CERTIFICATE OF LIABILITY INSURANCE (237)Client#: 6108 GRIMCRA3
AGOI�DTM CERTIFICATE OF LIABILITY INSURANCE ° oiotizo�'
THIS CERtIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CER7IFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATNELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING IN3URER(3), AUTHORIZED
REPRESENTATNE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certiflcate holder is an ADDITIONAL INSURED, the po8cy(les) muat be endorsed. ff SUBROGATION IS WANED, subject to
the tertns and condRions of the poHcy, certain poUcies may requlre an endorsement. A statement on this certiflcate does not confer �Igh� to the
certiflcate holder in Ileu of such endorsement(sl.
SunCoast Insurance, div of USI
P.O. Box 22668
Tampa, FL 33622-2668
813 289-5200
INSURED
Grimail Crawford, Inc.
4600 W. Cypress St., Suite 550
Tampa, FL 33607
COVERAGES
CERTIFICATE NUMBER:
813 289-5200
INSURER B : XL
INSURER D :
INSURER E :
AFFORDING COVERAGE
REVtS10N NUMBeR:
813 289-4561
NAIC AF
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LiSTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PER10D
fNDICATED. 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. LIMRS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TYPE OF INSURANCE POLICY EFF POLICY EXP
POLICY NUMBER MM/D MMID UMITS
A C'�E� ��� X 6805280L540 10/14/2012 10/1 M207 EACH OCCURRENCE s2 000 000
X COMMERCIAL GENERAL LIABILITY pREM 3E3 Ea ocwirenoa Si �O OOO
CUUMS-MADE �X OCCUR MED EXP (My one pe�son) S� O�OOO
�RSOwLL & aoV InuURY S2 OOO,OOO
GENERAL AGGREGATE S�i�OOO�OOO
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCT3 - COMP/OP AGG S�L�OOO OOO
POLICY X �a LOC i
/\ AUTOMOBILE W181L(fY )( X BA220M63� /2011 11/30/201 �MBIPIEO SINGLE LIMIT
X nrrv nuro
�� ��� E1 000 000
BODIIY INJURY (Per person) S
ALL OWNED AUTOS BODILY INJURY (Per acadent) E
SCHEDULED AUTOS OC 1 O�� �� pRppER7y pqMqGE
X HIREO AUTOS (Per acddent) S
X NON-0WNEDAUTOS 0����14'47. 1� �S �� f
S CS D��' a
�MBRE�U UAB ���R EACH OCCURRENCE f
EXCE38 LIAB GAIMS-MADE AGGREGATE E
DEDUCTI84E g
R TI f
WORKERS COMPENSATION WC STATU- OTH-
AND EMPLOYER8' WIBILITY Y I N
ANY PROPRIETORIPARTNERIEXECUTIVE
E.L. EACH ACCIDENT S
OFFICER/MEMBER EXCLUDEO? WA
(Mandatary In NH) E.L. DISEASE - EA EMPLOYEE S
Ifyes desciitie under
DESCRIPTI OF OPERATIONS bebw E.L. DISEASE - POUCY UMIT S
B Professional bPR9701929 5/29/2012 05/29/201 52,000,000 per claim
Liabfli S2 000,000 annl a r.
DESCRIPTION OF OPERATWNS / LOCA710N8 / VEHICLES (Adsch ACORD 101, Addilbnal Remarks 8chedule, N more speea la roqulrod)
Professional Liability coverage is written on a claims-made and reported basis.
RE: Engineer of Record RFQ16-92. The City of Clearwater is an Additional Insured as respects the Commercial
(See Attached Descriptions)
City of Clearvvater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Art11' Cltj/ CI@r1C THE EXP�R/►TION DATE THEREOF, NOTICE WILL BE DELNERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 4748
Clearwater, FL 33%SS-4%4� AUTHORI�D REPRESENTATNE
OLA� n,. 0�-ot.. ,C��•---.
01988-2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009/09) 1 of 2 ;fie ACORD name and Iogo are registered marks of ACORD
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