CERTIFICATE OF LIABILITY INSURANCE (12)ACVRD" DATE (MM/DD(YYYY)
PRODUCER CERTIFICATE OF LIABILITY INSURANCE 6/]/201] 5//25/2010
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.
INSURERS AFFORDING COVERAGE NAIL #
INSURED HDR ENGINEERING, INC.
1013472 ATTN: LOUIS J
PACHMAN
wsURERA: Hartford Fire Insurance Company
19682
.
8404 INDIAN HILLS DRIVE INSURER B St. Paul Fire and Marine Insurance Co 24767
OMAHA, NE 68114-4049
TAMPA/ INSURER C : New Hampshire Insurance Company 23841
JOHN HILBERT INSURER D : Insurance Company of the State of PA 19429
COVERAGES HDR1N01 SA T INSURER E : Zurich American Insurance Company
HIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT 16535
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u - r nc rvuI, r rcrctvU INI I tO. NU I WITHSTANDING
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
POI ICIFR ArrRFr ATF I IRAITC cuniNAl ¦AAW u
INSR
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INSP.D
TYPE OF INSURANCE - --- _ __
POLICY NUMBER V POLICY EFFECTIVE
DATE (MM/DD/YY POLICY EXPIRATION
) DATE (MM/DD/YY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ ] 00Q 000
A X COMMERCIAL GENERAL LIABILITY 37CSEQUO950 6/1/2010 6/l/2011 DAMAGE TO RENTED
PREMISES Ea occurence $ 1 000,000
CLAIMS MADE L?aj OCCUR MED EXP (Any one person) $ 10,000
X Contractual Liab.
PERSO
NAL & Al INJURY $ 1 000 000
GENE
RAL AGGREGATE $ 2,0W000
GEN'L AGGREGATE LIMIT APPLIES PER
PRODUCTS
COMP/OP AGG
2 00
PRO- - $
0 000
POLICY X JECT X LOC
A AU TOMOBILE LIABILITY 37CSEQU0951 (AOS) All
6/1/2011
A
i
X
ANY AUTO
37CSEQL095. (1-.-11
vi/2010
6/1/2011 COMBINED SINGLE LIMIT
(Ea accident)
$ 2,000,000
ALL OWNED AUTOS
'....
SCHEDULED AUTOS BODILY INJURY
(Per person) $ XXXXXXX
X HIRED AUTOS
X
NON-OWNED AUTOS BODILY INJURY
(Per accident)
$ XXXXXXX
PROPERTY DAMAGE $ XXXXXXX
(Per accident)
GARAGE LIABILITY
NOT APPLICABLE' AUTO ONLY - EA ACCIDENT $ XXXXXXX
ANY AUTO OTHER THAN _ EA ACC $ XXXXXXX
AUTO ONLY. AGG $ XXXXXXX
B EXCESS/UMBRELLA LIABILITY
QK08000912
6/1/2090
EACH OCCURRENCE
$
1,000,000
X OCCUR EICLAIMS MADE - 6/l,?Dl1 __
(EXCLUDES PROF
LIAR) AGGREGATE $ 1,000,000
X UMBRELLA . $ XXXXXXX
DEDUCTIBLE FORM
X RETENTION $ 0 $ XXXXXXX
C
' WORKERS COMPENSATION AND
' 3621 195 (AOS) 6/1 /2010 7/1/2011 WC STATU- OTH-
X
...... D EMPLOYERS
LIABILITY Y / N TORY LIMITS ER
ANY PROPRIETOR/PARTNER/EXECUTIVE 3621196 (CA) 6/1/2010 7/1/2011
]
000
00
OFFICER/MEMBER EXCLUDED? E.L. EACH ACCIDENT $
,
,
0
(Mandatory in NH)
If yes, describe under
SPECIA E.L. DISEASE - EA EMPLOYEE $ 1,000,000
-
E L PROVISIONS below
OTHER
E.L. DISEASE - POLICY LIMIT $ 1,000,000
ARC] IS & ENGS EOC9260026-03 6/1/2010 6/1/2011 PER CLAIM: $1,000,000. AGG:
PROFESSIONAL $1,000-000_
LIABILITY
DESC RIPTION hF
CITY OF CLEARWATER, FLORIDA IS ADDITIONAL INSURED AS RESPECTS GENERAL LIABILITY AND AUTOMOBILE LIABILITY.
310118
CITY OF CLEARWATER
PO BOX 4748
CLEARWATER FL 34618
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL 06Xe0, )TX MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ]Il(19XA[L111W'40[ WKSOMMOYN
AUTHORIZED
ACORD 25 (2009(01) -(D-1988-2009 D CORPORATION. All rights reserved
The ACORD name and logo are registered marks of ACORD
For questions regarding this certificate, contact the number listed in the 'Producer' section above and specify the client code'HDRIN01'.