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ARLIE AVENUE STORMWATER IMPROVEMENTS - 17-0068-EN - CERTIFICATE OF LIABILITY INSURANCE KEYSEXC-01 JF AVA DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 04/0212018 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 endorement(s). GO TACT PRODUCER NAME: ---,�® ._-.._ ...._ ` ASSOCIATES AGENCY,INC. PHOE 11470 N 53rd St (Arc NNo Extl:(813)988-1234 (AIC No):(813)988-0989 E MAIL cents a ssociatesins,com Temple Terrace,FL 33617 AA?�a3ss: .. INSURERS$AFFORDING COVERAGE NAIC tt INSURER A:Bltco National Insurance Comp ny 120109 INSURED INSURER B_Bltco General.Insuran,;e Corporation 20095 Keystone Excavators,Inc. INSURER 371 Scarlet Blvd. INSURER D i Oldsmar,FL 34677 INSURER E NSURER C; OVERAGES CERTIFICATE NUMBER: REVISION NUMAER: __ 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. — ._ NSR - ---.— „--ADDL SUBR - Toucy ECF POLICY EXP LIMITS LTR 1 TYPE OF INSURANCE IN D WVD POLICY NUMBERr I R Y MID A X COMMERCIAL GENERAL LIABILITY Ems,H OCCURM h,CE 5 CLAIMS-MADE I X I OCCUR CLP 3661589 12/01/2017 12/0112018 GAP1AGk I O F ELATED 300,000 ME i CkP_JLny_Q1T Pgrsan' 10,000'.. ,PERSONAL&ADV IN JURY � 1,000,000 GEN'G CeATE AGGREGATE LIMIT APPLIES PER: OENEF�At,AGGRE .... $ 2,000,000 2_— i. POLICY X PRO- LOC !�RfJJGCTS� COMPICJP RGG S 2,000,000'. ��JEC7 ,COMBINED SINGLE LIMIT 1,000 000 B AUTOMOBILE LIABILITY e.Ei aecltiena. .....- S ..... ......._.. X ANY AUTO CAP 3661590 12/01/2017 12/01/2018 BoDItY INJURY Per sbnp„ � OWNED SCHEDULED I AUTOS ONLY AUTOS BODILY IN.1,UIy�Pef ac� �ry,€� $ - r— P, OPERTY DAMAGE X HIRED X NON-OWNED PIP a�Ie�tr s 10,000 € AUTOS ONLY AUTOS ONLY �.....�. � _. s 5,000,000 B X UMBRELLA LIAB X OCCUR [Jk,CH OCCURRENCE „ EXCESS LIAB (CLAIMS MADE= 'CUP 2812266 12/01/2017 12/01/2018 5,000,000 F.GGReGATE )$ .. -- T__ ._ _ ."a2".I RI'IJTE OTH S DED RETENTION$ 10, _ 000 B WORKER CS OMPENSATION k I X _ AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y r N WC 3661588 12101/2017 1210112018 E._L EACH AC IDENT , 1,000,000 OFFICERIM MBER EXCLUDED? �) NIA 1,000,000 IMandatnry m NH) E.L DISEAS U-LA PMPLOYr, Ifye,s,doacmbeunder , 1,000,000 DESCRIPTION OF OPERATIONSoelow, E.L. DISEASE,-POLICY LIMIT i DESCRIPTION OF OPERATIONS f LOCATIONS f VEHICLES (ACORD 101,Additional FemarRs.Schedule,may be attached if more space Is required) Project:Arlie Avenue Stonnwater I in p roverne nts(17-00068-EN) The City of Clearwater is an additional insured with regard to the general liability where required by written contract. 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. 100 S Myrtle Ave#220 Clearwater,FL 133756 ""'" AUTHORIZED REPRESENTATIVE �J r f // ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD