CERTIFICATE OF LIABILITY INSURANCE (232)< ri a � � �
August 27, 2012
To Whom It May Concern:
Marsh Risk 8 Insurancs Ser�ices
345 California Street, Suits 1300
San Franasco, CA 94104-2679
California lnsurancs Licenss #0437153
888-7B9-3873
urs.ranswalcsrts�marsh.com
www.marsh.com
� �.
SEP 10 2012
��FIC��1. RDS ��
���l.�itVE SR�+CS DE�'
Attached is a Certificate of Insurance 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 e�idencing Insurance coverage for the
il/1J2012 renewal term in the near future.
If you ha�e any questions, please da not hesitate to contact us between 7AM - 6PM (PST) at
the following:
Teleph one : 1-888-769-3873
-I-, • �e •l-t •1
Sincerely:
Marsh Certificate Team
�....� ..s � , �... . • * ..... *" �.:., :►.... * ' .
�� CERTIFICATE OF LIABILITY INSURANCE D081281201�2�Y�)
O,RO
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 CERTIFlCATE 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. 0431153 E-MAIL
SAN FRANCISCO, CA 94104 ADDRESS:
URSCOR-ALL-PROF-12•13 Tam FL 16-12 Added
INSURED
URS Caporation Soutliem
7650 West Courtr�y Campbell Causeway
Tampa, FL 33607-1462
A: National 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 , Lexing[on Insurance Company
F: Lloyd's Of London & British Companies
9445
6535
19429
19437
15792
COVERAGES CERTIFICATE NUMBER: SEn-o0z27o924-ti REVISION NUMBER:78
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 CONDIT�ON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TH�S
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HERE�N IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR 7ypE OF INSURANCE ADDL SUBR ppLICY NUMBER MMIDD/YYYY MMND/YYYY ��M�TS
LTR
A GENERAL LIABILITY GL4870829 ���� 11/01/2012 Ep,CH OCCURRENCE $ 2,000,000
X DAMAGE TO RENTED 1,000,000
COMMERCIAL GENERAL LIABILIN PREMISES Ea occurrence $
CLAIMS-MADE � OCCUR MED EXP (Any one person) $ 10,000
X XCU,BFPD �Ep ' �01� PEFSONAL&ADVINJURY $ Z�Oi10,000
X ConVactual Liability GENERAL AGGREGATE $ Z�����
GEN'L AGGREGATE LIMIT APPLIES PEF: ������� �D� �o , PRODt1CTS - COMPlOP AGG $ 2,000,000
POLICY X PRO- LOC $
B AUTOMOBILE LIABILITY BAP938521502 I O � 11I01I2012 COMBINED SINGLE LIMIT 2,000,000
Ea ccidenU __ __
X ANY AUTO BOOILY INJURY (Per persun) $
ALL OWNED SCHEDUIED BODILY INJURY (Per accident) $
AUTOS AUTOS
NON-OWNED PROPERTY DAMAGE $
HIRED AUTOS AUTOS Per accident
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION $
/{ WORKERS COMPENSATION SEE ATTACHED • ACORD 101 OIIOlI2012 OIIOlI2013 X WC STATU- OTH-
AND EMPIOYERS' LIABIIITV
p Y� N SEE ATTACHED - ACORD 101 0110112012 0110112013 2,000,000
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
� OFFICER/MEMBER EXCLUDED? � N� A SEE ATTACHED - ACORD 101 OIIOlI2012 01I01I2013 2,000,000
(Mendetory in NH) E.L. DISEASE - EA EMPLOYE $
If yes, describe under 2,000,000
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
E Prof. Liab w/Lmtd CoMractual 015438088 05101/2011 11l0112012 Each Claim 81,000,000
F Claims Madel ReVO 11-t1-1938 PE1105150/PE1105490 05101/2011 11/0112012 Aggregate $1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more spaca is raquired)
RE: Engineer of Record Agreement. RFQ 16-12
The General Liabili[y 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 antl Automobile Liabiliry policies, where required by written corrcract.
Such insurance shall be primary insurance wdh respects to the interest of the adtlitional insured's and any other insurance maintained by the additional insuretl shall be excess and not contributing with the
insurance required hereunder.
Waiver of Subrogation applies in favor of the Additional Insured as respects General Liability and Automobile Liability, where required by written contract.
TE HOLDER
City of Clearwater
Attn: City Clerlc
P.�. Box 4748
Clearwater, FL 33758-4748
ACORD 25 (2010/05)
Ill�li
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVEHED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
of Marsh Risk 8 Insurance Services
ILynne Harrington '�..,;,,,Y)'`.�,
� 1988-2010 ACORD CORPORATION. Ali rights reserved.
The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: URSCOR
lOC #: San Francisco
ADDITIONAL REMARKS SCHEDULE Page 2 of 2
AGENCY NAMEDINSURED
MARSH RISK & INSURANCE SERVICES URS Corporation Southern
7650 West Courtney Campbell Causeway
POLICY NUMBER Tampa, FL 33607-7462
CAHRIER
NAIC CODE
EFFECTIVE DATE:
ACORD 101 (2008/01) � 2008 ACORD CORPORATION. All rights reservecJ.
The ACORD name and logo are registered marks of ACORD
POLICY NUMBER: BAP9385215�2
COMAAERCIAL AUTO
CA 20 48 02 39
THIS ENQQRSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
DESIGNATED INSUREQ
This er�orsement modifies insurance pro�ided under the fdlowing:
BUSINESS AUTO COVERAGE FORM
GARAGE COVERAGE F4RM
MOTOR CARRIER COVERAGE FORM
TRUCKERS COVERAGE FORM
With respect to ca�erage pra�ided by this endorsement, the provisions of the Coverage Form apply unless
modified by this endorsernent.
This end�rsement identiiies person(s) or organization{s) who are "insureds" under the Who Is An Insured Pro�ision
of the Co�erage Form, This endorsement does not alter coverage provided in ihe Co�erage Form.
This endorsement changes the pdicy effeciive on the inception date of the policy unless another date is irxiicated
6elow.
Endarsemerrt Effecti�e: 5/1 /2�11 Countersigned By:
' �.
��
Named Insured: URS Corporation Southern
Authorized R resentative
SCHEDULE
Narne of Person(s) ot- argar�izatian(s): Any persan or organizatiar to wh�m or which you are required io
provide �lditional insured status or additional insured status on a primary, non-contributory basis, in a written
contract or written agreement executed prior to loss, except where such contract or agreemer�t is prohibited by
law.
(If no errtry appears above, information required to complete this endorsement will be shown in the Declarations as
applical�le to the endarsement.}
Each person ar arganization shown in the Schedule is an "insured" for Liability Coverage, but only ta the extent that
person or organization qualifies as an "insured" under the Who Is An Insured Pro�ision contained in Section II of
the Co�erage Forrn.
This endorsement is executed by the company designaied belaw:
Zurich American lnsuran�e Company
Eifectiue dafe 5/1/2011
Issued to: URS Corporation Southern
CA 983 (2-99)
CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1
THI3 ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ENDORSEMENT #
This endorsemerit, effective 12:01 A.M. 511/2d11 forms a part of Policy No. GL4870829
issued to URS Corporatiorr Southem by National Union Fire Ins Co of Pittsburgh PA
ADDITIONAL INSURED- OWNER3, LES3EES, OR CONTRACTORS— COAAPLETED
OPERA,TIONS
This endorsemerrt modifies insurar►ce prov�c�ed under fhe fo!lowing:
COMMERCIAL GENERAL LIABILITY COVERAGE FORIIA
SCHEDULE
NAME DF ADDITIONAL INSURED PERSON OR ORGANIZATION:
WHERE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT
Cin oF C�w�wa�R
LOCATION AND DESCRIPTION OF COMPLETED OPERATIONS:
WHERE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT
RE: ENGNEER OF RECORO AGREEMENT.
ADDITIONAL PREMIUM:
(If No entry appears abo�e, information required to cornplete this endorsement will be shown in
the Dedarations as applicable to the endorsement.)
3ECTION II — WHfJ IS AN INSURED is amended to include as an insured;
The person or organization shown in the Schedule, but onlywith respect to 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 remain unchanged.
Countersigned by — - ��"^�'�
97$37 {4/08} Includes copyrighted material of
Insurance Ser�ices Office, Inc., with its permission.
THIS ENDOR8EMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ENDORSEMENT #
This endorsement, effective 12:01 A.M. 511/2Q11 forms a part of Policy No. GL4870829
issued to URS Corporation Southem by National Union Fire Ins Co of Pitisburgh PA
ADDITIONAL INSURED- �WNERS, LESSEES, OR CONTRACTORS — SCHEDULED PERS�N OR
ORGANIZATION
Thrs endorsemer►f modifres rr►surance provideci ur►der fhe fo!lowing:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
SCHEDULE
NAME OF PERSON OR ORGANIZATION:
WHERE REQUIRED BYWRITTEN CONTRACT ORAGREEMENT
CITY OF CI.EARWATER
{If no entry appears above, infwmalion required to complete this endorsement will be shown in the
Qeclarations as applicable to the endorsement)
A. SECTION II —WHO IS AN INSURED is amended to include as an insured;
The person or organization shown in the schedule, but only with respect to liability arising out
of your ongoing operations performed for that additional insured.
B. With respect to the insurance afforded to these additional insureds, SECTI�N I-
COVERAGES, COVERAGE A- BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2.
— Exclusions, is amended to include the fdlowing additional exclusion;
This insurance does not apply to "bodily injury" or "property damage" occurring after:
(1) all work, including materials, parts or equipmentfurnished in connection with such work,
on the project {other than service, maintenance or repairs) io be performed by or on
behalf of ihe additional insured{s) at the site of the covered operations has been
completed; or,
{2) that portion of "your work" out of which the injury or damag� arises has been put to its
intended use by any person or organization other than another cor�tractor or subcontractor
engaged in performing operalions for a principal as a part of the same project.
All olher terrns and condiiions remain unchanged.
Countersigned by - ����
97838 (4/08) Includes copyrighted material of
Insurance Services Office, Inc., with its permission.
0001240 SP 0279 -001-P01240-I
City of Clearwater
Attn: City Clerk
P.O. Box 4748
Clearwater, FL 33758-4748 �
�