".arBlderatikauarand�rr _ _.,.,._. .._...� ..._ .._. �-..._, .,,.,,,,._. D �S RIPTION OF f�&"EPdATdC7NS krtduadu E.1- CV�EAEEI �'iDLVC.d I VttBT $ DESCRIPTION OF OPERATIONS;LOCAPONS I VEHICLES(ACORD 141,Additional R ma rks Schodule,nay be aftached NY inam space Is unquudw ) Missouri Avenge Landscape knprove nts Project$1 Contract#AS063 City of Clearwater needs to the named as add"ItionaV insured Wth respects to the&Automobile Liability. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED PIOLICIES BE CANCELLED:BEFORE E EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF CL TER-ENGINEERING DEPARTMENT ACCORDANCE WITH THE POLICY PROVISIONS, AT"lN.CONSTRUCTION OFFVCE SPECIALIST AUTHORIZED REPRESENTAnVE F.O.BOX 4746 CLEARWATER FL 33752-4746 d 1968-2614 ACORD CORPORATION.All rights reserved. ACORD 2 (2014991) The ACORD name and logo are registered marks of CO