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CERTIFICATE OF LIABILITY INSURANCE (990) 0000380 Sp 0646 -661-Pv6360.1 Clearwater Gas System 00 N Myrtle Ave; Clearwater, FL 33755 " DATE(UMMMYYY) ,�icvl CERTIFICATE OF LIABILITY INSURANCE 1112212019 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(les)gust 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 ri hts to the certificate holder in lieu of such endorsements)., PRODUCER CONTACT Marsh USA Inc. NAME: PHONE. FAX 1560Sawgrass Corporate Pkwy,Suite 300 AIG No): SotMe,F 33323 E-MAIL _ INSURER(S AFFORDING COVERAGE NAIL# CNI0505&Fx%AlrGAWUP-19-20INSURER A:Greenwich Insurance Company 22322 INSUREDw 24554 2101 Waste Pro USA,Inc. INSURER B:XL Insurance America Inc- 2101 W.SR 434,Suite 11305 INSURER C:National Fire&Wrine Insurance Co 20079 Longwood,FL 3277937885 INSURER r 7(L_ S a�`I Insurance Con INSURER E:. INSURER F: COVERAGES CERTIFICATE NUMBER: ATL4675451-18 REVISION NUMBER: I THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOO 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. 4i INADL SUBR PC1LlCY ELIMITS FF POLICY EXP mm— TYPEOFSURANCE POLICYNUMBER MWDDIYYYY MMIODIYYYY A X COMMERCIAL GENERALLIABIUTY GEC300138202 11/2212019 1112212020 EACH OCCURRENCE $ I'M0,000 CLAIMS-MADE Ln' J OCCUR PREMISES`Ea occury e'i $ , 000 MED EXP(Any one person) 5,006 _ PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,006 X POLICY1-1 PRO- F-1LOCPRODUCTS-COMPIOP AGG $ 2,006,0170 JECT OTHER: S _ A AUTOMOBILE LIABILITY RAE943788402 11122019 11122126620 (21B,' OMBI{�ED SINGLE LIMIT $ 2,006,000 EII acaidoni X ANY AUTO SIR 11,000,0111} BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per maidenly X AIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per X UMBRELLALIAB X OCCUR 42UM030953401 11/2212019 1112212020 EACHOCCURRENGE $ 5'W0.000 EXCESS LIAB CLAIMS-MA.DE. AGGREGATE $ S,iXX1.0o1 DED RETENTI(3N $ B WORKERS COMPENSATION RWD300138002(AO ) 11122120ig 11 �( AND EMPLOYERS'LIABILITY STATUTE EERH ANYPROPRIETOR+PARTNERIEXECUTIVE YF A 7 E L.EACH ACCIDENT $ 1, • 000 OFF ICERIMEMBER EXCLUDED? rN J N to (Mandatory in NH) E L.DISEASE.EA EMPLOYEE $ 1,000,1700 Ir yas,gibe under 1 DESCRIPTION OF OPERATIONS Rrekyw E.L.DISEASE-POLICY LIMIT $ D Workers Compensation RWE943549702(FL&GA) 1112212019 1112212020 EmplikM Liability: 1,0M,000 SIR: 500,600 DESCRIPTION OF OPERATIONS I LOGATIONS I VEHICLES(ACORD 10 1,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION Clearwater Gas System SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 400 N Myrtle Ave THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Clearwater,FL 33755 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ,JA S Ms i I.-" of Marsh USA Inc. Manashi Mukherjee urea► * ale41A-te*1AA-t.1­ 0 1 988-201 6 ACCORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD AGENCYCUSTOMER ID. CN105058554 LOC#: Lauderdale etc R ADDITIONAL REMARKS SCHEDULE Page. 2 of z AGENCY NAMEDINSURED Marsh USA Inc.. Waste Pro USA,Ing, 21 W.SR 434;Suite#305 FOUCY HUMBER Longwood,FL 32779 CARRIER NAIC CODE EFFECTIVE LATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25. FORM TITLE.. Certificate Of.Liability Insurance Confractors Pollution Legal Liability-Job Site: PaWfidn CandiUorl.resulling'from Conlracting Services tlagned as: Trash compactor instalfabonand maintenance Cartier Indari Harbor lnsurance Company Policy Number;PECO4900302 Dales::0110112019=01!0312020 Limit:52,000, DO each Pollution C46006;12,000,00Annual Aggragale.. Self-insured Retention,$25;000 ACORD-101(2008101) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo ore.registered marks of ACORD