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CERTIFICATE OF LIABILITY INSURANCE - RFQ 34-15 (21)
Client#: 1048826 INTERENG2 ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD,/YYYY) 03/15/2017 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). PRODUCER !CONTACT USI Insurance Services, LLC, PHONE 1715 N.Westshore Blvd.Suite 700 A/c,No E.t:8) 13 321-7500 �A c o: 813 321-7525 ADDRESS: Tampa, FL 33607 _—....._—.._—_.—._—.... __ INSURER(S)AFFORDING COVERAGE NAIC# -- _ INSURER A:Phoenix Insurance Company 25623 INSURED Interflow Engineering, LLC INSURER B:.Travelers Casualty and Surety C 19038 i------- ---- 14499 N. Dale Mabry Hwy.,Ste.290 INSURER c XL Specialty Insurance Company 37885 Tampa, FL 33618 INSURER D, INSURER E: 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 ABOVE 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. INSR ADDLISUBR LTR TYPE OF INSURANCE POLICY EFF POLICY I W POLICY NUMBER (MM,`DD/YYYYI�MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY X X '6801922L734 6/06/2016 06/06/2017 EACH OCCURRENCE $2 000 000 -- —.;_�--r_.------ CLAIMS-MADE Xi OCCUR PREMISESO(EaoccuDnce) $1,000,000 — MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- GENERAL AGGREGATE $4,000,000 — POLICY;_ X:_I JECT LOC PRODUCTS-COMP/OP AGG $4,000,000 OTHER: I I j I$ A AUTOMOBILE LIABILITY X X 6801922L734 6/06/2016 06/06/2017 COMBPNED SINGLE LIMIT — )Ea accident) �I2,000,000 _ _ ANY AUTO ALL OWNED SCHEDULED BODILY INJURY(Per person) $ -� I AUTOS AUTOS ,BODILY INJURY(Per accident) $ X X NON-OWNED -PROPERTY DAMAGE ---- (— HIRED AUTOS AUTOS— � �-'Pecaccident �$ $ UMBRELLA LIAB �y,OCCUR j CH OCCURRENCE $ EXCESS LIAR CLAIMS-MAD -EA-- -- )-- "-------- AGGREGATE $ DED RETENTION$ F— B I"-------- — WORKERS COMPENSATION ! AND EMPLOYERS'LIABILITY X U 89096Y735 3/12/2017 03/12/2018 X 'PER OTH _$ YN STATUTE Rf` ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? Y N/A I E.L.EACH ACCIDENT $1 000,000 - (Mandatory in NH) -- I ...... - If yes,describe under — EI L.DISEASE-EA EMPLOYEE!$1 000 000 DESCRIPTION OF OPERATIONS-be9ow_ E.L.DISEASE-POLICY LIMIT >$1>OOO OOO --- -- C Professional Liability I DPS9724407 6/06/2016 06/06/2017 $1,000,000 per claim $1,000,000 annl aggr. ' I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Professional Liability coverage is written on a claims-made basis. REFERENCE: RFQ#34-15 Certificate holder is an additional insured with respect to the General Liability and Auto Liability policy as required by written contract. CERTIFICATE HOLDER CANCELLATION City of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Engineering Dept. ACCORDANCE WITH THE POLICY PROVISIONS. 100 S. Myrtle Ave.,#220 Clearwater, FL 33756 AUTHORIZED REPRESENTATIVE 0�- --n 06—w..A0 ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #S20057082/M20057075 GITEW