CERTIFICATE OF LIABILITY INSURANCE (11)ACOORU DATE (MMIDDNYYY)
`? CERTIFICATE OF LIABILITY INSURANCE 6/1/2011 5/25/2010
PRODUCER Lockton Companies, LLC-1 Kansas City THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
444 W. 47th Street, Suite 900 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Kansas City MO 64112-1906 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
(816) 960-9000 ALTER THE COVERAGE AFFORDED BY.THE POLICIES BELOW.
INSURED HDR ENGINEERING, INC.
1013472 8404 INDIAN HILLS DRIVE
OMAHA NE 681144049
INSURERS AFFORDING COVERAGE NAIC #
INSURER A : Hartford Fire Insurance Company 19682
INSURER B : St. Paul Fire and Marine Insurance Co 24767
INSURER C : New Hampshire Insurance Company 23841
INSURER D : Insurance Company of the State of PA 19429
INSURER E : Zurich American Insurance Company 16535
f_nVFRAnPA T-MRIN01 SA THIS aERTIFIGAT? OF?I?tiURANG? Wta NTM I?[,:V.Nall.;.V..l t A WNW KAG: DISC ?WCCN r?C??`S ?I?i
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 ADVL POLICY EFFECTIVE POLICY EXPIRATION
LTR INSRO TYPE OF INSURANCE POLICY NUMBER DATE MMIDD DATE (MMIDD/YY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1 000 000
A X COMMERCIAL GENERAL LIABILITY 37CSEQUO950 6/1/2010 6/1/2011 D
PREMISES (E. AMAGE TO RENccTuED
$ 1,000,000
CLAIMS MADE FRJOCCUR IVIED EXP (Any one person) $ 10 000
X Contractual Liab. PERSONAL & ADV INJURY $ 1'O00'000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000
PRO-
POLICY. X JECT X LOC
A AUTOMOBILE LIABILITY 37CSEQUO951 (AOS) 6/1/2010 6/1/2011 COMBINED SINGLE LIMIT $ 2
000 000
A X ANY AUTO 37CSEQUO952 (HI) 6/1/2010 6/1/2011 (Es awdent) ,
'
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS RE EIVED (Per person) $ ??x)=
X HIRED AUTOS BODILY INJURY
X
NON-OWNED AUTOS
' 1
3
1 O 2010
(Per accident) $ Xx3Cx)=
?
?J 1
J LU PROPERTY DAMAGE
(Per accident) $ XXXXXXX
GARAGE LIABILITY SRVCS DE PT AUTO ONLY - EA ACCIDENT $ XXXXXXX
NOT APPLICABLE LEGS IVE .
ANY AUTO OTHER THAN EA ACC $ XXXXXXX
AUTO ONLY, AGG $ XXXXXXX
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 1,000,000
B EI QK08000912 6/1/2010 6/1/2011 000 000
X OCCUR
CLAIMS MADE AGGREGATE $ 1
(EXCLUDES PROF, LIA 3) XXX
UMBRELLA
F-;-
71 $
3{XXX
7
FORM
DEDUCTIBLE $ XXXXXXX
X RETENTION $ 0 $ XXXXXXX
C WORKERS COMPENSATION AND 3621195 (AOS) 6/1/2010 7/1/2011 X WC STATU- OTH-
EMPLOYERS' LIABILITY IMIT
D YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
N? 3621196 (CA) 6/1/2010 7/1/2011
E.L. EACH ACCIDENT 1,000,000
$
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
E OTHER EOC9260026-03 6/1/2010 6/1/2011 PER CLAIM: $1,000,000. AGG:
ARCHS & ENGS $1,000,000.
PROFESSIONAL
LIABILITY
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE: 2009-2012 CITY OF CLEARWATER - ENGINEER OF RECORD AGREEMENT FOR PROFESSIONAL SERVICES. THE CITY OF CLEARWATER,
FLORIDA ARE NAMED AS ADDITIONAL INSURED ON GENERAL, AUTOMOBILE AND EXCESS LIABILITY AS PER WRITTEN CONTRACT ON A
PRIMARY, NON-CONTRIBUTORY BASIS. WAIVER OF SUBROGATION APPLIES WR RE APPLICABLE BY LAW. SEVERABILITY OF INTERESTS
APPLIES.
f IZ0TICIf:ATF Wnl 111=17 f`All 1 ATInIJ IM33U`)I IMbY801
10609419 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
CITY OF CLEARWATER, FLORIDA DATE THEREOF, THE ISSUING INSURER WILL ftX04 ,fl XXX MAIL 30 DAYS WRITTEN
ATTN: CITY CLERK NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,) tX ,III I )
PO BOX 4748
CLEARWATER FL 33754 ?U4?XiIC?1T??XI?X)1K
AUTHORIZED REPRESS E
ACORD 25 (2009/01) -'a 1988-2009 #CCVtD CORPORATION. All rights reserved
The ACORD name and logo are registered marks of ACORD
For questions regarding this certificate, contact the number Ildled in the'Protlucef section above and specify the client code'HDRINOV.
POLICY NUMBER: 37CSE000950
HARTFORD
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED BY CONTRACT OR AGREEMENT -
OPTION II
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Or Organization(s):
Blanket coverage as required by written contract.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or
organization(s) shown in the Schedule above with whom you agreed in a written contract or written
agreement to provide insurance such as is afforded under this policy, but only with respect to liability
for "bodily injury", "property damage" or "personal and advertising injury" caused by:
1. Your acts or omissions or the acts or omissions of those acting on your behalf:
a. In the performance of your ongoing operations for such additional insured at the project(s) or
location(s) designated in the Schedule;
b. In connection with your premises owned by or rented to you and shown in the Schedule; or
c. In connection with "your work" for the additional insured at the project(s) or location(s)
designated in the Schedule and included within the "products-completed operations hazard", but
only if:
(1). The written contract or agreement requires you to provide such coverage to such additional
insured at the project(s) or location(s) designated in the Schedule; and
(2). This Coverage Part provides coverage for "bodily injury" or "property damage" included within
the "products-completed operations hazard".
2. The acts or omissions of the additional insured in connection with their general supervision of your
.operations at the projects or locations designated in the Schedule.
B. The insurance afforded to these additional insureds applies only:
1. If the "occurrence" or offense takes place subsequent to the execution of such written contract or
written agreement; and
2. While such written contract or written agreement is in force, or until the end of the "policy period",
whichever is earlier.
C. With respect to the insurance afforded to these additional insureds under this endorsement, the
following additional exclusion applies:
This insurance does not apply to "bodily injury", "property damage" or "personal and advertising
injury" arising out of the rendering of or the failure to render any professional architectural,
engineering or surveying services by or for you, including:
1. The preparing, approving, or failing to prepare or approve maps, shop drawings, opinions,
reports, surveys, field orders, change orders, designs or specifications; and
2. Supervisory, inspection, architectural or engineering activities.
Miscellaneous Attachment : M5509
Certificate 1'D : 10609419
D. How Limits Apply To Additional Insureds
The most we will pay on behalf of the additional insured shown in the Schedule is the lesser of:
1. The limits of insurance specified in the written contract or written agreement; or
2. The Limits of Insurance shown in the Declarations.
Such amount shall be a part of and not in addition to Limits of Insurance shown in the Declarations
and described in this Section.
E. Duties Of Additional Insureds In The Event Of Occurrence, Offense, Claim Or Suit
The Duties Condition in Section IV . Conditions is replaced by the following and applies to the
additional insured shown in the Schedule:
1. Notice Of Occurrence Or Offense
The additional insured must see to it that we are notified as soon as practicable of an "occurrence"
or an offense which may result in a claim. To the extent possible, notice should include:
a. How, when and where the "occurrence" or offense took place;
b. The names and addresses of any injured persons and witnesses; and
c. The nature and location of any injury or damage arising out of the "occurrence" or offense.
2. Notice Of Claim
If a claim is made or "suit" is brought against the additional insured, the additional insured must:
a. Immediately record the specifics of the claim or "suit" and the date received; and
b. Notify us as soon as practicable.
The additional insured must see to it that we receive written notice of the claim or "suit" as soon as
practicable.
3. Assistance And Cooperation Of The Insured
The additional insured must:
a. Immediately send us copies of any demands, notices, summonses or legal papers received in
connection with the claim or "suit";
b. Authorize us to obtain records and other information;
c. Cooperate with us in the investigation or settlement of the claim or defense against the "suit";
and
d. Assist us, upon our request, in the enforcement of any right against any person or organization
which may be liable to the insured because of injury or damage to which this insurance may
also apply.
4. Obligations At The Additional Insureds Own Cost
No additional insured will, except at that insured's own cost, voluntarily make a payment, assume
any obligation, or incur any expense, other than for first aid, without our consent.
5. Additional Insureds Other Insurance
If we cover a claim or "suit" under this Coverage Part that may also be covered by other insurance
available to the additional insured, such additional insured must submit such claim or "suit" to the
other insurer for defense and indemnity.
However, this provision does not apply to the extent that you have agreed in a written contract or
written agreement that this insurance is primary and non-contributory with the additional insured's
own insurance.
6. Knowledge Of An Occurrence, Offense, Claim Or Suit
Paragraphs 1. and 2. applies to the additional insured only when such "occurrence", offense, claim
or "suit" is known to:
a. The additional insured that is an individual;
b. Any partner, if the additional insured is a partnership;
c. Any manager, if the additional insured is a limited liability company;
d. Any "executive officer" or insurance manager, if the additional insured is a corporation;
e. Any trustee, if the additional insured is a trust; or
f. Any elected or appointed official, if the additional insured is a political subdivision or public entity.
F. Other Insurance
With respect to insurance provided to the additional insured shown in the Schedule, the Other
Insurance Condition Section IV - Conditions is replaced by the following:
1. Primary Insurance
Miscellaneous Attachment : M5509
Certificate ID : 10609419
a. Primary Insurance When Required By Contract
This insurance is primary if you have agreed in a written contract or written agreement that this
insurance be primary. If other insurance is also primary, we will share with all that other
insurance by the method described in 3. below.
b. Primary And Non-Contributory To Other Insurance When Required By Contract
If you have agreed in a written contract or written agreement that this insurance is primary and
non-contributory with the additional insured's own insurance, this insurance is primary and we
will not seek contribution from that other insurance.
Paragraphs a. and b. do not apply to other insurance to which the additional insured has been added
as an additional insured or to other insurance described in paragraph 2. below.
2. Excess Insurance
This insurance is excess over any of the other insurance, whether primary, excess, contingent or
on any other basis:
a. Your Work
That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your
work";
b. Premises Rented To You
That is fire, lightning or explosion insurance for premises rented to you or temporarily occupied
by you with permission of the owner;
c. Tenant Liability
That is insurance purchased by you to cover your liability as a tenant for "property damage" to
premises rented to you or temporarily occupied by you with permission of the owner;
d. Aircraft, Auto Or Watercraft
If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent
not subject to Exclusion g. of Section I - Coverage A - Bodily Injury And Property Damage
Liability;
e. Property Damage To Borrowed Equipment Or Use Of Elevators
If the loss arises out of "property damage" to borrowed equipment or the use of elevators to
the extent not subject to Exclusion j. of Section I - Coverage A - Bodily Injury And Property
Damage Liability; or
f. When You Are Added As An Additional Insured To Other Insurance
That is any other insurance available to you covering liability for damages arising out of the
premises or operations, or products and completed operations, for which you have been added
as an additional insured by that insurance.
When this insurance is excess, we will have no duty under Coverages A or B to defend the
insured against any "suit" if any other insurer has a duty to defend the insured against that "suit".
If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's
rights against all those other insurers.
When this insurance is excess over other insurance, we will pay only our share of the amount of
the loss, if any, that exceeds the sum of:
a. The total amount that all such other insurance would pay for the loss in the absence of this
insurance; and
b. The total of all deductible and self-insured amounts under all that other insurance.
We will share the remaining loss, if any, with any other insurance that is not described in this
Excess Insurance provision and was not bought specifically to apply in excess of the Limits of
Insurance shown in the Declarations of this Coverage Part.
3. Method Of Sharing
If all of the other insurance permits contribution by equal shares, we will follow this method also.
Under this approach each insurer contributes equal amounts until it has paid its applicable limit of
insurance or none of the loss remains, whichever comes first.
If any of the other insurance does not permit contribution by equal shares, we will contribute by
limits. Under this method, each insurer's share is based on the ratio of its applicable limit of
insurance to the total applicable limits of insurance of all insurers.
Miscellaneous Attachment : M5509
Certificate ID : 10609419
POLICY NO.37CSE000951 HARTFORD
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED AND
RIGHTS OF RECOVERY AGAINST OTHERS
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
A. Any person or organization whom you are required by contract to name as additional insured is an
"insured" for LIABILITY COVERAGE but only to the extent that person or organization qualifies as
an "insured" under the WHO IS AN INSURED provision of Section II - LIABILITY COVERAGE.
B. For any person or organization for whom you are required by contract to provide a waiver of
subrogation, the Loss Condition - TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO
US is applicable.
Name of Additional Insured Person(s) of Organization(s):
Blanket coverage as required by written contract.
Miscellaneous Attachment : M6986
Certificate ID : 10609419