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CERTIFICATE OF LIABILITY INSURANCE (233). - _ : _�_ _-_ -„- - — _ .-._ __ .. -- -- - -=-= -- _ _- — ' � � Client#: 6108 GRIMCRA3 DATE (MM/DD/YYYIn ACORD� CERTIFICATE OF LIABILITY INSURANCE 9,2„20,2___ 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 NAME: SunCoast Insurance, div of USI PHONE g13 289-5200 aC, No : 813 289-4561 A/C No Ext : P.O. BOX ZZGGS E-M IL ADDRESS: Tampa, FL 33622-2668 I$� 3 289-520� CUSTOMER ID #: INSURER(S) AFFORDtNG COVERAGE NAIC # INSURED Grimail Crawford, Inc. 4600 W. Cypress St., Suite 550 Tampa, FL 33607 �NSUReRa: Phoenix Insurance Company 25623 iNSUReR s: XL Specialty Insurance Company 37885 INSURER C : INSURER D : INSURER E : INSURER F : 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. L POLiCY EFF POLICY EXP LIMITS TR TYPE OF INSURANCE POLICY NUMBER MM/DD MM/DD A GENERAL LIABILITY 6805280L540 10/14/2012 10/14/201 EACH OCCURRENCE $Z 0�� X COMMERCIAL GENERAL LIABILITY PREM SES Ea ocou ence $� ,OOO,OOO CLAIMS-MADE � OCCUR MED EXP (My one person) $� �,�0� PERSONAL & ADV INJURY $Z�OOO�OOO GENERAL AGGREGATE $4�000�000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $4�000�000 POLICY PRO- LOC $ A AUTOMOBILE LIABILITY BA220M6366 11/30/2011 11/30/201 COMBINED SINGLE LIMIT (Ea accident) $� 000 �� X ANY AUTO �� BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS �� PROPERTY DAMAGE $ X HIREDAUTOS (Peraccident) X NON-OWNED AUTOS $ �� `�:a a . <c� �s - :...j.;, .. $ � �' „� x.. UMBRELLA LIAB �'i�''a°� E��a "+tT�"g� p� P' EACH OCCURRENCE $ OCCUR �G�,:�J.v.S�-�.. i b" 6:: 't�. t�im� tl�+�: � EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEY � N E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? � N�A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ B Professional DPR9701929 05/29/2012 05/29/201 $2,000,000 per claim Liabilit $2,000,000 annl a r. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is requlred) Professional Liability coverage is written on a claims-made and reported basis. RE: City of Clearwater Engineering of Record City of Clearwater Engineering Dept. Ste. 200 Attn: Susan Chase PO Box 4748 Clearwater, FL 33758-4748 SHOULD 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 �l` � . . _� I�!�I � 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #S410523/M410515 AGB — - ___ _ __ __-- ._ -_- . . - — y Client#: 6108 = _ _ _ ----_ . ' GRIMCRA3 - - ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) -- -_---- - - - 9/21/2012 _ _ . ----- __ ---_ _ __ 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 �s 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 NAME: SunCoast Insurance, div of USI PHONE F ac No ex� :$13 289-5200 ac, No�: 813 289-4561 P.O. BOX 22668 E- L ADDRESS: Tampa, FL 33622-2668 813 289-5200 CUSTOMER ID #: INSURED Grimail Crawford, Inc. 4600 W. Cypress St., Suite 550 Tampa, FL 33607 INSURER(S) AFFORDING COVERAGE NAIC # iNSUReRn: Phoenix Insurance Company 25623 iNSUReR a: XL Specialty Insurance Company 37885 INSURER C : 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. TYPE OF INSURANCE POLICY EFF POLiCY EXP R D POLICY NUMBER MM/DD MM/DD LIMITS A GENERAL LIABILITY 6805280L540 10/14/2012 10/14/201 EACH OCCURRENCE $Z �00 00� X COMMERCIAL GENERAL LIABILITY DA AG TO N ED PREMISES Ea occurrence $� ��0 CLAIMS-MADE � OCCUR MED EXP (Any one person) $� 0��0 PERSONAL 8 ADV INJURY $Z�OOO,OOO GENERALAGGREGATE $4,000�000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $4�000,000 POLICY PR� LOC $ A AUTOMOBILE LIABILITY BA220M6366 11/30/2011 11/30/201 ' COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $1 000 000 BODILY INJURY (Per person) $ ALL OWNED AUTOS � i BODILY INJURY (Per accident) $ �� f.=t� SCHEDULED AUTOS PROPERTY DAMAGE $ X HIRED AUTOS (Per accident) X NON-OWNEDAUTOS 67Qm� �° ��i� $ $ UMBRELLA LIAB OCCUR g4tl �� +':i �a p p EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE ��W �"i: a`yf �_ _„ , ;,,J � � AGGREGATE $ DEDUCTIBLE $ RETENTION g WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y/ N � ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? � N�A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ B Professional DPR9701929 05/29/2012 05/29/201 $2,000,000 per claim Liabili $2,000,000 annl a r. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is requlred) Professional Liability coverage is written on a claims-made and reported basis. RE: Engineer of Record RFQ16-12. The City of Clearwater is an Additional Insured as respects the Commercial (See Attached Descriptions) City of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn: Clt Clerk THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 4748 Clearwater, FL 33758-4748 AUTHORIZED REPRESENTATIVE o� °' � 0��--et.� ,�•----- � 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 2 The ACORD name and logo are registered marks of ACORD #S410524/M410515 AGB