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SOLID WASTE TRANSFER STATION REPLACEMENT PROJECT - 15-0007-SW - CERTIFICATE OF LIABILITY INSURANCE 72/5/2018 E(MM/DD/YYYY) A�" 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 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 NAME: Monica Talma Alliant Insurance Services, Inc. PHONE FAX 7108 Fairway Drive A/c No Ext: 561.214.6366 A/C,No): Suite 225 ADODRESS: COIPBG @alliant.com Palm Beach Gardens, FL 33418 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Starr Indemnity& Liability Company 38318 INSURED INSURER B:Zurich American Insurance Company 16535 J. Kokolakis Contracting, Inc. 202 E. Center Street INSURERC: Navigators Insurance Company 42307 Tarpon Springs„ FL 34689 INSURER D: RSUI Indemnity Company 22314 INSURER E: Indian Harbor Insurance Company 36940 INSURER F: Aspen American Insurance Company 43460 COVERAGES CERTIFICATE NUMBER:938496058 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 SUBR 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 CLAIMS-MADE � OCCUR PREMISES TORENTED 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 PRO- ECT � LOC PRODUCTS-COMP/OP AGG $4,000,000 OTHER: $ B AUTOMOBILE LIABILITY Y Y BAP017336103 6/24/2017 6/24/2018 COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident A UMBRELLA LAB OCCUR Y Y 1000023773 6/24/2017 6/24/2018 EACH OCCURRENCE $10,000,000 C NY17EXC8127571V 6/24/2017 6/24/2018 D X EXCESS LAB X 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 A NYPR0PRI ETO R/PA RT N E R/EX EC UT I V E 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 E Professional&Pollution CE07446417 6/24/2017 6/24/2018 Each Claim/Agg $3M/$6M F Contractor's Equipment Y Y IMZ264417 6/24/2017 6/24/2018 Leased/Rent Per Item $250,000 Deductible $1,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Project: Solid Waste Transfer Station Reconstruction-Old Coachman Road, Clearwater, FL. 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 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Clearwater ACCORDANCE WITH THE POLICY PROVISIONS. Purchasing—RFQ 60-15 P.O. Box 4748 AUTHORIZED REPRESENTATIVE Clearwater FL 33758-4748 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD