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2018 SEWER POINT REPAIRS AND IMPROVEMENTS PROJECT - 17-0060-UT - CERTIFICATE OF LIABILITY INSURANCE (10) Client#: 1916902 69ROWLAINC DATE(MM/DD/YYYY) ACORDT. CERTIFICATE OF LIABILITY INSURANCE 9/27/2019 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Cyndi Ross McGriff Insurance ServicesPHONE 727 327-7070 FAX 8886328451 (A N12485-28th Street North E-MAILo,Ext): (A/c,No): ADDRESS: cynthia.ross@mcgriffinsurance.com Saint Petersburg, FL 33716 INSURER(S)AFFORDING COVERAGE NAIC# 727 327-7070 Great American Assurance Company 26344 INSURER A: P Y INSURED INSURER B: Travelers Property Casualty Co of Amer 25674 Rowland Inc INSURER C:Great American Insurance Co of NY 22136 6855 102nd Avenue N Westchester Surplus Lines Insurance 10172 INSURER D: P 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 INDICATED. NOTWITHSTANDING ANY REQUIREMENT, 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 POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADDLSUBR LTR TYPE OF INSURANCE NSR WVD POLICY NUMBER POLICY EFF POLICY EXP/YLIMITS (MM/DDYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY BINDERGLP376329301 10/01/2019 10/01/2020 EACHOCCURRENCE $1,000,000 CLAIMS-MADE [*OCCUR PREMISESOEaoccurDrence $500,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PPOLICY PRO- X LOC PRO- JECT PRODUCTS-COMP/OPAGG $2,000,000 OTHER: $ INED A AUTOMOBILE LIABILITY BINDERCAP376329202 10/01/2019 10/01/202 (CEO aBcdS entINGLELIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY Per accident $ B X UMBRELLA LAB X OCCUR BINDERZUP16N251281 10/01/2019 10/01/2020 EACH OCCURRENCE $5 OOO 000 EXCESS LAB CLAIMS-MADE AGGREGATE s5,000,000 DED I X RETENTION$10000 $ C WORKERS COMPENSATION BINDERWC376330200 10/01/2019 10/01/202 XTATUTE SOERH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N/A (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$1,000,000 D Pollution BINDERG71152613001 10/01/2019 10/01/2020 Each Condition: $2M Liability Aggregate: $4M Deductible: $2,500 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) **Workers Comp Information** Proprietors/Partners/Executive Officers/Members Excluded: Kevin Rowland, President Ken Rowland,Vice President Rick Mansfield,CFO (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION Cit f Clearwater Engineering SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City oearwaer g g 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 ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S24410638/M24410611 CROS DESCRIPTIONS (Continued from Page 1) 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. SAGITTA 25.3(2016/03) 2 of 2 #S24410638/M24410611