CERTIFICATE OF LIABILITY INSURANCE (217) O� CRATE t T)DIYYYY,w
CERTIFICATE II F LIABILITY ANC Page l of 2 04/02/21012
THIS CERTIFICATE IS ISSUED AS A BATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE EKES 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(les)rr ust be endorsed, If SUBROGATION IS WAIVED,subject to
he terns and conditions of the policy,certain policies may require an endorsement.A statermenton this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER CONIACI°
SrNq
Willis of New York„ Inc. ! PHONE �,
c/o 26 Century Blvd. T r�rf 577-945-7378 ��T��. 888-467-2378
P. O4 Box 3015191 t 0A IL .._......._._r. tificat ills-8 cCm
Nashville, IN 37210-5191
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I SI,,RER(S'IA F F0 C,1 NG C0V Ei ACa E. i NA�Cm
iNIS dFEP.A Greenwich insurance Company 1%322-0111
--------------
t LRECk iNS'UAEHi`? American guarantee & Liability insurance 26247-001
Atkins North America, Inc. � ,u
20171 NW 1 7tkx A S INSURERC XL pecialty insurance Company 37885-001
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Miami, FL 33172-2507
NSLUR-a C, Underwriter's at Lloyds 15792-001
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SJP .EI E;
(N.+Uh ESP,E; is
COVERAGES CERTIFICATE NUMBER 176471151 REVISION NUMBER
THIS IS TO CERTIFY TrHT CHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED O.f'THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED NO T WITHSTANDING ANY REQUIREMENT `,TERM OR CONDITION CAP 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 T3 ALL THE TERMS,
EXCLUSIONSAAD CONDITIONS OF SLICH POLICIES.LIMITS SHOWI4 MAY HAVE BEEN REDUCE BY PAID CLAIMS,
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1�sae,.. POLICY EFFP ( PCkll "Y EAP ( L3Wm6T
L1'C{ TYPE OF INSURANCE 1t*1I rffir�YA"'la'Ck POLIPL�t4JMBER a f5'YYY', Cu4 J"s°1°YY'9
A GENERAL LlASiLETy CGG740 0?601 4/1/2012 _ 4/1/2013 EAC ...CCURriC-N E
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TO RENTE
uC.AfiM HI-,!AL,CC.NL ,At LAELIC° e�h fEa occ&ence) F; t3(3P lC
_ M WS MADE X OCOUR, I,VED EXP{Anyone pe°nna is
3H,_000__
Contractual Aiabilit, �;ERSIDNAL&A"§V INi
GENFHAL APGCREGATE ' �e 00 �1�0
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L.A GIaEGATE LIMF,AP.P_3E,.,PER PRC 3C:TS COMPFOP Fa0, a 2 a B EJ'Q 0 0t}
rf f .
ABJ`tCYMOBILELIABILIT'f. .. � 740901701. 4/1/2012 ----. 4/1/2013 r'C,trii',IaL::E'itvG,.£-L!!n�T
A (t.x,Ui_ devil 2#000 006
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X A.tiY A. i T C:� t
BODILY ENJLa�RHV(Per peTzonI '
AL L OWN r0 CC i I llP E
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AUTOS ALIT OS - BODILY i I Jh1'll.1PAb V iq A�
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p P EL A;Tr° L OFhEr
`A,.L10 CPrL"t'f1ir
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LI IB ELLALIAa X Cr,.cJE AUC92434900 4/1/2012 4/1-/2013 FACHOCCURR E 1,000,000
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EXCESS LIAR CLAwAS-MA01' AGGREGATE 1,000,000
C WORKERS COMPENSATION
CWG740541501 /1/201 4./1/2013
AND EMIPLt7YERS LIABILITY Y f�N � --!—�.— .
Ahd`�=�P�'t" f«l...ii F 'w G. F-u wi idc - I r rt c NT
,� -i I,r dux EI EA. HA. ulDEN 1.e D
(a a d 1 rYS i E D rAS AEMP OYE is 1,000,000
_..
ye"Hd� god ( a iP.� je 1,000,000
i�,. .CIS[,.. O:,Ct LItu1" a
D Professional i B080111209P12 4/1/2012 4/1/2013 -$1.00I7.000 Each Claim &
Liability $1.1]070,000 Annual Aggregate
11/1l./19131. Retradate
DrSCRWTIC?N.CAP OPERATIONS LOCATIONS VEHICLES(Aflach Acard 441,Addktcnai Remarks Schedule,if more space is required)
Pe: City of Clearwater.
Effective April 1, 2011, Post, Buckley, Schuh Jernigan, Inc. , d/ /a PEAS&O
officially to .Atkins North Aterica, Inc, f"
Greenwich Insurance Companies Best Rating° A XV lI
American uarantwee, and Liability insurance Company Best Rating A XV
l_XL$geqial,ty Insurance Comcar Beat Ratin AA_ XV
_ -
CERTIFICATE HOLDER CANCELLATION
T r:
_ a
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
i NE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE W' TH THE POLICY PROVISIONS.
City of Clearwater
Engineer of Retard AUTHORIZED REPRESENTATIVE
100 S. Myrtle Avenue if;Engineering - Suite 224
Clearwater, FL 33756
Coll:369 7 5 7171:1424700 Cert:17647051 01988-2010ACORQ CORPORATION.All rights reser ed.
ACORD 2 (2010/05) The AC tRD name and logo are registered marks of AC RD