CERTIFICATE OF LIABILITY INSURANCE - RFQ 26-19 (24) IG T -01 WO O
QCf /RO' DATE(MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 2/2/2021
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 CONTACT
NAME:
Ames&Gough PHONE
859 Willard Street (A/C,No,Ext): (617)328-6555 SAA//c,No):(617)328-6888
Suite 320
E-MAIL boston@amesgough.com
Quincy,MA 02169
INSURER(S)AFFORDING COVERAGE NAIL#
INSURERA:Berkshire Hathaway Specialty Insurance Company 22276
INSURED INSURER B:
Wright-Pierce
11 Bowdoin Mill Island INsuRERc:
Suite 140 INSURER D:
Topsham, ME 04086 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.
INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
LTR INSR WVD MM/DD/YYYY MM/DD/YYYY
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $
CLAIMS-MADE ❑ OCCUR DAMAGE TO RENTED
PREMISES Ea occurrence $
MED EXP(Any oneperson) $
PERSONAL&ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
POLICY PRO-
JECT [::] LOC PRODUCTS-COMP/OPAGG $
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
Ea accident $
ANY AUTO BODILY INJURY Perperson) $
OWNED SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY Per accident $
HIRED NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY Per accident $
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION$ $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS'LIABILITY Y/N STATUTE ER
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
A Prof.Liability X 47-EPP-313603-01 1/1/2021 1/1/2022 [Per Claim Limit 5,000,000
A 47-EPP-313603-01 1/1/2021 1/1/2022 ggregate Limit 5,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
All Coverages are in accordance with the policy terms and conditions.
RE:RFQ#26-19
A waiver of subrogation will be issued in accordance with policy terms and condtions.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Cit of Clearwater THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Y ACCORDANCE WITH THE POLICY PROVISIONS.
Engineering Contrcts Speacilist-RFQ#26-19
P.O.Box 4748
Clearwater, FL 33758-4748 AUTHORIZED REPRESENTATIVE
ACORD 25(2016/03) O 1988-2015 ACORD CORPORATION. All rights reserved.
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