CERTIFICATE OF LIABILITY INSURANCE (99)DATE(MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 05/14/2010
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
Aon Risk Services south, Inc.
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.
Franklin TN 37067 USA
PHONE-(866) 283-7122 FAX- (847 953-5390 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Lexington insurance Company 19437 •-
1.
ARCADIS U.S., Inc.
INSURER B-
630 Plaza Dr Ste 200
Highlands Ranch co 80129-2379 USA INSURER C!
INSURER D: ?+
as
INSURER E: p
rnvGn Ar->a c SIR aDDI i es Der terms and conditions of the Dol i cv '?
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 EFFECTR'E POLICY EXPIRATION LIMITS
ATE MM/DDlYYYV DATE MM/DD/YYYY
RAL LIABILITY EACH OCCURRENCE
COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED
- -
- - PREMISES (Ea occurrence)
CLAIMS MADE F
1 OCCUR M.ED F XP (Anv OnO Derson)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGO
PRO-
POLICY
LOC
?
1:1
1:1
JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
ANY AUTO /? N (Ea accidmt)
ALL OWNED AUTOS 1
IZ
EC ¦ ?
, BODILY INJURY
SCHEDULED AU'I OS (Per person)
HIRED AUTOS Ay 4 2010 BODILY INJURY
NON OWNED AUTOS (Pcf accidcnl)
?CIAL
?
( ORDS l'?I'I
R PROPERTY DAMAGE
P K a
cid
nt
?
..
P f
.J'P f S Dt^ )
(
c
e
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT
ANY AUTO
OTHER THAN EA ACC
H AUTO ONLY
AGG
EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE
? OCCUR ? CLAIMS MADE AGGREGATE
DEDUCTIBLE
RETENTION
WC STATU- OTI-1-
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
E.L. L•ACFI ACCIDENT
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/EMBER EXCLUDED?
M
d
t
i
NH E.L. DISEASE-EA EMPLOYEE
(
an
a
ary
n
)
E.L. DISEASE-POLICY LIMIT
If ycs, dcscnbe under SPECIAL PROVISIONS Wow
A 015448990 0610112010 06/01/2011 Each claim $5,000,000
OTHER Prof. & Poll. Liability Annual Aggregate $5,000,000
contractor Poll SIR/Deductible (1) $1,000,000
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE: PHASE I, 1498 S. GREENWOOD AVE. FOR PROFESSIONAL LIABILITY COVERAGE, THE AGGREGATE LIMIT IS THE TOTAL
INSURANCE AVAILABLE FOR CLAIMS PRESENTED WITHIN THE POLICY PERIOD FOR ALL OPERATIONS OF THE INSURED. THE LIMIT
WILL BE REDUCED BY PAYMENTS OF INDEMNITY AND EXPENSE. CANCELLATION PROVISION SHOWN HEREIN IS SUBJECT TO SHORTER
CERTIFICATE BOLDER CANCELLA11ON
CITY OF CLEARWATER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE T HE EXPiRAI'lON
ATTN: CITY CLERK DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
P.O. BOX 4748 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
CLEARWATER FL 33758-4748 USA BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY -
OF ANY KIND UPON THE. INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2009/01) 01988-2009 ACORD CORPORATION. All rights reserved=
The ACORD name and logo are registered marks ofACORD
Attachment to ACORD Certificate for ARCADIS U.S., 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 terns, conditions, coverages or exclusions contained in the policy.
INSURED
ARCADIS U.S., Inc.
630 Plaza Dr Ste 200
Highlands Ranch CO 80129-2379 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
OTHER
El claims-made
r7l Professional Liabil
El and Contractors
El Pollution Liability
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL. PROVISIONS
OR LONGER TIME PERIODS DEPENDING ON THE JURISDICTION OF, AND REASON FOR, THE CANCELLATION.
Certificate No : 570038826949