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CERTIFICATE OF LIABILITY INSURANCE (2)ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) n„ 7/l/2009 PRODUCER Phone: 727-461-6044 Fax: 727-442-7695 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Brown & Brown Insurance - Clearwater ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P O Box 2456 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR . . i ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Su te 660 Clearwater FL 33757-2456 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER&National Fire ins of Hartford 0478 Ming Engineeri ng Assoc., Inc. i l INSURER B: Trans ortation Insurance Co. 0494 4921 Memor a Hwy Ste 300 ?- Tampa FL 33634 INSURERC:`jalle Insurance Com an -Forge 0508 INSURERD:Continental Casuals Co. 0443 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 MAX HAVE BEEN REDUCED BY PAID CLAIMS. ??? INSR LTR DD'L NSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE M b POLICY EXPIRATION DATE MM/DD NY) IMITS A X GENERAL LIABILITY 02066728229 1/1/2009 1/1/2010 EACH OCCURRENCE $11000,000 IAGEI7SRE1i : .. ..._ _.. - - . COMMERCIAL GENEP,P.L LIAHILITV _ _ _ _ y 7 aw.:wn CLAIMS MADE X OCCUR MED EXP (Any one person) $ 5 000 X XCLT IriCludp_d__._. PERSONAL &ADV INJURY- $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER- PRODUCTS -COMP/OPAGG -- $2,000,000 PDLICY PRO- X JET LOC A X AUT OMOBILE LIABILITY C2066728232 1/1/2009 1/1/2010 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1, 0 0 0, 0 0 0 ALLOWNEDAUTO$ R ECEIVE D BODILY INJURY $ X SCHEDULEDAUTOS (Per person) X HIREDAUTOS "'t IC A BODILY INJURY I 2Q? / U ]] 'y 0 (Per accident) $ X NON-OWNED AUTOS . PROPERTYDAMAGE OFFI ECORDS IA L R D (Per accident) $ GE LIABILITY LEGIS T ? /C IIE SRVCS C FP AUTO ONLY-EA ACCIDENT $ ANYAUTO OTHERTHAN EAACC $ AUTO ONLY: AGG $ $ EXCESS/UMBRELLA LIABILITY C2066728246 1/ 1/ 2 0 0 9 1/l/2010 EACH OCCURRENCE $5,000,000 X OCCUR 171 CLAIMS MADE AGGREGATE $5,000,000 i T DEDUCTIBLE RETENTION $ 0 $ C ESCOMPENSA-...-.. _. Y - TIONAND W6kk C163672013 __ - 2009 /1/2OlU "- W?STAT_U- 'X TRY 1 ES P O EM ERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1 000,000 OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 1 O O 0 , O O O If yes describe under SPECIAL PROVISIONS below E.L. DISEASE- POLICY LIMIT $1, 000, 000 D OTHER EH113805181 1/1/2009 1/1/2010 Per occurrence 5000000 Professional E&O Aggregate 5000000 Retro 1-1-1994 DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS Certificate Holder is additional insured per the terms of the liability policy with respect to Bodily Injury or Property Damage arising from the work performed by the named insured per form G140331A 01/01 (attached). Additional Insured status also applies to Auto Liability. Waiver of Subrogation for General Liability is included in blanket form. * 10 Day Notice for Non Payment of Premium overage is primary & Non Contributory to any policies held by the certificate holder as required by written contract- CERTIFICATE HOLDER CANCELLATION City of Clearwater Attn: City Clerk PO Box 4748 Clearwater FL 33758-4748 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS* WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE T. Ip? ACORD 25 (2001/08) ©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 (2001/08) CNA G-140331-A (Ed. 01/01) IMPORTANT: THIS ENDORSEMENT CONTAINS DUTIES THAT APPLY TO THE ADDITIONAL INSURED IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT. SEE PARAGRAPH C.1. OF THIS ENDORSEMENT FOR THESE DUTIES. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTOR'S SCHEDULED AND BLANKET ADDITIONAL INSURED ENDORSEMENT WITH PRODUCTS-COMPLETED OPERATIONS COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDU. Name of Person or Organization: Designated Project: A. s B. (Coverage under this endorsement is not affected by an entry or lack of entry in the Schedule above.) WHO IS AN INSURED (Section II) is amended to include as an insured any person or organization, including any person or organization shown in the schedule above, (called additional insured) whom you are required to add as an additional insured on this policy under a written contract or written agreement; but the written contract or written agreement must be: 3. The coverage provided to the additional insured by this endorsement and paragraph f. of the definition of "insured contract" under DEFINITIONS (Section V) do not apply to "bodily injury" or "property damage" arising out of the "products-completed operations hazard" unless required by the written contract or written a reement 1. Currently in effect or becoming effective during the g term of this policy; and 4. The insurance provided to the additional insured - - -- -.-.-:.__does=-not--apply--4o "bed4:? 'u rv ert =_- y 2. --Executed prior to the bodily injury," "property damage nlrying inj p ury" damage," or "personal and advertising injury". ," or "personal and advertising arising out of an architect's, engineer's, or The insurance provided to the additional insured is surveyor's rendering of or failure to render any limited as follows: professional services including: 1. That person or organization is an additional insured solely for liability due to your negligence specifically resulting from "your work" for the additional insured which is the subject of the written contract or written agreement. No coverage applies to liability resulting from the sole negligence of the additional insured. 2. The Limits of Insurance applicable to the C additional insured are those specified in the written contract or written agreement or in the Declarations of this policy, whichever is less. These Limits of Insurance are inclusive of, and not in addition to, the Limits of Insurance shown in the Declarations. G-140331-A (Ed. 01/01) a. The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and b. Supervisory, or inspection activities performed as part of any related architectural or engineering activities. As respects the coverage provided under this endorsement, SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS are amended as follows: 1. The following is added to the Duties In The Event of Occurrence, Offense, Claim or Suit Condition: Page 1 of 2 G-140331-A (Ed. 01/01) e. An additional insured under this endorsement until we receive written notice of a claim or will as soon as practicable: "suit' from the additional insured. (1) Give written notice of an occurrence or an 2. Paragraph 4.b. of the Other Insurance Condition is offense to us which may result in a claim deleted and replaced with the following: or "suit" under this insurance; 4. Other Insurance (2) Tender the defense and indemnity of any b. Excess Insurance claim or "suit" to any other insurer which also has insurance for a loss we cover This insurance is excess over any other under this Coverage Part; and insurance naming the additional insured (3) Agree to make available any other as an insured whether primary, excess, contingent or or) any other basis unless a insurance which the additional insured written contract or written agreement has for a loss we cover under this specifically requires that this insurance be Coverage Part. either primary or. primary and -1h/e- have-no-duty to defend or 'r --mntontributin - --- additional insured under this endorsement G-140331-A (Ed. 01/01) Page 2 of 2