CERTIFICATE OF LIABILITY INSURANCE (9)�''�1
CERTIFICATE OF LIABILITY INSURANCE I �12I3OIZO��YYY)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(sl.
PRODUCER
MARSH RISK & INSURANCE SERVICES
345 CALIFORNIA STREET, SUITE 1300
CALIFORNIA LICENSE N0. 0437153
SAN FRANCISCO, CA 94104
INSURED
URS Corporation
600 Montgomery Street, 26th Floor
San Francisco, CA 94111
E:
National Union Fire Ins Co Pittsburgh PA
Illinois National Ins Co
Insurance Company Of The State O( PA
19445100
23817001
19429100
COVERAGES CERTIFICATE NUMBER: SEA-0o227092a-01 REVISION NUMBER:O
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 CONOITION 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.
�LTR ryPE OF INSURANCE ADDL UBR pOLICY NUMBER MM/ DnYYY MM/DD/YYYY LIMITS
GENERAL LIABILITY
EACH OCCURRENCE $
COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED
PREMISES Ea occurrence $
CLAIMS-MADE � OCCUR MED EXP (M one person) $
*�� �i h P 'b t�
� i �, � } i ' PERSONAL & ADV INJUFY $
� GENERALAGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $
�
POLICY PRO- LOC � �'�! � a $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
Ea accidentl
c�''K'��' �' `' � �� W' �'"�3"'" BODILY INJUHY (Per person) $
ANY AUTO 'aes�'s �1 e�„r`u . . , . � . .
ALLOWNED SCHEDULED A �n«»
AUTOS AUTOS &,�� .�,�:; . , ;',' BODILYINJURY(Peraccident) $
HIRED AUTOS NON-OWNED � PROPERTY DAMAGE $
AUTOS Per accident
$
UMBRELLA LIAB pCCUR EACH OCCURRENCE $
EXCESS lIAB CLAIMS-MADE AGGREGATE $
DED RETENTION $ $
p WORKERS COMPENSATION SEE ATTACHED • ACORD 101 0110112012 01101/2013 X WC STATU- OTH-
AND EMPLOYERS' LIABILITY
� ANY PROPRIETOR/PARTNER/EXECUTIVE Y/ N SEE ATTACHED - ACORD 101 0110112012 Ol/01I2013 2,000,000
OFFICER/MEMBER EXCLUDED? � N� A E.L. EACH ACCIDENT $
� (Mandatory in NH) SEE ATTACHED - ACORD 101 01/01/2012 01101/2013 E.L. DISEASE - EA EMPLOYE $ 2,000,000
It yes, describe under 2,000,000
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Atfaeh ACORD 101, Additional Remarke Schedule, if more space is requiretl)
E: Engineer of Recard Agreemen[.
City of Clearwater
Attn: City Clerk
P.O. Box 4748
Clearwater,FL 33758-4748
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFOHE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
of Marsh Risk & Insurance Services
Lynne Harrington I�,ti,.,_��Yy�.,,,��,,,r,,�,.��;..,,,
m 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
ACORD�
AGENCY
MARSH RISK & INSURANCE SERVICES
POLICY NUMBER
CARRIER
AGENCY CUSTOMER ID: URSCOR
LOC #: San Francisco
ADDITIONAL REMARKS SCHEDULE
NAMEDINSURED
URS Corporation
600 Montgomery Street, 26th Floor
San Francisco, CA 94111
NAIC CODE
EFFECTIVE DATE:
Page 2 of 2
ACORD 101 (2008/01) � 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
� �
December 23, 2011
Dear Certificate Holder:
Marsh Risk & Insurance Services
345 Califomia Street, Suite 1300
San Francisco, CA 94104-2679
California lnsurance License #0437153
88&769-3873
u rs. renewalcerts�marsh.com
www.marsh.cpm
Attached is an updated Certificate of Insurance which evidence URS's Workers Compensation
program effective ]anuary 1, 2012. Upon your review, please note the following:
1. You may aiready have anather C�rtificate on file evidencing URS's other coverages (ie,
other than Workers Compensation). If so, that certificate remains current since these other
coverages have not expired.
2, If you have any questions, please do not hesitate to contact us between 7am - 6pm (PST):
a. Telephone: 1-$88-?69-3873
b. Email: urs.renewalcertsCa�marsh.com
Sincerely,
Marsh Certificate Team
MARSH & MCLENNAN
t.E��SERSH[P, t�iVt'�WtEC��.5OUITIC�VS�...WC1RLCiW3DE. CC�MPANtES
0001102 SP 0414 -COt-P01102-I
City of Clearwater
Attn: City!Clerk
P.O. Box 4748
Clearwater, FL 33758-4748 �