CERTIFICATE OF LIABILITY INSURANCE (50)
PRODUCER LOCKTON COMPANIES. LLC-1 KANSAS CITY
444 W. 47th Street, Suite 900
Kansas City Mo 64112-1906
(816) 960-9000
DATE (MWDDIYY)
12/3 J /2008 12/ J 9/2007
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
A TE T COVERAGE AF OR BY THE P L CIES LOW.
ACORDTM CERTIFICATE OF LIABILITY INSURANCE
INSURERS AFFORDING COVERAGE
INSURED
1059807
MASTEC NORTH AMERICA. INC.
ATTN: MAUREEN POPOVICH
7221 DR, MARTIN LUTHER KING JR BLVD E
TAMPA FL 33619
INSURER A ACE AMERICAN INSURANCE COMPANY
INSURER B INDEMNITY INS. CO. OF N. AMERICA
COVERAGES
MASTECO J SE
POLICY NUMBER
LIMITS
A X COMMERCIAL GENERAL LIABILITY HDOG2] 722443
CLAIMS MADE W OCCUR
12/3] /2007
] 2/3 J /2008
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS. COMP/OP AGG i $
LOC
ISAH0823739fl
COMBINED SINGLE LIMIT
12/3112007 I 2/3 I 120m; lEa accident)
; ~--_._--_.._-_._._-
R: J:CEI' I~.D' I BODILY INJURY
~ V I: ! (Per person}
, ,
A X ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
ix HIRED AUTOS
I
IX NON.OWNED AUTOS
;' ~~~ C'1
--V (~.J 2007
BODILY INJURY
(Per accident)
c..
PROPERTY DAMAGE i
. , ; I)E- ~ : (Per accident) I :;.
,I, c:
I'"
\, ,!. ,. ,AN(,,) DEPj._J\~.!..O.O~hY.:..~.!\_ceCIDE~T i $
EA ACC i $
AGG !
, GARAGE LIABILITY
o ANY AUTO NOT APPLICABLE
, f
..
~~. '....
OTHER THAN
AUTO CNL Y
i EXCESS LIABILITY
P OCCUR 0 CLAIMS MADE NOT APPLICABLE
D UMBREllA
DEDUCTIBLE FORM
RETENTION
EACH OCCURRENCE
~J\QGREGATE ..____
2.000.000
500.000
25.000
2.000.000
10.000.000
4.000.000
3.000.000
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iXITORYlIMlTst IER I
E L EA~r- A~~:L'ENT_ u ___~~_J.:.{)()()}2()Q___
~L DISEASE - EA EMPLOYEE; $ 1.000.000
iEL DISEASE - POLICY LIMIT i $ 1.000.000
J 2/31/2007 '. c' TllJT7TOUS-
I 2n I COO";"
I 2n 1/2007
I 2n 1/21l1l8
J 2/.' 1121108
! OTHER
I
DESCRIPTION OF OPERATIONSlLOCATIONSlVEHICLESlEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
THE CITY OF CLEARW A TER IS SPECIFICALLY INCLUDED AS AN ADDITIONAL INSl'RED ON LIABILITY INSl'RANCE COVERAGE DESCR IBED
ABOVE. BID NO. 29-06
CERTIFIC TE HOLDER ADDITIONAL INSURED' INSURER LETTER:
2633021
CITY OF CLEARWATER
ATTN: CITY CLERK
PO BOX 4748
CLEARWATER FL 33758
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25-S (7/97)
For questions regarding thIS certificate. contact the number lisled in the 'Producer' sectton above and specify the client code 'MASTEC01'.