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F LORSAF-01 VARAN 1
<br /> ACORO" DATE(MM/DD/YYYY)
<br /> CERTIFICATE OF LIABILITY INSURANCE 01/29/2018
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
<br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
<br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT Angela Vargas
<br /> Construction Casualty Insurance,LLC
<br /> PHONE FAX
<br /> 3637 4th Street North (A/C,No,Ext):(727)222-0680 (A/C,No):(727)502-2191
<br /> Suite 310 Ao RIEss:avargas@constructioncasualty.com
<br /> Saint Petersburg,FL 33704
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> INSURER A:Property and Casualty Insurance Company of Hartford 34690
<br /> INSURED INSURER B:Hartford Fire Insurance Company 19682
<br /> Florida Safety Contractors,Inc INSURERC:Starstone National Insurance Company 25496
<br /> 11825 Jackson Road INSURER D:Brld efield Casualty Insurance Co 10335
<br /> Thonotosassa,FL 33592 INSURER E:Westchester Surplus Lines Insurance Companyl 10172
<br /> INSURER F
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> INSR TYPE OF INSURANCE /ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD MMIDD MM/DD
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE X OCCUR 21UEAHV7026 01/29/2018 01/29/2019 DAMAGE TO RENTED 300,000
<br /> X X PREMISE a occurrence $
<br /> MED EXP(Any oneperson) $ 10,000
<br /> PERSONAL BADVINJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> POLICY a PECOT LOC PRODUCTS-COMP/OP AGG $ 2,000,000
<br /> OTHER: $
<br /> B AUTOMOBILE LIABILITY EO acic tlentSINGLE LIMIT $ 1,000,000
<br /> X ANY AUTO X X 21 UEAHV7574 01/29/2018 01/29/2019 BODILY INJURY Perperson) $
<br /> OWNED SCHEDULED 1,000,000
<br /> AUTOS ONLY AUTOS BODILY INJURY Per accident $
<br /> X AUTOS ONLY X NON-OWNED
<br /> PROPERTY DAMAGE 1,000,000
<br /> Per accdent $
<br /> C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000
<br /> EXCESS LIAB CLAIMS-MADE X X 75121W170ALI 01/29/2018 01/29/2019 AGGREGATE $ 4,000,000
<br /> DED I I RETENTION$ $
<br /> D WORKERS COMPENSATION X
<br /> AND EMPLOYERS'LIABILITY STATUT ERH
<br /> 0196-38935 05/01/2017 05/01/2018 1,000,000
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE ® N/A X E.L.EACH ACCIDENT $
<br /> OFFICER/MEMBER EXCLUDED?
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1 000 000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> E Pollution Liability G46826652001 10/09/2017 10/09/2018 General Aggregate 1,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required)
<br /> When required by written contract the certificate holder is an additional insured with respects to the general and auto liability on a primary and
<br /> non-contributory basis.Waiver of subrogation is granted in favor of the additional insured. Umbrella is follow form.Thirty(30)Days written notice of
<br /> cancellation is required for all policies herein.
<br /> To request changes or endorsements please contact Certs@constructioncasualty.com
<br /> FSC Job#18-005;Bid No.IFB-DL-18-019,Intersection Signalizat)on(Eiland Blvd.and Geiger Road),Pasco County
<br /> i
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Pasco County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> ty ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 8919 Government Drive
<br /> New Port Richey,FL 34654
<br /> AUTHORIZED REPRESENTATIVE
<br /> ACORD 25(2016103) @ 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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