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CERTIFICATE OF LIABILITY INSURANCE (131) .aco?zo® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1212212009 PRODUCER Aon Ri sk services south, Inc. Aon THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY Franklin TN office AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 501 Corporate Centre Drive CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE Suite 300 COVERAGE AFFORDED BY THE POLICIES BELOW. F kli TN 37067 USA ran n INSURERS AFFORDING COVERAGE NAIC# PHONE-(866) 283-7122 FAX-(847) 953-5390 INSURED INSURERA: Greenwich Insurance company 22322 •• Malcolm Pirnie, Inc. INSURER B: XL specialty Insurance CO 37885 104 Corporate Park Drive white Plains NY 10602 USA INSURERC INSURER D: i, .O INSURER E: p COVF.RAC3F.S SIR applies Der terms and conditions of the DOlicv x 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. LIMITS SHOWN ARE AS REQUESTED INSR ADD' LTR INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE(MM/DD/YYYY DATE(MM/DD/YYYY) A GENERAL LIABILITY GE0001076108 i i i 0110112010 01/01/2011 EACH OCCURRENCE $1,000,000 ' X General L ab l ty COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $1,000,000 PREMISES (Ea occurrence) CLAIMS MADE F1 OCCUR MED EXP Any one person) 10 , 000 PERSONAL & ADV INJURY $1,000,000 ? GENERAL AGGREGATE $2 000 000 ' , , GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $2,000,000 ? POLICY El PRO- LOC JECT B AUTOMOBILE LIABILITY AE0001075808 0110112010 01/01/2011 COMBINED SINGLE LIMIT X ANY AUTO Auto (AOS) (Ea accident) $1,000,000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS ( Per person) X HIRED AUTOS BODILY INJURY X NON OWNED AUTOS (Per accident) PROPERTY DAMAGE P id t ( er acc en ) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT H ANY AUTO OTHER THAN EA ACC AUTO ONLY AGG A EXCESS/ UMBRELLA LIABILITY UE0001075908 0110112010 01 01 2011 EACH OCCURRENCE $10,000,000 b ll X OCCUR ? CLAIMS MADE Um re a AGGREGATE $10,000,000 DEDUCTIBLE RETENTION $10,000 B RWD943528401 01 01 2010 0110112011 X WC STATU- OTH- WORKERS COMPENSATION AND Workers Compensation TORY LIMITS ER EMPLOYERS'LIABILITY Y/N Y E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandator in NH) E.L. DISEASE-EA EMPLOYEE $1,000,000 y E.L. DISEASE-POLICY LIMIT $1,000,000 Ifyes, describe under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Re: All Operations of the Named Insured. If required by written agreement, the certificate Holder is included as additional insured as it pertains to the work or services performed for the certificate holder (except for WC) subject to all terms, exclusions and conditions of such policies. If specifically required by written agreement, m M M Q0 r-I M O O n O Z u O u w a+ i, W W c1 6 lu CERTIFICATE HOLDER CANCELLATION city of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION _ Attn : City clerk DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL PO BOX 5748 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Clearwater FL 337 58 USA BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. - AUTHORIZED REPRESENTATIVE canO?c ?s6ureeD ?t???zzo. ACORD 25 (2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD Attachment to ACORD Certificate for Malcolm Pi rni e , Inc. The terms, conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the coverage afforded by the insurer(s). This attachment does not contain all terms, conditions, coverages or exclusions contained in the policy. INSURED Malcolm Pirnie, Inc. 104 corporate Park Drive white Plains NY 10602 USA INSURER INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LTR ADD'L INSRD TYPE OF INSURANCE POLICY NUMBER POLICY DESCRIPTION POLICY EFFECTIVE DATE POLICY EXPIRATION DATE LIMITS DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS the policies of the Insured will provide for contractual Liability, waiver of subrogation, or separation of Insureds/severability of Interests. If required by written agreement, the WC/EL, General, Auto & umbrella/Excess liability policies of the Insured will be primary and non-contributory with any other insurance as it pertains to the work or services performed for the certificate holder. The "xCU" exclusion has been removed for General Liability insurance. Cancellation provision shown herein may be subject to shorter or longer time periods depending on the jurisdiction of, and reason for, the cancellation. Certificate No : 570037163393