The URL can be used to link to this page

CERTIFICATE OF LIABILITY INSURANCE (849)ACORl7® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/OD/YYYY) 6/23/2017 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 Alliant Insurance Services, Inc. 7108 Fairway Drive Suite 225 Palm Beach Gardens, FL 33418 CONTACT NAME: (A/c No Est): 561.214.6366 F�"/G,NO,, 561 799 3307 E -MAIL monica.talma @alliant.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURERA:Starr Indemnity & Liability Company 38318 INSURED J. Kokolakis Contracting, Inc. 202 E. Center Street Tarpon Springs„ FL 34689 INSURER B :Zurich American Insurance Company 16535 INSURER C :Navigators Insurance Company 42307 INSURER D :RSUI Indemnity Company 22314 INSURER E: Indian Harbor Insurance Company 36940 INSURER F : TE NUMBER: 1422216703 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 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS B X COMMERCIAL GENERAL LIABILITY Y Y GLO017336303 6/24/2017 6/24/2018 EACH OCCURRENCE $2,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $300,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $10,000 PERSONAL 8 ADV INJURY $2,000,000 GENERAL AGGREGATE $4,000,000 GE 'L AGGREGATE POLICY OTHER: X LIMIT APPLIES PRO- JECT X PER: LOC PRODUCTS - COMP /OP AGG $4,000,000 $ B AUTOMOBILE X X LIABILITY ANY AUTO ALLOSVNED HIRED AUTOS X SCHEDULED NON -OWNED AUTOS Y Y BAP017336103 6/24/2017 6/24/2018 (Ea COMBINED SINGLE INGLE LIMIT $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A D X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE Y Y 1000023773 NY17EXC8127571V NHA079748 6/24/2017 6/24/2017 6/24/2017 6/24/2018 6/24/2018 6/24/2018 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 $ DED RETENT ON $ g WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below YNN NIA Y WC017336503 6/24/2017 6/24/2018 X STATUTE OTH- ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 E Contractors Professional & Pollution 0E07446417 6/24/2017 6/24/2018 Each Claim $3,000,000 Aggregate $6,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD Evidence of insurance. The City of Clearwater is included as Additional and Automobile Policies as required by a written required by written contract. No policy will 101, Additional Remarks Schedule, may be attached if more space is required) Insured on a Primary & Non - Contributory basis with respect to the above General Liability contract. A Waiver of Subrogation is included and applies in favor of the Additional Insured as I 1 modification without thirty (30) days prior written notice. ii (M 9 A ')n17 CANCELLATION OFFICIAL RECORDS AND City Clearwater n Attn: City Clerk LEGISLATIVE SRVCS DEPT, PO Box 4748 Clearwater FL 33758 -4748 1 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 P'el'ts . ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD