The URL can be used to link to this page

CERTIFICATE OF LIABILITY INSURANCE (462) TIERINC-01 LVELEZ '4�c,oRO` [ E CERTIFICATE OF LIABILITY INSURANCE DAT6/112 D/YYYY) 5/1/2017 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 have ADDITIONAL INSURED provisions or 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 Hub International Southeast PHONE FAX 600 Cleveland Street IAIC No,Ext) (727)797-0441 Ia/C,No):(727)669-0673 Suite 600 E-MAIL Clearwater,FL 33755 ADDRESS. - -- _____-_- ___ INSURER(S).AFFORDING-COVERAGE_-, --_-_ _ NAIC# INSURER A:Charter Oak Fire Insurance Company 25615 _ INSURED INSURER B:The Phoenix_Insurance_Company__- 25623 Tierra,Inc. INSURER C:Travelers Property Casualty Insurance Company 36161 7351 Temple Terrace Hwy""y INSURERD:Travelers_Casualty_and Surety Company_- 1_9.038 Tampa,FL 33637 - — - INSURER E.Illinois Union Insurance Co_mpa_ny-- 27960 INSURER F:Continental Casualty Company 20443 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 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 ADDL:SUBR' - POLICYEFF POLICYEXP --- --- --__--- -- _-- ----- -- LTR TYPE OF INSURANCE IN SD WVD POLICY NUMBER D/YYYY DIYYYY LIMITS A X COMMERCIAL GENERALLIABILITY 1,000,000 _---;-_—..._ ._.._.__ � EACH OCCURRENCE_ -$_ CLAIMS-MADE X OCCUR DAMAGE TO RENTED 300,000 - - 660-1H805464-17 05/01/2017 05/01/2018 _pREMISES_(Eaoccurrence) $_ 0 X Contractual 5,00 MED EXP(Any one person) S_ PERSONAL_&ADVINJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 2 000,000 ,.GENERAL_AGGREGATE ,._S.- POLICY -X PRO- LOC 2,000,000 JECT ; - _PRODUCTS. COMP/OP AGG $. _ OTHER EBL AGG $ 2,000,000 B AUTOMOBILE LIABILITY i COMBINED SINGLE LIMIT 1,000,000(Ea accident)_ _—_—_ ;.$_- ___.—.__ _ X ANY AUTO 810-1H756011-17 05/01/2017 05/01/2018 BODILYINJURY(Perperson) ,.$. .--..� OWNED SCHEDULED I AUTOS ONLY I AUTOS HIRED NON-pWNEp INJUDRAY M __- AUTOS ONLY ,_- ..i AUTOS ONLY - _{Per accident) - C X UMBRELLA LIAB _X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LI AB CLAIMS-MADE CUP-111805464 05/01/2017 05101/2018 5,000,000 AGGREGATE g-- DED X RETENTION$ 10,000 I$ D AND EMPLOYERSELIABILOITY �X—I ORH Y!N UB-8254A71A-17 05/01/2017 05/01/2018 1,000000 ANY PROPRIETOR?PARTNER/EXECUTIVE --,- E.L.EACH ACCIDENT S GrFICERiMEMBER EXCLUDED? - - - - NIA (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 E Pollution/Environm CPYG46634937001 05/01/2017 05/01/2018 /mil per occ/2mil ag 25,000 F Professional Liab. MCH591877674 07/14/2016 07/14/2017 Palm/Agg 5,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) I 4 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE f THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Clearwater ACCORDANCE WITH THE POLICY PROVISIONS. Engineering Contract Specialist 100 S.Myrtle Ave. Clearwater,FL 33756 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD