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2013-14 SANITARY SEWER AND MANHOLE REHABILITATION - 14-0025-UT - CERTIFICATE OF LIABILITY INSURANCE (14) CONCO-4 OP I • LDB ABC-�C�RL.� DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 06/12/2017 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 904-296-3390 CONTACT Lesley Baker Vandroff Insurance Agency Inc. PHONE 904-296-3390 FAX 904-296-6144 5150 Belfort Road#200 (A/C,No,Ext): (A/C,No): Jacksonville, FL 32256 E-MAIL lesley@vandroff-insurance.com Vandroff Insurance Agency ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Continental Casualty Company INSURED Concrete Conservation,Inc. INSURERB:Transportation Insurance Co. 20494 P.O. Box 57309 INSURER C:Travelers Indemnity Company Jacksonville, FL 32241 INSURER D:St. Paul Travelers 24767 INSURER E:Endurance American Specialty 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 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 ADDL SUER POLICY NUMBER POLICY EFF !. POLICY EXP LIMITS LTR IN D WVD MMIDD/YYYY MM/DD/YYYY C :X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR i DAMAGE TO REED I 300,000 DT34Q�1�1982 IND-17 06/13/2017 06113/2018 pREMI E Ea ocNTcurrence._�i$ °. ,. MED EXP(Anv one erson $ 5'000 -- PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER � r e, '. GENERAL AGGREGATE $ 2'000'000 POLICY PRO- LOC `'fI. 2,000,000 JECT PRODUCTS-COMP/OP AGG $ OTHER: / $_ A I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 - c d n')_ $ X ANY AUTO 20941$$ "' �� _; - 06/13/2017 06/13/2018 BODILY INJURY Per personj $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident _._ $ D X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 EXCESS LIAB CLAIMS-MADE ZUP-15P15851-17-NF 06/13/2017 06/13/2018 AGGREGATE $ 10,000,000 DED I X I RETENTION$ 10,000' B WORKERS COMPENSATION PER OTH- $ SAND EMPLOYERS'LIABILITY X STATUTE ER YiN ;, 2094737808 06/06/2017 06/06/20181 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? I N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 11000,000 If yes,describe under DESCRIPTION OF OPERATIONS below ! E.L.DISEASE-POLICY LIMIT $ E Pollution Liab AHSEC1102100 11/01/2016 11/01/2017 'Occurrenc 1,000,000 Aggregate 2,000,000 gESQRa TIOg @V1 @C F ManllLOf K tV]VllltafS( Project-ORD11 VItio URemarks Schedule,maybe attached if more space is required) 0 art (14-002-5-UT) CERTIFICATE HOLDER CANCELLATION CITY-27 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Clearwater Municipal Services Bldg Robert S. Fahey, P.E. AUTHORIZED REPRESENTATIVE 100 South Myrtle Ave,Ste 220 iClearwater, FL 33756 ! V ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD