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HomeMy Public PortalAboutSupporting DocumentsCOMMISSIONERS WILLIAM F. KOCH, JR. Mayor JOAN K. ORTHWEIN. Vice Mayor FRED S. DEVITT III CHRIS D. WHEELER MURIEL J. ANDERSON June 25, 2009 Tag Grinding Attn: Jerry P. 0. Box 25 Daviston, AL Gentlemen: TOWN OF GULF STREAM PALM BEACH COUNTY, FLORIDA Services, Inc. Brooks & Sonny Armond 36256 Telephone (561) 276-5116 FU (561) 737-0188 Town Manager WILLIAM H. THRASHER Town Clerk RITA LTAYLOR Please find enclosed a letter I have prepared for your personnel to present to anyone delaying them when enroute to Gulf Stream. I hope the content is adequate. If not, just let me know and I will revise it to fit your needs. There is one other matter that needs our attention. The current contract document on file expired in May 2009. I am enclosing a copy of Section 4. of the document for your review. Are you preparing something to reinstate this for another 2 years? Please advise. Very truly yours, Rita L. Taylor Town Clerk Encl. 100 SETA ROAD, GULF STREAM, FLORIDA 33483 TOWN OF GULF STREAM PALM BEACH COUNTY, FLORIDA COMMISSIONERS WILLIAM F. KOCH, JR. Mayor JOAN K. ORTHWEIN, Vice Mayor FRED 0. OEVITT III CHRIS 0. WHEELER MURIEL J. ANDERSON June 25, 2009 TO WHOM IT MAY CONCERN: Q F Telephone is T'n (561) 276.5116 F Fax (561) 737.0188 Town Manager WILLIAM H.THRASHER Town Clerk RITA L TAYLOR This is to confirm that the bearer of this letter, TAG GRINDING SERVICES, INC, is under contract for the entire year 2009 with the Town of Gulf Stream, Florida to remove storm debris. We are respectfully asking your cooperation by allowing all equipment and personnel, employed by or leased to, TAG GRINDING SERVICES, INC., to immediately pass through in order that they be able to open the streets in the Town of Gulf Stream, Palm Beach County, Florida without delay. Anything you can do to expedite their arrival will be greatly appreciated. Thank you for your cooperation and assistance in this time of disaster. Very truly William F. Koch, Jr. Mayor 100 SEA ROAD, GULF STREAM, FLORIDA 33483 TAG Grindir Services Inc. TAG Grinding Serui��l 1113 Horseshoe Bend Road Dadeville, Alabama 36853 Phone: 256-825-4400 Fax: 256-825-4100 8395 Williams Road Palmetto, Georgia 3oz68 Visit us at w .taggrindingxom EMERGENCY CONTACT INFORMATION Jerry Brooks — CFO Cell: (256) 786-9673 Home: (256) 329- 3519 Office: (256) 825-4400 Email: ierry(abtaggrinding.com Charlene Daniel — VP/Operations Cell: (256) 749-2997 Home: (256) 896-4563 Office: (256) 825-4400 Email: charlene(a)tagorinding.com Sonny Armond — Director of Field Operations Cell: (504) 722-4975 Home: (985)201-0810 Office: (256) 825-4400 Email: sonny(a)taggrinding.com Jay Brooks — VP/Debris Removal Cell: (256) 675-7055 Home: (256) 329-3519 Office: (256) 825-4400 Email: iay(dltaggrinding.com 543 Olivier Street New Orleans, LA 70114 Phone: 504-722-4975 Page 1 of 1 Rita Taylor From: Bill Thrasher Sent: Thursday, August 04, 2011 1:58 PM To: ramondiiCPaol.com Cc: Rita Taylor; Garrett Ward; Linda Harvel; Gail C. Abbale Subject: Stand-by H Emily Ramon, Thank you for contacting us and letting us know you are on "stand-by" Please confirm your direct t-# 504-722-4975 8/4/2011 Rita,Taylor From: donna@taggrinding.com Sent: Thursday, May 30, 2013 4:38 PM To: Bill Thrasher Subject: Intent to renew TAG Grinding Attachments: img-530153342.pdf UJ img-530153342.p df (338 KB) Mr. Thrasher, Please see attached letter of intent to renew from TAG Grinding. Thanks Donna Hawkins TAG Grinding Services, Inc (256)825-4400 donna@taggrinding.com TAGGR-1 OP ID: TT A� CERTIFICATE OF LIABILITY INSURANCE DAM 241201YV) o7/2a/2o1a 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 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 Hawkins 8 Rawlinson,lnc. P.O. Box 3493 CONTACT NAME Chuck Hawkins e PHONE .EdI,888-822-1173 IFAx Not: 334-821-5801 2515 East Glenn Ave, Ste 101 Auburn, AL 36831-3493 A�ESS: chawkins@hrinsurance.com 100 Sea Road Chuck Hawkins INSURER(S) AFFORDING COVERAGE NAIL$ INSURERA:Companion Property& Casualty 12157 MED EXP one pearl $ _ INSURED TAG Grinding Services, Inc. JWB Leasing Co,. Inc 1113 Horseshoe Bend Rd INSURER B: INSURER C: GENERAL AGGREGATE $ Dadeville, AL 36853 INSURER O: INSURER E: AUTOMOBILE NSURER 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 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. ILSR TYPE OF INSURANCE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE POLICY NUMBER POLICY MMDDrDIYYYY LIMA COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FlOCCUR AUTHORIZED REPRESENTATIVE Rita Taylor 100 Sea Road EACH OCCURRENCE $ PREMISES Ea occurrence $ MED EXP one pearl $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT F-1 LOC OTHER GENERAL AGGREGATE $ PRODUCTS-COMP/OP AGG $ It AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOSNON-OWNED AUTOS P 1 COMBINED SINGLE LIMIT $ e accident BODILY INJURY (Par Person) $ BODILY INJURY (Per accident) $ PROPEIQDAMAGE $ paraccidenl $ UMBRELLA UAB EXCESS LUIS OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATIONPER AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YaN/A OFFICERIMEMBER EX (Mandatory In NH) CLUDED7 N yes, describe urcer DESCRIPTION OF OPERATIONS below CWC 3070514 12 03 07/27/2014 07/27/2015 OTH• X STA ITEEIR E.L. EACH ACCIDENT $ 1,000,00 E.L DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE -POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more spans Is required) Grinding / Covered states are Georgia, Alabama, Texas and Florida CERTIFICATE HOLDER CANCELLATION TOWGU01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Gulf Stream fax 561-737-0188 AUTHORIZED REPRESENTATIVE Rita Taylor 100 Sea Road iGulf Stream FL 33483 ACORD 25 (2014101) ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Jun 03 2011 14:29:07 -> 561-737-0100 J Smith Lanier Client#! 67166 9ATA(%r%RIMnIN Page 003 ACORD. CERTIFICATE OF LIABILITY INSURANCE -06 Y) CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. /0312011 THIS CERTIFICATE IS ISSUED ASA 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: It the certificate holder Is an ADDITIONAL N ED, the po lcy(les) must be endorsed. it SLISROOATIONIS 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 NAON U ME: T Rachel Bulloch "ai J Smith Lanier 8 Co of Newnan N N �AP,�a:771/6831048 '70 683-1010 P. O. Box 71429 ADDRESS: rbulloch(MJsmithlanler.com� Newnan, GA 30271.1429 "PRODUCER" - 779 683-1 ODD CUSTOMER ID W. INSURER(S)APFORDINOCOVERAGE NAICA (FL Only)S-MAOE INSURED INSURERA• Employers Mutual Casualty Compa 21415 TAG Grinding Services, Inc. -- --- - - -- INSURERa: Great American Insurance Compan 16691 W B Leasing Inc. INSURER C, Indian Harbor Ins. Co, 36940 1 B 1 113 HorseshoeBend Rd. -------- --' - - Dadeville,AL 36853 INSURER O: INSURER E INSURER F: .. .. _ ..,,.. COVEKAGES CERTIFICATE NUMBER, OCVIe1nM M11E.n Co• THIS I6 TO CERTIFY THAT Tr IS POLICIES OF INSURANCE LISTED DELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTI'dER DOCUMENT WITH RESFECTTO WHICH THIS CERTIFICATE MAYBE 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 PAID CLAIMSINHR, LTjL 4DDL TYPE OF INSURANCE BUSH POLICY NUMBER CyyBY MMIDO MIN YPY OMIT A oENERALUABILTY 3K74918 0712712010 0712712011 FACHOCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY CLAIMOCCUR (FL Only)S-MAOE PREMISES (<a aauavnceJ sf 00000 � ~ MEM D EXP (Any one ra.n Pel f5,00D PERSONAL A ADV INJURY $1,000000 XI PD Ded: 500 .. .. _ ..,,.. OtNERALA004EGATE --- $2,0001000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG 52,00(0,0D0 POLICY X PRO- LOC $ A AUTOMOBILE LIABILITY • X' ANY AUTO 3E74918 7/27/2010 07/2712011 cOMDINEDawGLEHMIT tEn a00kien,) 1 1.000 00 BODILY INJURY IP., u.man) f ALL OWNED AUTO$ BODILY INJURY (P.rA«Nem) -- $ SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE PoractlanU f XI NON.OWNEDAUI03 �_ 5 5 B X UMBRELLA une X OCCUR SUB01939880D 8109/2010 08109/2011 EACH OCCURRENCE 54,000,000 EXCESS LIAB CLAIMN-MAUE! AGGREGATE f4OD0000— DEoucnBLE ..—....—.... .... ...—.... f X RET NnoN S 10,000 _...--....— _,_,..... s WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PPCLPRIETORIPARTNF.R/FXFGUTIVF OFFICEWMEMBER E%GL11C/EA7 �. WA (MRNIAIary In NHI H a, NITON 0170 ) Sr Pn nF P TI S I WCa ATU- OTH• C.L. EACH ACCIDENT f F.L. DISEASE - EA EMPLOYEE E.L. DISE0.aE-POLICV LIMIT f C Equipment Floater UMOOOOD165MA10A 712712010 07/2712011 Limit Per Policy C Leased/Rented Ecip UM00000165MAIOA D7127120110 0712712011 $100,0001 SS -000 Ded DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IARadr ACURD 101, AW slag. R.Am Ike 30"W., If mor..pen I. r.gww) Certificate Holder is named as Additional Insured as respects to the General Liability policy described above when required by written contract, but only with respects to (See Attached Descriptions) City of Gulf Stream Attn: Rita Taylor 100 Sea Road Gulf Stream, FL 33483 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL 0E DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REPRESENTATIVE DIM -2009 ACORD CORPORATION, All richis reserved, ACORD 25 (2009/09) 1 of 2 The ACORD name and logo are registered marks of ACORD i13121656O)M1216554 HXS Jul 27 2009 10:10:43 -> 561-737-0100 J Smith Lanier nn..f b a71nn Knrnnn oulnlu Page 003 ACORDI. CERTIFICATE OF LIABILITY INSURANCE INSK LYN 7DATEIM200MIODPYYY) !27/9 PRODUCER THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION J Smith Lanier & Co of Newnan ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P. O. Box 71429 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Newnan, GA 30271-1429 - 770 683-1000 INSURERS AFFORDING COVERAGE NAIC N INSURED INSURER A, Employers Mutual TAG Grinding Services, Inc. INSURER D National Union Fire Insurance J W B Leasing Co„ Inc. INSURER C: Catlin Specialty Insurance Comp P. O. Box 25 INSURER Daviston,AL 36256 CLAIMS MADE Q OCCUR C INGVRER C. 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSK LYN 40011 OW TYPE OF INSURANCE POLICY NUMBER POLT Y FF TVE P ATELICY DD ION LIMITS A GENERAL UAaIUTY 3D74918 07/27/09 07/27110 EACH OCCURRENCE $1,000,000 COMMERCIAL GENERAL LIABILITY AO"iU HENI'ED S1 000 CLAIMS MADE Q OCCUR MEO FXP (Any Mw Wm ) S5,000 PERSONAL AOV INJURY $1.000.000 X PD Ded:500 CENERAL AGGREGATE $2,000,000 OENL AOOREOAi'E LIMIT APPUER PER PAODUCTS-COMPIOP FOG $2,000,000 POLICY F X FHO LOC A AUTOMOBILE X UASILnY ANYAUTO 3E74918 07/27/09 07/27/10 COMBINED 4ddant) SINGLE LIMIT 511000,000 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Par".M/ 5 X X HIREDAUTOS NON•OWNEDAUTOS BODILY INJURY IPwr ac nl, 5 PROPERTY DAMAGE S (Par Paldan0 GARAGE UABIUTY AUTO ONLY. EA ACCIDENT S OEA ACC S ANY AUTO AVID 10ONLYHAN AGO S B EXCESBNMBRELLA LIABILITY X OCCUR F-1 CLAIMS MADE BE1658273 07/27/09 07/27/10 EACH OCCURRENCE 52,000,000 AGGRErATE 5 000 000 S 5 DEOUCTIRL.E S HCTENTIDN s WORKERS COMPENSATION AND WC 'TA LLLITH. EMPLOYERS' LIABILITY E.I. EACH ACCIDENT S ANY PROPRIETOWPARTNER/EXECUTNE F..L. DISEASE EA EMPLOYEE 6 OrnCERIMEMOCR EXCLUDED? R ai. W. be YIMaf BECIAL P OVIRI R hMow .L. DISEASE • POLICY LIMIT I S C OTHER Equipment FI IM1064230710 07/27/10 Limit Per Policy C Leased/Rented IM1064230710 T071,27109 7/09 07/27/10 $100,000 Per Item Limit Equipment E5 ODO Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT) SPECIAL PRDVISIONS Certificate Holder Is named as Additional Insured as respects to the General Liability policy described above, but only with respects to operations of the named insured and subject to provisions and limitations of the policy, City of Gulf Stream Attn: Rita Taylor 100 Sea Road Gulf Stream, FL 33483 28 (2001108) 1 of 2 N3621338IM621312 I ANY Of THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION IEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN TO THE CERTIFICATE HOWER NAMED TO THE LEFT. BUT FAILURE To DO 60 SMALL NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. 17S AGENTS OR AUTHORIZED RXR 0 1888 Cliantg- R71nR 50TAGGRINDIN ACORDra CERTIFICATE OF LIABILITY INSURANCE 05/06/ 0139"�" PRODUCER J Smith Lanier & Co of Newnan P. O. Box 71429 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Newnan, GA 30271-1429 TYPEOFINSURANCE 770 683-1000 INSURERS AFFORDING COVERAGE NAIC # INSURED TAG Grinding Services, Inc. J W B Leasing Co., Inc. P. O. Box 25 Daviston, AL 36256 INSURER A: Employers Mutual INSURER a: National Union Fire Insurance w$u!sac! Federal Insurance INSURER 0: INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPEOFINSURANCE POLICY NUMBER DATEIMMMONY)E PDA E MMDDNYIN LIMITS A GENERAL LIABILITY 31374918 07/27108 07/27/09 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEDPRFMIRFS IF, occurrence) s100000 CLAIMS MADE 51OCCUR MED EXP (Any one person) S5,000 PERSONAL 9ADV INJURY $1,000,000 X PD Ded:500 GENERAL AGGREGATE S2 QQQ QQQ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGS 52000000 POLICY MX PEI LOC A AUTOMOBILE LIABILITY 3E74918 07127106 07127109 COMBINED SINGLE LIMIT Be accident) $1 000000 X ANY AUTO BODILY INJURY $ ALL OWNED AUTOS SCHEDULED AUTOS (Par person) BODILY INJURY $ X HIRED AUTOS X NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GAR AGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC S ANY AUTO AUTO ONLY: AGG $ B EXCESSNMBRELLA LIABILITY BE1658273 08106108 07127109 EACH OCCURRENCE s2,000,000 X OCCUR F] CLAIMS MADE AGGREGATE s2,000,000 S DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION ANDWC STATU- OTH- ER EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE S OFFICERIMEMBER EXCLUDED? Des. describe ander SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT S C OTHER Equipment FI 6640674 07/27/08 07/27/09 Limit Per Policy C Leased/Rented 6640674 07/27/08 07/27/09 $100,000 Per Item Limit ,Equipment $5,000 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate Holder is named as Additional Insured as respects to the General Liability policy described above, but only with respects to operations of the named insured and subject to provisions and limitations of the policy. Town of Gulf Stream 100 Sea Road Gulf Stream, FL 33482 ACORn 2s t2nn1/OR11 .d O eccai nncreeci Rn71 OF WE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION ENDEAVOR TO MAIL . In DAYS WRITTEN TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED ovo 1QRR ACOR - CERTIFICATE OF LIABILITY INSURANCE T 101 i DATE 06 s PRODUCER Hawkins & Rawlinson I Inc. P.O. Box 3493 2515 East Glenn Avenue, Suite Auburn AL 36831-3493 Phone: 888-822-1173 Fax:334-821-5801 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 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIL 4 INSURED T83 Grinding SerY1CC51, Ino. Pa 5 tto GA�30268d INSURERA caaP.asm, vrapaeeY c orvaLey 12157 INSURER B: INSURER C: INSURER D: NSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NMAED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TD 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. AGGREGATE LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAN) CLAMS. LTR S0. TYPE OF INSURANCE POUCYISMOER DATE MMIDOIYY PATE MMRID LIMITS GENERAL LIABILITY EACH OCCURRENCE S PREMISES Et acanrrca S COMMERCIAL GENERAL LABILITY CLAIMS MADE OCCUR MEDEXPU%M mPrraal) S PERSONAL S ADV INJURY $ GENERAL AGGREGATE S GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMPIOP AGG 3 POLICY JECT LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (EM aee m) 5 SODLY INJURY (PK Panora) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY 5 (Par accldaM) HIREDAUTOS NON -OWNED AUTOS PROPERTY DAMAGE S (Pa aaJd") GARAGE LABILITY GARAGE AUTO ONLY -EA ACCIDENT Is - OTHER THAN EAACC S ANY AUTO AUTOONLY: AGO $ EXCESSUMBRELLA LIABLLITY EACH OCCURRENCE S OCCUR F—I CLAIMS FADE AGGREGATE S S $ DEDUCTIBLE S RETENTION S WORHERS COMPENSATION AND IOTM x TORY LIMITS ER A EMPLGYERVWORnY ANY PROPRIETOSPARTNESEXECUTME CWC 3070514 06 03 07/27/08 07/27/09 E.LEACH ACCIDENT 51000000 E.LDISEASE-EAEMPLOYE 31000000 OFFICERMENBER EXCLUDED? It SPECIALaPRbOVID80 SONav EL MSEASE-POUCYLMIT 51000000 OTHER DE MPTIDNOFOPERATIONSILOCATIONS1VEHICLES? EXCLUMONSADDEDBYENDORSEMENTISPECMLPROVISIONS Grinding Town of Gulf Stream fax 561-737-0188 Rita Taylor 100 Sea Road Gulf Stream FL 33483 MJnr�Glv.nal TOWGU01I eHOUWMYOFTHEABOVEDESCMBEDPOUCIESBECANCELLEDBEFORETHEEXPIRADON GATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO W $0 SHALL IMPOSE NO OBLIOAMON OR LIABILITY OF ANY RIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AC CERTIFICATE OF LIABILITY INSURANCE OP ID TT DATE IMM /DDIYYVYI -ORD- TAGGR-1 07 23 08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Hawkins, Rawlinson, Lanier Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Sox 3493 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2515 East Glenn Avenue, Suite ALTER THE COVERAGE AFFORDED BYTHE POLICIES BELOW. Auburn AL 36831-3493 GENERAL LIABILITY Phone:888-822-1173 Fax:334-821-5801 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA Camps�on Prapacty s Casually 12157 INSURERS: INSURER C: TAG Grinding Services, Inc. 8395 Williams Road Palmetto GA 30268 INSURER D: INSURER E. COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/Y' Y EXPIRATION PLIILTR DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ PREMISES (Eat a ccrenca $ COMMERCIAL GENERAL LIABILITY CLAIMS MADE F7OCCUR MED EXP (Any we person) $ PERSONAL B ADV INJURY $ GENERAL AGGREGATE S GENL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG S POLICY PRO JECT LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ (Ea ectltlenl) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per Person) $ HIREDAUTOS NON -OWNED AUTOS BODILY INJURY (Per accident)$ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT It OTHER THAN EAACC It ANY AUTO AUTO ONLY: - AGO S EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR 71 CLAIMS MADE AGGREGATE $ S g DEDUCTIBLE $ RETENTION $TH'I A WORKERS COMPENSATION ANO EMPLOYERS'LMBILfTY ANY PROPRIETORPARTNER:1 ECUTIVE CWC 3070514 06 03 07/27/08 07/27/09 A TORY LIMITS ER E.L. EACH ACC-TATIDENT 51000000 E.L.DISEASE-EAEMPLOYEE1 $ 1000000 OFFICERIMEMBER EXCLUDED? liyas, describe Under SPECIAL PROVISIONS below 1 E.L. DISEASE -POLICY LIMIT I $1000000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS TOWGUO1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN Town of Gulf Stream NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL fax 561-737-0188 Rita Taylor IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 100 Sea Road REPRESENTATIVES. Gulf Stream FL 33483 AUTH E�T9nVE o7dKa7=7�IKi777i7:7a\I[HaFL•i:1 cel 8/7/2008 Timex 8136 AM To/ R 1-561-737-0188 Client#: 67108 S SMITH LANIER a CO Pagel 002 50TAGGRINDIN ACORDTa CERTIFICATE OF LIABILITY INSURANCE TYPE OF INSURANCE PODGY NUMBER POLICY EFFECTIVE GATE MMOO/YY 08062008 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION J Smith Lanier & Cc of Newnan ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P. O. Box 71429 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 07/27/09 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Newnan, GA 30271-1429 770683-IGOD INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A. Employers Mutual 21415 TAG Grinding Services, Inc. INSURERS. Federal Insurance 20281 J W B Leasing Co., Inc. INSURER c National Union Fire Ins C 19445 16418 Highway 22 E Daviston,AL 36256-6616 INSURER D: PERSONAL 8 ADV INJURY $1,000,000 INSURER E 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 MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE PODGY NUMBER POLICY EFFECTIVE GATE MMOO/YY POLICYEXPIRATION DATE(Mi DMFS A GENERAL LIABILITY 3D74918 07127/06 07/27/09 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENIEO $100,0G0 MED EXP (Any one person) s5,000 CLAIMS MADE 51OCCUR PERSONAL 8 ADV INJURY $1,000,000 X PD Ded:500 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO s2,000,000 POLICY X ECT LOC A AUTOMOBILEUMBLRY X ANY AUTO 3E74918 07/27/06 07/27/09 COMBINED ENGLE LIMIT $1,000,000 (Ea accident) ALL OWNED AUTOS SCHEDULEOAUTOS BODILY INJURY IParpamon) $ X X HIREDAUTOS NON OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ IPeracaa.0 GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OEA ACC $ AN ANY AUTO AUUTOTO OONLNLY AGO $ C EXCESSAIMBRELLALIIIBILFY X OCCUR F1 CLAIMS MADE 553858960 08/05/08 07/27/09 EACH OCCURRENCE $2,000,000 AGGREGATE $2 000 000 8 $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND WCSTArU OTH EMPLOYERS' LIABILITY ANV PROPRIETOR/PARTNERIEXECtn NE E. L. EACH ACCIDENT $ E.L. DISEASE EA EMPLOYEE $ OFFICER/MEMBER EXCLUDED? T ECIALP OVISIer SPECIAL PROVISIONS bel. E.L. DISEASE -POLICY LIMIT $ B OTHER Equipment FI 6640674 07/27/08 07/27/09 Limit Per Policy B Leased/Rented 6640674 07/27/08 07/27/09 $100,000 Per Item Limit Equipment $5,000 Deductible IESCRIPFON OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS :ertificate Holder is named as Additional Insured as respects to the 3eneral Liability policy described above, but only with respects to Iperations of the named insured and subject to provisions and limitations Athe policy. City of Gulf Stream Attn: Rita Taylor 100 Sea Road Gulf Stream, FL 33483 (CORD 25 (2001/08) 1 of 2 AS5075151M505487 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ESUNG INSURER WILL ENDEAVOR TO MAL 10_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY MIND UPON THE INSURER ITS AGENTS OR RXB O ACORD CORPORATION 1988