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ACORDT" CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDIYYYY) 11/12/2010 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 I:-e endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may r(quire an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER I ~2~~~C Paul H. DeSilva .r~gN,;o Extl: 954941-0900 I i..c2, No): 954 786-5342 Bateman, Gordon & Sands, Inc. I Po'b'}lfss: P.O. Box 1270 Pompano Beach, FL 33061 ~_MER 10 #: INSURER(S) AFFORDING COVERAGE NAIC# INSURED INSURER A: American Safety Ind/Eidyia Ins. The BG Group, LLC INSURER B : Amerisure Insurance Co. 19488 1140 Holland Drive; Suite #19 INSURER C : Boca Raton, FL 33487 ". INSURER 0 : INSURER E : INSURER F : 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 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. INSR DDLSUBR IP~r.'1Jg6~1 P~r.'1Jg6R~1 LTR TYPE OF INSURANCE NSR WvD POLICY NUMBER LIMITS A GENERAL LIABiLiTY ENV0273151001 11/10/2010 11/10/2011 EACH OCCURRENCE 51,000 000 - ~ COMMERCIAL GENERAL LIABILITY ~~~~~~J?E~~~ence\ 550,000 - =:J CLAIMS-MADE ~ OCCUR' MED'EXP (Anyone person) 55,000 X BI/PD Ded:5,000 PERSONAL & ADV INJURY 51,000,000 f---- GENERAL AGGREGATE 52,000,000 n'L AGGRE~E LIMIT APPLIES PER: PRODUCTS - COM PlOP AGG 52,000,000 POLICY X ~bW;: n LOC ,1 /\ 5 AUTOMOBILE LIABILITY ~~ COMBINED SINGLE LIMIT 5 f---- (Ea accident) f---- ANY AUTO ! /, BODILY INJURY (Per person) 5 - ALL OWNED AUTOS ,L BODILY INJURY (Per accident) $ - SCHEDULED AUTOS PROPERTY DAMAGE I _ $ - HIRED AUTOS r (Per acadent) NON-OWNED AUTOS -../ $ - $ A UMBRELLA LlAB M OCCUR ENU0273461 001 11/10/2010 11/10/2011 EACH OCCURRENCE $5,000 000 f---- EXCESS LlAB X CLAIMS-MADE AGGREGATE $5,000,000 f---- DEDUCTIBLE $ X RETENTION $ 10000 $ B WORKERS COMPENSATION WC206561801 11/10/2010 11/10/2011 X 1~~D~\~r,Y;c I I~JH- 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 s1,000,000 If yes, describe under $1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE. POLICY LIMIT I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) BID# CP-0019-11 Demolition & Site Clearance of 6 Apartment Buildings (See Attached Descriptions) City of Jacksonville, Procurement Division 214 N. Hogan Street Suite 110 I J cksonville FL 32202 COVERAGES CERTIFICATE HOLDER .. Client#. 57209 BGGRO CERTIFICATE NUMBER: REVISION NUMBER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE @1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD 25 (2009/09) 1 of 2 #S332273/M332017 JMR