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2006-24;' ~'' CITY OF CLERMONT • NON-EXCLUSIVE COMMERCIAL ROLL-OFF SOLID WASTE CONTAINER COLLECTION AND DISPOSAL AGREEMENT THIS AGREEMENT is made and entered into this 26`x' day of September, 2006, by and between the CITY OF CLERMONT, FLORIDA ("City"), and Metro Waste Services, whose address is P. O. Box 681730, Orlando, FL 32868 ("Grantee"). RECITALS: WHEREAS, City as a municipal corporation of the State of Florida has the authority and right to regulate the use of public right-of--way and related facilities in conjunction with the commercial activity of the collection and disposal of commercial waste; and WHEREAS, Grantee has requested the City grant to it anon-exclusive franchise right to operate within the incorporated municipal limits of the City of Clermont; and NOW THEREFORE THE PARTIES DO HEREBY AGREE AS FOLLOWS: SECTION 1 DEFINITION. Definitions of terms used in this Ordinance: (a) "Refuse" includes all garbage and other trash generated by citizens of the City and businesses within the City. • (b) "Residential Refuse" is that refuse generated by residents of the City. (c) "Commercial Refuse" is that refuse generated by commercial and industrial establishments presently operating in the City and any such establishment which may begin operation during the term of the contract contemplated herein. Multi- familyresidential maybe considered commercial use. SECTION 2 GRANT OF FRANCHISE. Pursuant to City of Clermont Ordinance No.: 567-M the City hereby grants to Grantee, and the Grantee hereby accepts, anon-exclusive right and privilege to operate a refuse collection system in, upon, over and across the present and future streets, alleys, bridges, easements and other public places of the City, for the purpose of collecting commercial refuse, subject to certain limitations hereinafter set forth. SECTION 3 INCORPORATION OF THE ORDINANCE. The Franchise granted hereunder is issued pursuant to and subject to the provisions of the Ordinance No.: 567-M as passed on September 26, 2006, hereinafter "the Ordinance". Grantee agrees to comply with all provisions of the Ordinance, as amended from time to time by the City in the lawful exercise of its Police Powers. SECTION 4 COMPLIANCE WITH OTHER FEDERAL, STATE AND LOCAL REQUIREMENTS. The Grantee agrees to comply with all applicable federal and state laws, rules and regulations. Failure on the part of the Grantee to comply with material requirements of this Agreement, the Ordinance or and any other local, state or federal law, ordinance, or rule or regulation relating to the collection and disposal of solid waste will result in the cancellation of this Franchise. • SECTION 5 INSURANCE, INDEMNIFICATION, HOLD HARMLESS AND DUTY TO DEFEND. (a) Grantee shall, within five (5) days from the adoption of this ordinance, cause to be written a policy of general liability insurance, insuring it and the City against all claims made by any person or persons for personal injuries or property damage incurred in connection with the performance by Grantee, its servants, agents, and employees, of the services required under this ordinance and the franchise hereby granted, which said policy shall be written within limits of $1,000,000 per person and $3,000,000 per occurrence, and for not less than $100,000 for damages to property per occurrence. In the event that said policy is ever canceled or terminated, Grantee shall notify City immediately with the name and proof of the replacement insurance carrier and policy. (b} Grantee does hereby agree to indemnify, hold harmless and defend City from any and all causes of actions or claims of any kind for damages of any kind, including attorney fees, whether actual or threatened, and related in any manner, directly or indirectly to the Grantee's exercise of any of the rights granted hereunder, either within or without the City limits. (c) Nothing herein shall be construed or act as a waiver of any sovereign immunity the City may enjoy in accordance with applicable law, the protection of which the City expressly reserves. • SECTION 6 LIMITATION OF GRANT OF FRANCHISE. The non-exclusive franchise right granted herein is limited by the Ordinance and shall specifically not include the following to the following: (a) the collection and disposal all residential refuse; (b) the collection and disposal of all commercial refuse generated by establishments which: (i) utilize 12 or less refuse cans per pick up each with a capacity not exceeding 30 gallons andlor (ii) require service two or less times per week. SECTION 7 SERVICE REQUIREMENTS. Any and all services to be provided hereunder by Grantee shall be performed in accordance with applicable professional standards, this Agreement, the Ordinance, and all Local State and Federal Laws. In addition thereto, Grantee shall act as follows: (a) All commercial waste to be picked up by Grantee will be stored in standard manufactured, mechanically serviced containers approved by the City. Grantee will supply such containers as needed by customers. Location of containers is subject to City approval. 2 (b) Size of containers and frequency of service will be agreed upon by Grantee and each customer. Minimum container size shall be two cubic feet. Containers will • be disinfected a minimum of once per week to remove all noxious and/or obnoxious odors. (c) The rates for each individual customer are to be negotiated between Grantee and each customer it serves. The City and each customer shall be notified of any proposed rate change at least 60 days prior to the effective date of the rate change. (d) Grantee, its agents, servants or employees shall collect refuse collected hereunder in enclosed, standard, packer-type vehicles approved by the City, and shall perform their obligations hereunder in a courteous, workmanlike manner so as not to create a nuisance for any of the residents of the City. All such commercial refuse collected hereunder shall be disposed in a lawful manner. (d) Grantee, its agents, servants or employees shall refrain from and take all steps necessary to prevent spilling of any such refuse in the process of collecting or hauling for disposition on any private property or public thoroughfare within the limits of the City. If any refuse is spilled during the process of handling, storing or hauling, it will be promptly removed by Grantee and the area promptly cleaned up. (e) Grantee shall have the sole responsibility for the billing and collection of charges provided hereunder. Billings shall be monthly and payable on or before the 15th . day of the succeeding month. In the event bills are not paid within this time, Grantee shall have the right to discontinue service for non-payment. Nothing herein shall be construed or act as an acknowledgement or guarantee by City of any fees or billings owed to Grantee. (f) Collection shall be made during hours as set forth in a schedule approved by the City. All collection will be made as quietly as possible. SECTION 9 PAYMENT OF FRANCHISE FEE. Grantee shall pay monthly to the City a franchise fee established by separate resolution of the City of Clermont. Grantee shall provide an annual audit report to the City showing gross annual billings and receipts, if requested by the City. Fees to be assessed commencing with the first billing of any customer. In the event services have been provided prior to this agreement, all past due fees calculated from the first billing shall be paid within 30 days of this Agreement. SECTION 10 POSTING OF PERFORMANCE BOND. Within thirty (30) days of the execution of this Agreement, Grantee shall provide to the City, and at all times thereafter shall maintain in full force and effect for the term of this Franchise or any renewal thereof, at Grantee's sole expense, a performance bond with a company and in a form approved by the City, in the amount of one hundred thousand dollars ($100,000), consistent with the requirements of the Ordinance and this Agreement. • 3 SECTION 11 TERM, TERMINATION AND ASSIGNMENT. This franchise and this Agreement shall be in full force and effect until September 12, 2007 commencing immediately; • and this franchise and contract shall thereafter be automatically renewed from year to year unless terminated by either party upon not less than sixty (60) days written notice sent via U.S. registered or certified mail, return receipt requested, to the other party. This franchise and the contract between the City and Grantee maybe assignable to an affiliated company by Grantee it has first obtained the consent of the City for such assignment. In the event of default of any of the terms of the Ordinance or this Agreement, City may terminate this agreement after providing to Grantee thirty (30) days written notice and an opportunity to cure. SECTION 12. NOTICE, PROPER FORM. Any notices required or allowed to be delivered hereunder or under the Ordinance shall be in writing and be deemed to be delivered when (1) hand delivered to the official hereinafter designated, or (2) upon mailing of such notice when deposited in United States Mail, postage prepaid, certified mail, return receipt requested, Federal Express or courier, addressed to a party at the address set forth opposite of the party's name below, or such other address as the party shall specify by written notice to the other party delivered in accordance herewith: City: City of Clermont 685 W. Montrose Street Clermont, FL 34711 Attention: City Clerk • Grantee: Metro Waste Services P. O. Box 681730 Orlando, FL 32868 Attention: Ronald Pruim, Jr. SECTION 13. DISCLAIMER OF THIRD PARTY BENEFICIARIES. This agreement is solely for the benefit of and shall be binding upon the parties hereto and their respective successors in interest. No right or cause of action shall accrue upon, or by reason hereof, to or for the benefit of any person not a party to this Agreement or a successor in interest. SECTION 14. SEVERABILITY. This Agreement is declared by the parties to be severable. SECTION 15. APPLICABLE LAW AND VENUE. This Agreement shall be construed, controlled, and interpreted according to the laws of the State of Florida. Venue for any cause of action hereunder shall be exclusively in Lake County, Florida. SECTION 16. ENTIRE AGREEMENT: MODIFICATION. This Agreement constitutes the entire agreement between the parties and supersedes all previous discussions, understandings and agreements. Modifications to and waivers of the provisions herein may be only by the parties hereto and only in writing. IN WITNESS WHEREOF, the parties hereto have hereunder executed this Agreement • on the date and year first above written. 4 CITY OF CLERMONT, FLORIDA Mayor Harold S. Turville, Jr ATTE T: :~~ Tracy Ackroyd, City Cle GRANTEE: (~(e~ro ~As~- S~a~ra-S By: ~CJ Title: Ro-~ F~cwi w+ 7r: I~tz.ES~ dan-3- ATT • itle: CAA ~ ~( o2-kohl - Sla ~s t~GR- RightFax • 9/5/2006 4:09 PAGE 002/003 Fax Server ACORQM CERTIFICATE OF LIABILITY INSURANCE °o9iosiioo6' PRODUCER (gOp)407-4Q77 FAX (321) 752-7980 Envi rorrnental Insurance Spatial fists 158 N. Harbor City Blvd. 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. Melbourne, FL 32935 Sue Teodoro INSURERS AFFORDING COVERAGE NAIC # IN3URE0 One Waste Services Inc. INSURER A: L7nCOln General Ins. Co DBA: Metro Waste Services INSURER 6: Interstate Fire and Casualty P.O. Box 681730 wsuRER c Essex Insurance Co. Orlando, FL 32868 INSURER D: Bridgefield En~loyers MSURER E. V V M CJ THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR ANY REQUIREMENT , MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 1S SUB,fECT TO ALL THE TERMS, EXCLUSIONS AND CON DITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EF FECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY LWG101412-~1 / 07/21/ 2006 07/21/207 EACH OCCURRENCE $ 1,000, X COMMERCIAL GENERAL LIABILITY DPM AGE TO RENTED $ 100, CLAIMS MADE ~ OCCUR PRIMARY & MED EXP (Any one person) $ 5 A X X CONTRACTUAL NON CONTRIt3UTORY PERSONAL EADV INJURY $ 1~Q0(}~Q X PER JOBSITE LDCATI GENERAL AGGREGATE $ 2~QQQ~ GEN'L AGGREGATEL(MiT APPLIES PER: PRODUCTS-COMP/OP AGG $ INCWDE POLfCY PE0. LOC AUT OMOBILE LIABILITY LWI101412-OZ 07/21/2006 07/21/2007 coMBrNED srN GLELIMrT $ ANY AUTO (Ea accident) 1 ~OQ 00 ALL OWNED AUTOS BODILY INJURV $ X SCHEDULED AUTOS (Per person) A X X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY UMD1607105 07/21/2006 07/21/2007 EACH OCCURRENCE $ 4,000, X OCCUR ~ CLAIMSMADE AGGREGATE $ g VER GL & AUTO $ DEDUCTIBLE $ X RETENTION $ 5, $ WORKERS COMPENSATION AND 830-28631 02/24/2006 02/24/2007 X we sraru- orH- EMPLOYERS' LIABILITY R/P RTNER/EXECUTfVE E.L. EACH ACCIDENT $ ],~QQQ~ D ANY PROPRIETO A OFFICER/M EMBER EXCLUDED? E.L. DISEASE•EA EMPLOYEE $ 1,000, If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE-POLICY LIMIT $ 1,000 QQ OTHER IM505615 07/21/2006 07/21/2007 $2,500 PER OCCURENCE EXCEPT 376 LAND MARINE C (MIN. S5,000) WIND/HAIL PER OCCURENCE DESCRIPTION OF OPERATIONS! tACATIONS f VEH{CLES I EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS ITY OF CLERMONT IS LISTED A5 ADDITIONAL INSURED • IF T T SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE IRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL EX P . ~~ // DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ~Si ~ ~~~ C11 , ~~ __ ATTN • TRACY ACKI~DYD BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 68 5 WEST MDNTROSE STREET OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. CLERMONT, FL 34711 AUTHORIZED REPRESENTATIVE ~ Paul Zizzo ST 1 ~ ACORD 25 (2001!08) FAX: (352)394-2379 ©ACORD CORPORATION 1988 RightFax 9/5/2006 4:09 PAGE 003/003 Fax Server r L ACORD 25 (2001/08) .. - • tnot~o Ulerto August 10, 2006 Jane Warrant Administrative Assistant to the City Manager City of Clermont 685 W Montrose Street _ Clermont, FL 34711 Dear Jane: 1 of 1 Metro Waste is requesting a franchise to provide solid waste services in the city limits of Clermont. If you have any questions regarding this request please contact me directly at 321-436-4804. Sincerely, Heather Edwards Outside Sales Manager • PO Box 681730 Phone 407-522-1498 Orlando, FL 32868 Fax 407-522-1499 Commercia{ - Industria{ -Construction -Special Events w • RightFax 8/10/2006 1:24 PAGE 001/002 Fax Server ACORQM CERTIFICATE OF LIABILITY INSURANCE osiio%ioo6' PRODUCER (800)407-4077 FAX (321) 752-7980 Envi rorgnental Insurance Specialists 158 N. Harbor City Blvd. 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. Melbourne, FL 32935 Sue Teodoro INSURERS AFFORDING COVERAGE NAIC # INSURED One Waste Services Inc. INSURERA Lincoln General Ins. Co DBA: Metro Waste Services INSURER 6: Interstate Fire and Casualty P.O. Box 681730 INSURER C: Essex Insurance Co. Orlando, FL 32868 INSURER D. Bridgefield Employers INSURER E: !'M/CD A(]CC vTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THUS CERTIFICATE MAY BE ISSUED OR ANY REQUIREMENT , MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' TYPE OF INSURANCE POUCY NUMBER POLICY EFFECTIVE POUCY EXPIRATION UMRS GENERAL UABILRY LWG1O1412-OZ 07/21/2006 07/21/2007 EACH OCCURRENCE $ 1, ~~, X COMMERCIAL GENERAL LIABILITY DPM AGE TO RENTED $ 1~, GLPJMSMADE ~ OCCUR PRIMARY & MED EXP (Any one person) $ 5 A X X CONTRACTUAL NON CONTRIBUTORY PERSONAL 8 ADV INJURY $ ], ~ 01)0 ~ X PER ]OBSITE LOCATI GENERPLAGGREGATE $ 2~000~ GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS- COMP/OP AGG $ INCWD POLICY jEa LOC AUTOMOBILE UABILRY LWI101412-02 07/21/2006 07/21/2007 COMBINED SINGLELIMIT ANY AUTO (Ea acddent) $ 1 0~ , PLL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person} A X ~( HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DPMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLa UABILRY UM01607105 07/21/2006 07/21/2007 EACH OCCURRENCE $ 4,000, X OCCUR ~ CLAIMSMADE AGGREGATE $ B $ DEDUCTIBLE $ X RETENTION $ 5, $ WORKERS COMPENSATION AND 830-28631 02/24/2006 02/24/2007 X WC STATU• OTH- D EMPLOYERS' LIABILITY ANV PROPRIETORlPARTNERlEXEGUTIVE E.L. EACH ACCIDENT $ 1,000, OFFI CERM1 EM BER EXCLUDED? E.L. DISEASE-EA EM PLOYE $ , , tt yes, describe under SPECIAL PROM SIGNS belay E.L. DISEASE-POLICY LIMIT $ 1 000 OTHER IM505615 07/21/Z006 07/21/2007 52,500 PER OCCURENCE IXCEPT 3% LAND MARINE C (MIN. 55,000) WIND/HAIL PER OCCURENCE DESCRIPTION OF OPERATIONS f LOCATIONS f VEHICLES! EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS ITY OF CLERMONT IS LISTED AS ADDITIONAL INSURED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3t~ DAYS WRITTEN NOTICE TO TH£ CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY • CITY OF CLERMONT ATTN: JANE WARREN 685 WEST MONTROSE CLERMONT. FL 34711 OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ,,,, B L%9~IJ Paul Zizzo/ST J ""~ %° ACORD 25 (2007/08) ©ACORD CORPORATION 1988 RightFax 8/10/2006 1;24 PAGE 002/002 Fax Server IMPORTANT If the certificate holderis an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). if SUBROGATION IS WAVED, subject to the terrns and conditions of the policy, certain policies may require an endorsement A statement on this certificate does notconfer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. • • ACORD 25 (2001/08) RightFax 9/5/2006 4:10 PAGE 002/003 Fax Server ~CORI~M CERTIFICATE OF LIABILITY INSURANCE 09/05/2006 P CER (800)407-4077 FAX (321) 752-7980 ronmental Insurance Specialists 1 8 N. Harbor City Blvd. THIS CERTIFICATE 15 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. Melbourne, FL 32935 Sue Teodoro INSURERS AFFORDING COVERAGE NAIC # INSURED One Waste Services Inc. INSURER A: L7nCO1 n General Ins. Co DBA• Metro Waste Services INSURER e: Interstate Fire and Casualty P.O. Box 681730 INSURER G: Essex Insurance Co. Orlando. FL 32868 INSURER D: Bri dgefi el d Employers INSURER E: cvvtKA~t~ E POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING TH TERM OR CONDITION OF ANY CONTRACT Oft OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR ANY REQUIREMENT , THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH MAY PERTAIN , POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DO' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIYE POLICY EXPIRATION LIMITS GENERALUwBILITY LMIG101412-O1 07/21/Z006 07/21/2007 EACH OCCURRENCE $ 1,000, X GOMM ERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100 r CLAIMS MADE ~ OCCUR PRIMARY & MED EXP (Anyone person) $ 5 QQ A X X CONTRACTUAL NON CONTRIBUTORY PERSONPL & ADV INJURY $ 1 r 000 r QO X PER JOBSITE LOCATI GENERAL AGGREGATE $ 2, 000 r (()() GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS- CCIvIP(OP AGG $ ~uJ(~ POLICY PE7 LOC AUTOMOBILE LIABILITY LWI101412-02 U7/Z I/ZOO6 O7/Z1/2007 COMBINED SINGLELIMIT $ ANY AUTO (Ea acddenq ~- r 000 ALL OWNED AUTOS BODILY INJURY erson) (Per $ X SCHEDULED AUTOS p A X X HIRED AUTOS BODILY INJURY id t P $ X NON-OWNED AUTOS er acc en ) ( PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACG $ AUTO ONLY: AGG $ EXCESSNMBRELLA LIABILRY UM01607105 07/21/2006 07/21/2007 EACH occuRRENGE $ 4,000. X OCCUR ^CL AIMS MADE AGGREGATE $ B VER GL & AUTO $ DEDUCTIBLE $ X RETENTION $ 5 r 0 $ WORKERS COMPENSATION AND 830-28631 02/24/2006 02/24/2007 X WG sTAru- oTH- EMPLOYERS' LIABILffY E.L. EACH ACCIDENT $ 1 r OOO, 00 D ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYE $ 1, 000 r OO If yes, describe under DISEASE -POLICY LIMIT E L $ 1 000 00 SPECIAL PROVISI ONS belay . . orH IMS05615 07/21/2006 07/21/2007 S2r500 PER OCCURENCE IXCEPT 3% LAND MARINE 000) WIND/HAIL PER (MIN 55 C . . OCCURENCE DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ITY OF CLERMONT IS LISTED AS ADDITIONAL INSURED CA C L 10 C RTIFIC TE O R 5HOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE RATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL EXPI A ~.Y- DAYS WRITTEN NOTICE TO THE CERTIFICATE HoL.OER NAMED TO THE LEFT, CITY OF CLERMONT ATTN • TRACY ACKROYD BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 68 5 WEST NpNTROSE STREET OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. CLERMONT, FL 34711 AUTHORIZED REPRESENTATIVE ~,,II~ Paul Zizzo/ST J '"~ ACORD 25 (2001/08) FAX: (352) 394-2379 ©ACORD CORPORATION 9988 09/05/2006 TUE 16:16 (JOB N0. 8101 ~ 002 RightFax 9/5/2006 4:10 PAGE 003/003 Fax Server • IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement{s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. • • ACORD 25 (2001/08) 09/05/2006 TUE 16:16, .JOB N0. 8101 X003