CERTIFICATE OF LIABILITY INSURANCE (8) AC
IFI _I I L I I DATE tMMDDDrYYYr}
1211912018
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($), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les) must have ADDITIONAL.INSURED provisions or be endorsed,
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement, A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CON . T ,
Wallace Welch VMII1ngham, InC. NAMES Certificates
PHONE
300
1st Ave. So„ 5th Floor 727-52 7777 ra NSD 727 521-2542
Saint Petersburg FL 33701 E-MAIL —
Aon,,_.eSS:•_Certificates w3ins.ccm
INSURERS AFFORDING COVERAGE MAIC#D
INSURER A,Zurich American Ins,Co. 1 X535
INSURED BILTCON-f11 -" -
Biltmore Construction Co., Inc. INSURER B�American Guarantee Liability Ins.Co. 26247
1055 Ponce de Leon Blvd. INSURER C:Indian Harbor Insurance Co, 36940Belleair FL 33755 INSURER D
INSURER E
INSURER F
COVERAGES CERTIFICATE NUMBER:440170609 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN Is SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND coiNDi rlONs OF SUCH POLICIES.LIMITS SHOWN MAY I AV B EN REDUCED B`Y PAID CLAIMS•
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' URANCE ADD SLIER 1212 POLICY NUMBER POL9CY EFF POLICY ExP
ERALLIARILITY fu DDlYYYY MMtDDrY1°Y1P LIMITS
OLC20fl"'I 1P112019 1/112020 EACHOCCURRENCt S1,D010,000
�OCCUR A E EN.REMISE$ Ea occurrence $1,000,000
MEO EXP(An one person) S 15 000
�t.XCU r .t's, -
OEN L AGfiyREOATE L TAPP
_ I i13 1 PERSONAS..&ADV INJURY _$1,000,000
�r,X,j � LAI APPL:ESPER •-
POLICY L�.e_J)ECT L l LOC GENERAL AGGREGATE S ,G(3{�000
OTHER,
PRODUCTS-COMP/CP AGG $2,000,ODD
! - - -
S
A AUTOMOBiLELIABILITY - E1'Al1,e„i54"a12D4 OBINEt3GLELIMIT
111V2019 CMINrr)5IN1/1/2020 O $1,400,000
X ANY AUTO l ,
OWNED i�SCHEDULED ! -..BODILY INJURY(Per person) S
AUTOS ONLY I� AUTO$
HIRED NON-OWNED - BODILY INJURY(Per acciden t,•$
AUTOS ONLY 11 A.;,fTOs ONLY PROPERTY DAMAGE -
Per accident $
B X UMBRELLALIABX ,C,�,L.;yI AUC5781fi5505 111/2019 1/112020 S
EACH OCCURRENCE
-
EXCESS UAB _ $24,oD0,000
CLA`.hlS-'MADE,
DED X RETENTIONS AGGREGATE $20,000,000
11 -WORKERSCOMPENSATION _ $ -
AND EMPLOYERS`LIABIWTY WC008451404 1!112019 11112020 X PER OTH
ANYPROPREETOWPARTNER,EXECUTIVE YIN STRTUTE EtR,•�
OFFICERWE-MBEREXCLJOED4 �_NIAE.L EACH ACCIDENT
(Mandatory In NH)
� J
If yes,describe under E.L DISEASE-EIA Eh4PU0Y S '••
DESCRIPTION OF OPERATIONS be.''ovu 1,0DO..000,RDDM,..,._.
C Profsss'OnallPot.Iu.ion Liability E,L.615EASE POLICY LIMIT s;1,000 000
PEC004885102 11112019 11112020 Per Claim 2,000,000
Age ate 2,000,000
Deductible 50,000
DESCRIPTION OF OPERATIONS)LOCATIONS;VEHICLES(ACORD 191,Additional Remarks Schedule,may be attached if more space is required)
Construction Management at Risk Services for Continuing Contracts
Additional Insured only subject to terms,conditions and exclusions of the policy form y,#ith respect to General Liability applies on a primary basis and the
Insurance of the Additional Insured shall be Non-Contributory:Certificate Holder, Project Owner and Others as required by written contract.
The following supersedes the cancellation wording.Should any of the above described policies be cancelled before the expiration date,ata Days written notice
(10 Days for Non-Payment)w€II be delivered to the certificate holder,
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.
PO Box 4748
Clearwater FL 33758-4748 AUTHORLZEDREP RES ENTATIVE
0'1988-2015 ACCORD CORPORATION, All rights reserved.
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