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CERTIFICATE OF LIABILITY INSURANCE (171)CERTIFICATE OF LIA THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONU CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUi REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the the terms and conditions of the policy, certain policies may require an e certificate holder in lieu of such endorsement(s)- PRODUCER Aon Risk services South, Inc. Franklin TN Office 501 Corporate Centre Drive Suite 300 Franklin TN 37067 USA INSURED Malcolm Pirnie, Inc. 44 S. Broadway 15th & 16th Floors white Plains NY 10602 USA Y) DATE(MM/ 2011 BILITY INSURANCE osrzarol ' AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES E A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to Indorsement A statement on this certificate does not confer rights to the CONTACT NAME: PHONE (NC.No.Ext; (866) 283-7122 ? No.: (847) 953-5390 E4MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Lexington insurance company 19437 INSURER B: INSURER C: INSURER D: INSURER E: INSURER F: MBER• OVERAGES CERTIFICATE NUMbtK: 07UU4GD79105 REVISION NU THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as request6 rR TYPE OF INSURANCE INSR WVD POLICY NUMBER p ILWLICY LIMBS GENERAL LIABILITY EACH OCCURRENCE COMMERCIAL GENERAL LIABILITY PREMISES Ea currence CLAIMS-MADE ? OCCUR MED EXP (Any one person) GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRo- LOC JECT AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED ??? O? AUTOS B AUTOS HIRED AUTOS NON-OWNED UMBRELLA UR EXC SS AB CLAIMS-MADE I I I YLEGAJI.r7„ `E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR! PARTNER 1 EXECUTIVE OFFICERIMEMBER EXCLUDED? N/A (Mandatory In NN) If Yes, describe under DEPT PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG BODILY INJURY ( Par person) BODILY INJURY (Per accident) ::J PROPERTY DAMAGE EACH OCCURRENCE AGGREGATE E.L. EACH ACCIDENT E.L. DISEASE-EA EMPLOYEE E.L. DISEASE-POLICY LIMIT A Archit&Eng Prof I U154409vu E."al /vi/coil h liProf & Poll Liab I Annual Aggregate $1,000,( SIR applies per policy ter & tondi}lions DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101. Additional Remarks Schedule, It more space Is required) Re: All Operations of the Named Insured. 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 or longer time periods depending on the jurisdiction of, and reason for, the cancellation. 9 m a 0 0 0 u? r N v O Z w M H m CERTIFICATE HOLDER CANCELLATION W-A City of Clearwater Attn: city clerk P.O. Box 5748 Clearwater FL 33758 USA SHOULD ANY OF THE ASOvE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS- AUTHORIMD REPRESENTATIVE JgC e?iLb? V 1, L ®1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD Attachment to ACORD Certificate for Malcolm Pirnie, 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. 44 S. Broadway 15th & 16th F=loors white Plains NY 10602 USA ADDITIONAL POLICIES INSURER INSURER INSURER INSURER INSURER If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR wVD POLICY NUMBER/ POLICY DESCRIPTION POLICY EFF (MMIDWYYYY) POLICY EXP (MMIDD/YYM LIMITS OTHER X Claims-Made X Professional Liabil X and Contractors IX Pollution Liability Certificate No : 570042675105