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CERTIFICATE OF LIABILITY INSURANCE (219)Client#: 6108 GRIMCRA3 ACORDTM CERTIFICATE OF LIABILITY INSURANCE Dg�14/ 012� THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATNELY OR NEGATNELY 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), AUTHORI2ED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAI 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(s). PRODUCER NAME: USI/Suncoast-Tampa PHONE g13 289-5200 ,vc wo �s : ac, No : 813 289-4561 P.O. BOX ZZ6GS ADDRES3: Tampa, FL 33622-2668 CUSTOMERIDN: 813 289-5200 INSURER(8) AFFORDING COVERAGE NAIC # INSURED Grimail Crawford, Inc. 4600 W. Cypress St., Suite 550 Tampa, FL 33607 �NSUReRa: Phoenix Insurance Company iNSUr�R s: XL Specialty Insurance Company INSURER C : INSURER D : ' IN3URER E : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. IN D L U R OLICY EFF POLICY EXP 7 TYPE OP INSURANCE pOL MIDD MMIDD LIMRS A GENERAL LIABILITY 6805280 ..... ON4/2011 10/14/201 EACH OCCURRENCE S� �� X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurtence 3� �OOO�OOO CLAIMSMADE �X OCCUR A�� 1� 2p� MED EXP (My one person) E'I O,OOO PERSONAL & ADV INJURY S2�OOO�OOO y� �94'� ��~�j GENERALAGGREGATE 54�000,000 �w'��If�.. �� t�� GEN'L AGGREGATE LIMFT APPLIES PER: �±,pB � A �� i1 ��i"+ PRODUCTS - COMPfOP AGG $�L�OOO�OOO POLtCY PRa LOC �V13L:�� SC�� j g /� AUTOMOBILE LIABILITV BA220M6366 11/30/2011 11/30/201 COMBINED SINGLE LIMIT X ANY AUTO (Ea accidenl) $� �00 000 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per axident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ X HIRED AUTOS (Per accident) X NON-0WNEDAUTOS $ $ UMBRELLA LIAB pCCUR EACH OCCURRENCE �� EXCE33 LIAB CWMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION � $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBEREXCLUDEDI � N�A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTiON OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S B Professional DPR9701929 5/29/2012 05/29/201 a2,000,000 per claim Liabili 52,000,000 annl a r. DESCRIPTION OF OPERATION81 LOCATIONS / VEHICLES (Atfach ACORD 107, Additional Remarks Schedule, it more space is requlred) RE: Engineer of Record RFQ16-12. The City of Clearwater is an Additional Insured as respects the Commercial General Liability policy where required by a written contract prior to a loss per policy terms and conditions. Professional Liability coverage is written on a claims-made and reported basis. City of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn: Ci Clerk THE EXPIRATION DATE TNEREOF, NOTICE WILL BE DELIVERED IN tY ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 4748 Clearwater, FL 33758-4748 AUTHORIZED REPRESENTATIVE � OL9�' �n p�¢.e[.o .�..�--- �1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #S401506/M387097 JMB Client#:6108 GRIMCRA3 E("""D ACORD- CERTIFICATE OF LIABILITY INSURANCE =OT 3 013 ,51 0, 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 POLACIES BELOW,THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BErWEEN THE ISSUING INSU RER(S),AUTHORIZED REPRESENTA'nVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMP CtITANT-,tr the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to ffie terms and conditions of the policy,certain poUcies may require an endor'-semant,A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s), PRODUCER NAPE M, Sun Coast Insurance,div of US I PAONP Ac.Na E,,813 321-7500 813 321-7525 1715 N.Westishore Blvd.#700 E-MAIL ADDRESS: Tampa,FL 33607 813 321.7500 INSURERS AFFORDING COVERAGE r4AJC# INSURED INSUPER A Phoenix Insurance Company 25623 Grimall Craw1ord,Inc. liqsup.�R 0 Everest National Insurance Comp 10120 4600 W.Cypress St.,Suite 550 INSURER C; Tampa,FL 33607 NSURERD: INSURER E; WSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: TIHIS I STOCEFATIFYTHAT THE PO?I GIES OF 0,01,PANCE ISTf i BELOW HAVE BEEN ISSUIM�TO THE INISUREC,NAMED ABOVE THE iPOLCY FERIOD fNDiC,xTE[a NiCTIVITHSTAN'DING a.tt REQU REMEN'T.T-E-11�A1 CR'f CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WNTH RESPECT TOWFliCH TKS CERTIF"CATE MAY BE SSUEDD.R'VIA'(PER-AIN.THE INSURANCE AfFl"011DED BY THE POLICIES DESC'q BED HEREIN IS ISUBJECT TO A!I T-17 TERMS, ECXICLOSIONS AND CONDJ71ONS OFS1_IC",I-1 POLICIES,LltK'S�_HOV,'N IthAY HA,' E BEEJ REDUCED BY PAID Dj J 'U FIC PV Ic 'F_ Y EXP Trr 71PE OF INSURANCE _N81f WV a POUCY NVIVEEA IM amy.Ury,111 I"MCIUS'rlyyyy) LIWTS A GENERAL UAWLITY X X '6805284L540 I Oil 4j2l[112110,1141`2013 -Acriocc,;rAENCE s2,000.000 X 150 MMF R0-A;,GEN ERA:_1jA_Pi'_i TV PRV'1';SZS 16�DDGUff'=Q� 181,000,000 IAED EX''ARY Dne -MADE Xi � 71 000 BEN Alqo_019�0__ GE,N1 AGGASGATF I-IM f AP P Li r S P=P- PRODUC73- 00 AGG S4,0 ,ODO P'c iw A AUTOMOBILE LlAil_7Y X X BA220M6366 'VA =r363 2012 11 Wj'201� COMBINED SINGLE LIMIT A 11.000�000 X ANY.A'J-C IS ALL DIVNED AIJ7QS SC_'WED_1LEDAJ70S PROPEA7�DAMAGE k Jt ' HIRED AUT e%% (Par aoddemf X NrONoW'NED AUTOS UMORELLA LIAD EXCESS IJAB LatdF, 1L<E Tr 9 ----------------- S WORKERS COMPENSATION AND EMFLOYE HVLJAB�Ul, Af,1Y CIP",;PART Ni,_,;'�_XEG J K1, L Al"I"CIP W, 1, A LA f"MR-C"f, 8 Protessional 79AE002030131 05129/2013�05/2i,2C�l 4; j2,500,000 per claim I Liabifl!y $2,000,000 an R q tv Professional Liability coverage is written on a claims-made and reported basis. RE:City of Clearwater Engineering of Record CERTIFICATE HOLDER CANCELLATION City of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPRATION DATE THCHEOF,NOTICE WILL BE DELIVERED IN Engineering Dept.Ste.200 ACCORDANCE WITH THE POLiCY PROVISIONS. Attn:Susan Chase PO Box 4748 A UTH,OFUME D RE,Pq F S E K17,%,-n VE, Clearwater,FL 33758.4748 V—SQA' 'Ift A01— 0 1 9884OU9 ACORD CORPORATION.All rights reserved. ACORD 25(2009/09) 1 oft The ACORD name and logo are registered marks of ACORD #S.47653511`,11476522 MRL