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2017 SIDEWALK CONSTRUCTION PROJECT - 16-0016-EN - CERTIFICATE OF LIABILITY INSURANCE (5) DATE(MM/DD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 05/31/2019 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 CONTNAME, Sharon Murphy Masi Insurance Inc 8211 113th St N A/CONNo, Ext: 7273991900 FAX No: 7273982500 Seminole, FL 33772 E-MAIL ADDRESS: Sharon@masiinSUrance.COm License#: d084372 INSURER(S)AFFORDING COVERAGE NAIL# INSURER A: Indian Harbor Insurance Company INSURED Central Florida Contractors Inc INSURER B: MERCURY INDEMNITY COMPANY OF AMERICA 11201 George Gomes INSURER C: Insurance Company of the West PO Box 3987 INSURER D: Great American Seminole, FL 33775-3987 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 00000000-730143 REVISION NUMBER: 41 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 MMIDD MM/DDIYYYY A X COMMERCIAL GENERAL LIABILITY Y 3200101821-1 05/31/2019 05/31/2020 EACH OCCURRENCE $ 1,000,000 DAMAGE TCLAIMS-MADE [XIOCCURPREM SESOEa ocicunerce $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY[X]PE'' 1:1 LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY BA090000008719 05/31/2019 05/31/2020 EOa aBcideDtSINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY X AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ `+ WORKERS COMPENSATION 946305-03 08/24/2018 08/24/2019 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE YIN N E.L.EACH ACCIDENT $ 500,000 OFFICERWEMBER EXCLUDED? F N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 D Inland Marine IMP429459600 05/31/2019 05/31/2020 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 2017 Sidewalk Construction Project#16-0016-EN.City of Cleawater as Additional Insured 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 33756 AUTHORIZED REPRESENTATIVE I (�L_ SHM © 8-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Printed by SHM on May 31,2019 at 01:21 PM