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2018 SEWER POINT REPAIRS AND IMPROVEMENTS PROJECT - 17-0060-UT - CERTIFICATE OF LIABILITY INSURANCE (4) MR P88 2 of 3 Client#: 1916902 69ROWLAINC DATE(MMIDDNYYY) ACORD.. CERTIFICATE OF LIABILITY INSURANCE 1 4/09/2019 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. It 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 any rights to the certificate holder in Ileo-of-such endorsernent(s), PRODUCEA CONTACT Cyndi Ross NAME McGrIfl Insurance Services PHONEFAX 888-632-8459 INC,No,Ell1 727-327-7070 IAJCj No} 12485-28th Street North EMAIL ADDRESS: C,ynthia,Ross,@mcgriffinsurance.core Saint Petersburg, FL 33716 INSURERS)AFFORDING COVERAGE MAIC� 727 327-7070 INSURE RA iirosi Anwocon Assunmou company INSURED INSUREFIB: F.Wa Mopany Ceauafty Cool A 25674 Rowland Inc INSURER C�CoamAmnsu of"niroC nwooTNY 22136 6855 102nd Avenue INS U n E RD SUrplue LInew 10172 Pinellas Park, FL 33782 INSURER E 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 INDICATEDL NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OVA MAY PERTAIN, THL INSURANCE AFFORDED BY THE POLICIES DESCRIBED FIEFIEIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLsU6P' POLICY EFF POLICY EXP LTR TYPE OF INSURANCE fNSRWVp POLICY NU MISER (MWPPNYYY) fleWODNYYY) , LIMITS ' A X COMMERCIAL GENERAL LIAOILITY GLP37632930110/0112018 10/01120191EACHOCCURRENCIE $1,000,000 WAGE TOREN I'ED CLAINIS-AAADE X!OCCUR REMISES IEa occw,,elwell 500,000 MED EXP(A,iy o„e polmon) s10(J00 () Id PER'30NA1 &ADV NJJHY $1,000,000 2 J GEN AGGREGATE I.-IM T APPLIEF,PER GENERAl,AGGREGATE s2,000,000 'Prat- AMICIPAGG PC)[..ICY JPRODUCTS CON ECT X TOD s 2,000,000 OTHER 9 O6'_ IN FC S ,E IM 17 A AUTOMOBILE LIABILITY CAP3763292 10/01/2018 101011201 BODILY INJURY(Pe,person) S X I ANY AUTO OWNED SCHEDULED RODLY NiURY�Pe,ar,,denn S AUTOS ONLY AU x,HIRED x NON-OWNFO PROPERTY DAMAGE Art TOSONLY AUTO$ONLY -1per X UMBRELLA LIAB X Occun ZUP1 GN2512818NF 07/01/2018 1 O/Cri/2019'EACM OCCURAENCE $5,000,000 EXCESS LAB CLAIMS-MADE AGGREGATE ,S5,010101 000 nED X RETE�'TT ION,S1 0000 C WOR I I(Ens COM I PEN I SATION WC376330200 01/2019 10/01/2019XPER 07H AND EMPLOYERS LIABILITY Y I h, I _&TATLrE 'ER ANY PROPRIETORPARTNFIAEXECUTIVE _E1 EACHACCIDENT 0 000,000 OFFIQERLIABMER EXCWDED' Y NPA (Mandatory In NH) DISEASE EAEMPLOYEIE,51,000,000 If yc-,de.�cnbe under E L DISEAGE-POLICY LIMIT $1,000I000 DESCRIPTION OF OPERATIONS below D Pollution 07115,2613001 D7/01/2018 10/0112019, Each Condition: $1 M Liability Aggregate: $21M Deductible. $2,500 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101 Additional Remarks Schircluie,maybe attached If more space is required) "Workers,Comp Information** Proprietors/Partners/Executive Otticers/Meimbers Excluded: Kevin Rowland, President Ken Rowland,Vice President Rick Mansfield, CFO (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Clearwater Engineering THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Department ACCORDANCE WITH THE POLICY PROVISIONS, Attn: Construction Office Specialist PO Box 4748 AUTHORIZED REPRESENTATIVE Clearwater, FL 33758-4748 0 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016t03) 1 of 2 The ACORD name and logo are registered marks of ACORD #5233153217tM23314357 DP page 3 of 3 DESCRIPTIONS (Continued,from Page 1 Pollution$1,000,000 Each Pollution Condition; $2,000,000 General Aggregate subject to$2,500 Deductible Project: 2018 Sewer Point Repair&Improvements Project 17-0060-UT City of Clearwater is an Additional Insured on a Primary and Non-Contributory basis with a waiver of subrogation on the General Liability when required by written contract subject to the terms and conditions of the policy, I i c SAGITTA 25,3 i2o16/03i 2 of 2 S23315320IM23314357 668 page 2 of M, Clientf#: 1916902 69ROW LAINC GATE IMMrO[r�tY ACORD,, ERTIFICAT" 'LIABILITY INSURANCE YYI3/28121319 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 any rights to the certificate holder in lieu of such endoreement(s). PRODUCER NA61E. C11ndi Ross McGrlff Insurance Services PhONra Ext):72-7 27 327®7070 tarc,Np) 8886328451 12485-28tH Street North ADDRESS cynithia.ross Imcgrifflnsura'nce.co _ Saint Petersburg, FL 33718 _._, .. _ _ - iw6URER(5)AFFgRRiNG COVE RACENAIL tl 727 327-7070 263 1 44 INStiRERA Gvsaa Aa�trv,iuearrca G�mpariv INSURE INSURER a NavOINS Provanv casuafty Cc of Atmsr — Rowland Inc11 INSURE C.fat Arrsran hsSaraamxa Ca oa NY 221 11 36 6855102nd Avenue - 1011 172 INSURER O;1Vecaur aual i I..I irauranre Pinellas Park, FL 33782 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY RFQUIREMENT TERM OR CONDITION OF ANY CONTRACTOR 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 POLiOES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS" dwSR .. .. .. .. ADD BRP ducY E0F LIC POY EXE LTR TYPE OF INSURANCE .... mINSR,YWyp, .. ....POLICY NYNIBER ..... #IMtt70a'YYWgI,IMXtfOC?lYYYY i LIMITS A X COMMERCIAL GENERAL LIABILITY GLP3 6329301 11101/2018 10/01/2019 EACHOCICURRENCE $1",000,000 . CAMAGE TO RENTED CLAIMS MADE X OCCUR ,REMISES�Ea sreartencgl X500,000 ME[)EXP IA,y yr e ,jo,II $10,000 ...._ �{ IPERSONAL&ADV INJURY $1,000,000 GEN1 AGGREGATE LIMIT APS',.IES PER ,'.. t,, 11" .' GENERAL AGGREGATE s2,OW,000 � - I j'RCk ,' LGr PRODUCTS-CC:x'v PrOP A O 12,000,000' POLICY s" OTHE a - A AUTOMOBILE LIABILITY CAP3763292 0/01/2018 1 01/2019 LEaMal3lnae1 sh,ca !IMI Icy 6INEDM $1,000,000 ANY AUT{} ........ 1 BODILY INJURY IPw tatrsanl OWNED SCHEDULED AUTOS ONLY AIJTOrS BODILYIP�dJUFi't(Pee ace�rdenla i'3 HIED NON-OWNED PROPERTY DAMAGE AUTOS ON LY AOTOS ONLY {F"•er ame lerett,,. __.... R 4;UMeREtaa Lroe )COC..R UPIGN2512818NF 7/01/2018 10/01/2019 EA_11CH OCCURRENCE T,5,0 ,ow r EXCESS LIAR OLAIMS-MADE ! 1 AGGREGATE I 55,1700r1100 DED 1 7( RETENITON 510000 $ C �ANDEePL EMPLOYERS' TION WC37 3 0200 /01/2019 110/01/2019 X TL,rE PER ri AND EN3PLOYER 'LIABILITY ANY P'ROPRIE'TC;3'RPARTNER/EXECUlIVE YIN w L!. EACH ACCIDENT Si 000 -- .OFFICERIMEM'SE'HEXC UDE.LS7 Y N/A --. __.._ a... , a ..-_. (Mandatory In NIH) E L D' EASE EA EMPLOYEE 51,000,000 'if Yes,dmcnbe under . DESC:F1l PTION OF COPERATIONS Mow L.L DISEASE:.POLICY LIMIT $1,000,000 'Pollution 671152613001 7/01/2018 07/01/2019' Each Condition: 1 Liability Aggregate. $2M, Deductible: $2,500 CIESCAIFTION OF OPERATIONS!LOCATIONS/VEHICLES(ACORD 1 Q1,Addlilenal Remarks Schedule,maybe attached 11 mare apace lag required) Workers Comp Information roprietor Partner 'Executive Officers/Members Excluded: Kevin Rowland, President Kerr Rowland,Vice President Rick Mansfield, CFO (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION City of Clearwater Engineering SHOULD ANY OF THE.A13OVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Department, ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Construction Office Specialist P.O. Box 4748 AUTHORIZED REPRESENTATIVE Clearwater, FL 33758-4748 � 1988-2015 ACORD CORPORATION All rights reserved. ACORD 25(2015103) 1 of 2 The ACORD name and logo are registered marks of ACORD 41,42 S23224978/M23203385 DVP page 3 of 6 Pollution$1,000,0W Each Pollution Condition; $2,000,000 General Aggregate subject to$2,500 Deductible Engineering Department Attn. Construction Office Specialist SAGITTA 25.3(2016103) 2 of 2 #S23,224978/M23203385 4143