CERTIFICATE OF LIABILITY INSURANCE (11)� �
�
August 27, 2012
To Whom It May Concern:
M arsh Risk & Insuran cs Ser�icss
345 California Strest, Suits 1300
San Frandsco, CA 94104-2679
Califomia insurance Licenss #0437153
888-769-3873
urs. rsnewalcerts�CDmarsh.com
www.marsh.com
�:
? ..� ��
SEP 0 4 20i2
C)���C�.�l. R���� ��
L���l�i�ll� S��'�S ���"�
Attached is a Certificate of Tnsurance which provides evidence of the current insurance
policies in place for URS Corporation for the period 5/1/2011 to 11/1/2012. Marsh will issue
another Certificate of Insurance evidencing Insurance co�erage for the
11/1/2012 renewal term in the near future.
If you have any questions, please do not hesitate to contact us between 7AM - 6PM (P5T) at
the following:
Telephone : 1-888-769-3873
.!� •t•.- �gl �11= _ •lt
Sincerely:
Marsh Certificate Team
. , �. . , . ,; ,; „� � ,, . �, � � # , i '
� �� CERTIFICATE OF LIABILITY INSURANCE °o�zaizo�°`"""�'
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(s).
PRODUCER CONTACT
MARSH RISK & INSURANCE SERVICES NAME:
345 CALIFORNIA STREET, SUITE 1300 PHONE ac No :
CALIFORNIA LICENSE N0. 0437153 E-MAIL
SAN FRANCISCO, CA 94104 ADDRESS:
URSCOR-ALL-PROF-12-13 Tam FL 16-12 Added
INSURED
URS Corporation Southem
7650 West Courtriey Campbell Causeway
Tampa, FL 33607-1462
COVERAGES
CERTIFICATE NUMBER:
A: Naaonal Union Fire Ins Co Pittsburgh PA
B: Zurich American Insurance Company
�; Illinois National Ins Co
p: Ir�surance Canpany Of The State Of PA
E : Lexington Insurance Company
�. Lloyd's Of London & British Companies
SEA-002270924•09 REVISION NUMBER:18
NAIC ff
9445
23817
19429
19437
15792
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.
INSR TypE OF INSURANCE ADDL SUBR pOLICY NUMBER MMI D�Y� MM%DD�Y ��M�TS
LTR
A GENEpAL LIABILrrv GL4870829 0510112011 11101/2012 EACH OCCURRENCE $ 2,000,000
X COMMERCIAL GENERAL LIABILITY DAMA E T RENTED 1,000,000
PREMISES Ea occurrence $
CIAIMS-MADE � OCCUR MED EXP (M one person) $ 10,000
X XCU, BFPD PERSONAL & ADV INJURY $ 2.000,000
X ConVactual Liability GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000
POLICY X PRO- LOC $
B AUTOMOBILE LIABILITY BAP938521502 ��� Ol l 11101/2012 COMBINED SINGLE LIMIT Z��
Ea acciden�_
X ANY AUTO BODILY �NJURY (Per person) $
ALL OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS AUTOS SEP 0 4 2 i2
HIRED AUTOS NON-OWNED PROPERTY DAMAGE $
AUTOS Per ccident
' $
UMBRELLA LIAB OCCUR �b �:��� ��� ��°g„� EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE L��i��'�� �� � D��' AGGREGATE $
DED RETENTION $
q WORKERS COMPENSATION SEE ATTACHED - ACORD 101 01101I2012 OIIOlI2013 X WC STATU- OTH-
AND EMPLOYERS' LIABILITY
D Y� N SEE ATTACHED - ACORD 101 01/01/2012 01/0112013 2,000,000
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
� OFFICER/MEMBER EXCLUDED? a N�A SEE ATTACHED - ACORD 101 01101I2012 OIIOlI2013 2,000,000
(Mandatory in NH) E.L. DISEASE - EA EMPLOYE $
It yes, describe under 2,000,000
DESCRIPTION OF OPERATIONS below E.L. DISEASE - PO�ICY LIMIT $
E Prof. Liab wlLmtd Cornractual 015438088 0510112011 11l0112012 Each Claim 81,000,000
F Claims Madel Revo 11•17•1938 PE11051501PE1105490 0510112011 1110112012 Aggregate $1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attech ACORD 101, Additional Remarks Schedule, N more apace is requiretl)
RE: Engineer of Recad Agreemen[. RFQ 16-12
The G�eral Liabiliry policy includes a Severability of Interest clause where required by written contract.
City of Clearwater is included as Additional Insured as respects the General Liability and Automobiie Liability policies, where required by written contract.
Such insurance shall be primary insurance with respects to the interest of the additional insured's and any other insurance maintained by the additional insured shall be excess and not contributing with the
insurance required hereunder.
Waiver of Subrogation appiies in fava of the Additional Insured as respects General Liability and Automobile Liability, where required by written contract.
City of Clearwater
Attn: Ciry Clerk
P.O. Box 4748
Clearwater, FL 33758•4748
ACORD 25 (2010/05)
SHOU�D ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
of Marsh Risk & Insurance Services
Lynne Harrington
� 1988-2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
AC ��
�....-�"
AGENCY
MARSH RISK & INSURANCE SERVICES
POLICY NUMBER
CARRIER
AGENCY CUSTOMER ID: URSCOR
LOC #: San Francisco
ADDITIONAL REMARKS SCHEDULE
NAIC CODE
NAMEDINSURED
URS Corporation Southem
7650 West Courtney Campbell Causeway
Tampa, FL 33601-1462
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
POLICY NUMBER: BAP938521502
COMMERCIAL AUTO
CA 20 48 02 99
THIS END4RSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSURED
This end+orsemeni modifies insdirance provided under the following:
BUSINESS AUTO COVERAGE FORM
GARAGE COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
TRIJCKERS COVERAGE FORM
With respect to coverage �xo�ided by this endwsement, the provisions of the Co�erage Form apply unless
modified by lhis endorsemer�t.
This endorsement identifies person(s} or organization{s} who are "insureds° underthe Who Is An Insured Pro�ision
of the Co�erage Form. This endorsement does not alter co�erage pro�ided in the Coverage Form.
This endorsernent changes the policy effective on the inception date of the policy unless another date is indicated
below.
Endorsemerrt Effecti�e: 5/1/2011 Countersigned By:
' �,
�
Named Insured: URS Corporati� Southem
Autha�ized Re resentative
SCHEDULE
Name of F'ersar�(s) ar Organization(s): Any person or organizaiion tn whorn or which you are required to
pro�ide �clditional insured siatus or addiiiar�al insured status on a primary, non-contrihutwy basis, in a writlen
cantract or wriiien agreement executed prior to lass, except where such contract or agreemeni is prohibited by
law.
(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as
applicable to the enda�sement.)
Each persan or organization shown in the Schedule is an "insured" for Liability Coverage, but only io the exierrt that
persan or organization qualities as an °insured" under the Who Is An Insured Pro�isi� contained in Section II of
the Co�erage Form.
This endorsement is executed by the company designated below:
Zurich American Insurance Company
Elfecti�e date 5/1/2011
Issued to: URS Corporation Southem
CA 983 (2-99)
CA 20 48 U2 99 Copyright, Insuran�e Services Office, Inc., 1998 Page 1 of 1
THIS END�RSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ENDORSEMENT #
This endorsement, effective 12:d1 A.M. 51112Q11 forms a part of Policy No. GL487b829
issued to URS Corporation Southem by National Union Fire Ins Co of Pittsburgh PA
ADDITIONAL INSURED- OWNERS, LE5SEE3, OR CONTRACTORS - COMPLETED
ClPERATIONS
Thrs endorsemenf modr`fies rnsurance provicled urrder the fotlowrng:
C�MMERCIAL GENERAL LIABILITY COVERAGE FORM
SCHEDULE
NAAAE OF ADDITIONAL INSURED PERSON OR ORGANIZATION:
WHERE REQUIRED BY WRITTEN CONTRACT ORAGREEMENT
CITY OF CLEARWATER
LOCATION AND DE3CRIPTION OF COMPLETED OPERATIONS:
WHERE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT
RE: ENGWEER OF RECORD AGREEMENT.
ADDITIONAL PREMIUM:
(If No entry appears above, information required to complete this endorsement will be shown in
the Dedarations as applicable to the endorsement.)
SECTION II - WH� IS AN INSURED is amended to include as an insured;
The person or organiza�on shown in the Schedule, but onlywith respect io liability arising out of
"your work° at the location designated and described in the schedule of this endorsement
performed for that additional insured and included in the "products-completed operations hazard".
All other terms and conditions rernain unchanged.
Countersignsd by -� - �°'�'"��
97837 (4/08} Includes copyrighted material of
Insurance Services Office, Inc., with its permission.
THIS END�RSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ENDORSEMENT #
This endorsemeni, effective 12:Q1 A.M. 5/112Q11 forms a part of Policy No. GL487D829
issued to URS Corporation Southem by National Union Fire Ins Co of Pittsburgh PA
ADDITIONAL INSURED- OWNERS, LESSEES, OR CONTRACTORS — SCHEDULED PERSON OR
ORGANIZATION
This enclorsemenf modifies rnsurarrce provided uncler the fo!lowing:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
SCHEDULE
NAAAE OF PERSON OR ORGANIZATIQN:
WHERE REQUIRED BYWRITTEN CONTRACT DRAGREEMENT
CITY OF CLEARWATER
�If no entry appears abo�e, information required to complete this endorsement will be shown in the
declarations as applicable to the endorsement.)
A. SECTION II —WHO IS AN INSURED is amended to indude as an insured;
The person or organization shown in the schedule, but only with respect to liability arising out
of your ongoing operations pertorrned for thai addiiional insured.
B. With respect to the insurance afforded to these additional insureds, SECTION I-
COVERAGES, COVERAGE A- BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2.
— Exclusions, is amended to include the following additional exclusion;
This insurance does not apply to "bodily injury" or "property damage" occurring after:
{1) all work, including materials, parts or equipmentfumished in connection with such work, .
on the project (other than senrice, maintenance or repairs) to be performed by or on
behalf of the additional insured(s) at the site of the correred operations has been
completed; or,
(2) that portion of "your work" out of which the injury or damage arises has been put to its
intended use by any person or organization other than another contractor or subcontractor
engaged in performing operations for a principal as a part of the same project.
All other terms and conditions remain unchanged.
Countersigned by
' � _ ...,�.�,.....�`--
97838 (4/0$) Includes copyrighted material of
Insurance Services Office, Inc., with its permission.
0000688 SP 0279 -001-P00688-I
City of Clearwater
Attn: City Clerk
P.O. Box 4748
Clearwater, FL 33758-4748 �