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CLEARWATER POLICE FIRING RANGE RENOVATIONS - 13-0013-PD - GUARANTEED MAXIMUM PRICE GMP - CERTIFICATE OF LIABILITY INSURANCE - RFQ 24-16 (11) DATE(M A� M/DD/YYYY) 6/22/2017 DATE(M" CERTIFICATE OF LIABILITY INSURANCE 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 NAME: Alliant Insurance Services, Inc. PHONE 561.214.6366 FAX 561.799.3 307 7108 Fairway Drive E-MAIL A/c No Suite 225 ADDRESS:monica.talma @alliant.com Palm Beach Gardens, FL 33418 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Starr Indemnity&Liability Company 38318 INSURED INSURERB:Zurich American Insurance Company 16535 J. Kokolakis Contracting, Inc. INSURERC:Aspen American Insurance Company 43460 202 E. Center Street INSURER D:Navigators Insurance Company 42307 Tarpon Springs„ FL 34689 INSURER E:RSU I Indemnity Company 22314 INSURER F: COVERAGES CERTIFICATE NUMBER: 985523328 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 TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD/YYY MM/DD/YYY B X COMMERCIAL GENERAL LIABILITY Y Y GLOO17336303 6/24/2017 6/24/2018 EACH OCCURRENCE $2,000,000 IX OCCUR PREMISES TORENTED CLAIMS-MADE PREMISES Ea Occurrence) $300,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $4,000,000 POLICY jECT LOC PRODUCTS-COMP/OP AGG $4,000,000 OTHER: $ B AUTOMOBILE LIABILITY Y Y BAP017336103 6/24/2017 6/24/2018 COMBINED SINGLE LIMIT $ (Ea accident) 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) A UMBRELLA LAB I X I OCCUR Y Y 1000023773 6/24/2017 6/24/2018 EACH OCCURRENCE $10,000,000 D NY17EXC8127571V 6/24/2017 6/24/2018 E X EXCESS LIAB CLAIMS-MADE NHA079748 6/24/2017 6/24/2018 AGGREGATE $10,000,000 DED RETENTION$ $ B WORKERS COMPENSATION y WC017336503 6/24/2017 6/24/2018 X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ❑N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 C Contractors Equip Y Y IMZ264417 6/24/2017 6/24/2018 Rented/Leased Equipment Per Item $250,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Project: 2016-2020 Construction Management at Risk Services for Continuing Contracts RFQ#24-16. City of Clearwater is included as an Additional Insured on a Primary/Non-Contributory basis with respect to the above General Liability and Automobile Policies as required by a written contract. A Waiver of Subrogation is included and applies in favor of Additional Insured as required by written contract. No policy will permit cancellation or modification without thirty(30)days prior written notice. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Clearwater THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATTN: Engineering Contract Specialist, RFQ#24-16 ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 4748 Clearwater FL 33758-4748 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD