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CERTIFICATE OF LIABILITY INSURANCE (2)Adak r? AC OM CERTIFICA OF LIABILITY INSURA CE MIDD/Y1n DATE (M /08 /08 100 /08 PRODUCER 1-866-220-4625 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Holmes Murphy and Associates - Omaha ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2637 South 158th Plaza ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 200 Omaha, NE 68130 INSURERS AFFORDING COVERAGE INSURED INSURERA:Zurich American Insurance Company/#16535 Post, Buckley, Schuh & Jernigan, Inc. d/b/a PBS&J INSURERB:Zurich American insurance company / #16535 2001 NW 107th Avenue INSURER C: Steadfast Insurance Company/#26387 i i 33172 2507 INSURER D: M am , FL - INSURER E: rnvcown_ec 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 CONTRACT OR 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 1311 TYPE OF INSURANCE POLICY NUMBER - - POLICY EFFECTIVE POLICY EXPIRATION DATE flYNA(I)Offin LIMIT S . A GENERAL LIABILITY - GLO 9139458-02 09/30/08 09/30/09 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (An one fire $1,000,000 7 CLAIMS MADE F_x1OCCUR MED EXP An one person) $25,000 X , Contractual Liability PERSONAL& ADV INJURY $ 1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OPAGG $2,000,000 POLICY X PRO X LOC B AUT OMOBILE LIABILITY HAP 91394 52-0 2- /30/08 09/30/09 COMBINED SINGLE LIMIT $ 2,000,000 X ANY AUTO R ECEIVE D (Ea accident) ALL OWNED AUTOS BODILY INJURY $ (Per person) SCHEDULED AUTOS X HIRED AUTOS /ry OCT 1 5 2,908 BODILY INJURY $ X NON-OWNED AUTOS (Per aoddent) X Contractual Liability CITY PROPERTY $ OF CLEARWA R (Per cGdent) GARAGE LIABILITY L&IJARTA IENT AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ C EXCESS LIABILITY AUC 508762104 09/30/08 09/30/09 EACH OCCURRENCE $ 25, 000, 000 X OCCUR CLAIMS MADE AGGREGATE $ 25, 000, 000 DEDUCTIBLE $ RETENTION $ 0 $ A WORKERS COMPENSATION AND WC 9139459-02 09/30/08 09/30/09 g WCSTATU- OTH- TORY LIMITS ER EMPLOYERS' LIABILITY - E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1, 000, 000 OTHER S S DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: City of Clearwater. ?^ r?? ((?? p City of Clearwater is an Additional insured on the General Liability and Automobile Li '2f1t `rdriZQ06espect to the operations of the insured. RECORDS DEN See attached for additional wording. Clearwater, City of Engineer of Record 100 South Myrtle Avenue, Engineering - Suite 220 Clearwater, FL 33756 ganderson USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ffMXMWW 90 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, WJUMiJMQCXtZVX%V§9JX9X AUTHORIZED REPRESENTATIVE. O ACORD CORPORATION 1988 luuz5yy.s ACORD. CERTIFICATE OF LIABILITY INSURANCE 9/30/2009 DATE (MM/DD/YYYY) 10/8/2008 PRODUCER Lockton Companies, LLC-1 Kansas City 444 W. 47th Street, Suite 900 Kansas City MO 64112-1906 (816) 960 9000 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 NAIC # INSURED POST, BUCKLEY, SCHUH AND JERNIGAN, INC. INSURER A: LLOYDS OF LONDON A XV 1307320 DBA PBS&J INSURER B : 2001 NW 107 AVENUE MIAMI FL 33172-2507 INSURER C : INSURER D : INSURER E : NSUREP(S). AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE la %,rK l Ir R.P1I c yr rnauKnret.c uvca nv r V Vna"i v 1 G X Vvn 1 K v 1 Gc 1 w-rv i n rllve HOLDER, COVERAGES PD i n 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. - INSR ADD'L -POLICY EFFECTIVE` POLICY-EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE (MMIDDIYY) DATE (MM/DD/YY) LIMIT S GENERAL LIABILITY EACH OCCURRENCE $ XXXXXXX COMMERCIAL GENERAL LIABILITY PRAEMI ET Ea occTErenc $ XXXXXXX CLAIMS MADE E]OCCUR NOT APPLICABLE MED EXP (Any one person) $ XXXXXXX PERSONAL & ADV INJURY $ XXXXXXX GENERAL AGGREGATE $ XXXJxXX GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ XXXXXXX PRO- POLICY JECT LOC AUTOMOBILE LIABILITY r 1 COMBINED SINGLE LIMIT $ XXXXXXX ANY AUTO ? 1 (Ea accident) C ALL OWNED AUTOS BODILY INJURY $ XXXXXXX SCHEDULED AUTOS NOT APPLICABLE 'I (Per person) HIRED AUTOS BODILY INJURY $ XXXXXXX NON-OWNED AUTOS O (Per accident) P ?0! ENj PROPERTY DAMAGE $ XXXXXXX pF G M (Per accident) -a .1 r710 GARAGE LIABILITY NG? EE AUTO ONLY - EA ACCIDENT $ XXXXXXX ANY AUTO NOT APPLICABLE E OTHER THAN EA ACC $ XXXXXXX R AUTO ONLY: AGG $ XXXXXXX EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ XXXXXJx I OCCUR F_1CLAIMS MADE AGGREGATE $ XXXXXXX NOT APPLICABLE XXXXXXX UMBRELLA $ DEDUCTIBLE FORM $ XXXXXXX -- - - - - -12ETEN1'ION--?-___:.- -- -_ _.. ----- - ---- - ?"X?i OTH- WORKERS COMPENSATION AND -DRY IMIT EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE NOT APPLICABLE E.L. EACH ACCIDENT $ XXXXXXX OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ XXXXXXX If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ XXXXXXX A OTHER LDUSA0800811 9/30/2008 9/30/2009 $1,000,000 EACH CLAIM & $1,000,000 A CLAIMS-MADE FORM ANNUAL AGGREGATE. PROFESSIONAUPOLLUTION 11/11/1961 RETRODATE. LIABILITY DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS RE: CITY OF CLEARWATER. r 20U8 '?ECORD f)EPT CERTIFICATE HOLDER CANCELLATION 3922433 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CLEARWATER, CITY OF DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN ENGINEER OF RECORD NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 100 S. MYRTLE AVENUE ENGINEERING - SUITE 220 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR CLEARWATER FL 33756 REPRESENTATIVES. AUTHORIZED REPRESE E ACORD 25 (2001108) For questions regarding this certificate, contact the number listed In the'Producee section above. - " V IF 0 ACORD CORPORATION 1988 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-S (7/97)