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2018 SEWER POINT REPAIRS AND IMPROVEMENTS PROJECT - 17-0060-UT - CERTIFICATE OF LIABILITY INSURANCE (7) DATE(MM/DD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 7/31/2020 7/31/2019 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 Lockton Companies CONTACT NAME 3280 Peachtree Road NE,Suite#250 PHONE FAX Atlanta GA 30305 (A/C, o xt: A/c No (404)460-3600 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Zurich American Insurance Company 16535 INSURED Envlrowaste Services Group,Inc. INSURER B:American Guarantee and Llab.Ins. Co. 26247 1422101 Envirowaste Holding Corp. INSURER C:Ironshore Specialty Insurance Co 25445 18001 Old Cutler Road,Suite 554 INSURER D:Travelers Property Casualty Co of America 25674 Palmetto Bay EL 33157 INSURER E:Great American Insurance Company 16691 INSURER F: COVERAGES CERTIFICATE NUMBER: 15848595 REVISION NUMBER: XXXXXXX 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/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY Y Y GL05571339-07 7/31/2019 7/31/2020 EACH OCCURRENCE $ 1,000,000 DAMAGE TO CLAIMS-MADE 1XI OCCUR PREMISES (E.occurrDence $ 300,000 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 I X I ECT I yv I LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY Y y BAP5571338-07 7/31/2019 7/31/2020 COMBINED SINGLE LIMIT $ Ea accident 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ XXX�GGG� OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS XXX�000� X HIREDX NON-OWNED PROPERTY DAMAGE $ XXXYGGG� AUTOS ONLY AUTOS ONLY Per accident $ XXXY-XXX E X UMBRELLA LIAB X OCCUR Y Y TUU 264433601 7/31/2019 7/31/2020 EACH OCCURRENCE $ 20,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 20,000,000 DED RETENTION$ $ XXXXXXX WORKERS COMPENSATIONPER OTH- B AND EMPLOYERS'LIABILITY Y/N Y WC0176362-05 7/31/2019 7/31/2020 X STATUTE ER ANY PROPRIETOR/PARTNER/EX-11— N/A E.L.EACH ACCIDENT $ 1,000,000 /M OFFICEREMBER EXCLUDED? (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 C POLLUTION LIABILITY N N 004156800 7/31/2019 7/31/2020 $1,000,000 LIMIT CONTRACTORS **See Attached** D EQUIPMENT OT-630-8N704915-TIL-19 7/31/2019 7/31/2020 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:Project Name:2018 SEWER POINT REPAIRAND IMPROVEMENTS;Project No:#17-0060-UT.City of Clearwater,the Owner,Contractor,Subcontractors,Engineer, Engineers Consultants and all other persons or entities identified in the Supplementary Conditions are named as Additional Insured with respects to General Liability,Auto Liability,and Umbrella Liability on a Primary and Non-Contributory Basis.Waiver of Subrogation is granted in favor of the additional insured with respects to General Liability, Auto Liability,Umbrella Liability,and Workers Compensation. CERTIFICATE HOLDER CANCELLATION See Attachment 15848595 City of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Engineering Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g g p ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Construction Office Specialist P.O.Box 4748 33758-4748 Clearwater,FL, AUTHORIZED REPRESENTATIVE 1"- ©1988-201 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD CONTINUATION DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS(Use only if more space is required) 30 Days'Notice of Cancellation applies, except 10 Day's for non-payment. ACORD 25(2016/03) Certificate Holder ID: 15848595 Attachment Code:D548512 Master ID: 1422101,Certificate ID: 15848595 INLAND MARINE LIMITS Listed Items : $905,911 Unlisted Items : $200,000 Not to Exceed $5,000 Per Item Leased or Rented Items : $250,000 Per Item Deductible : $ 1,000; Windstorm 1% subject to $ 1,000 Minimum, $ 10,000 Maximum