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CERTIFICATE OF LIABILITY INSURANCE (5)�`` ° "`� CERTIFICATE OF LIABILITY 1NSURANCE °A�`M""�°°"'"Y' ��o,z 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 conditlons of the policy, certain policies may require an endorsement. A statement on this certificate dces not confer NgMs to the certiflcate holder in lieu of such endorsemeM/sl. non Risk services southwest, inc. Houston rx Office 5555 San Felipe Suite 1500 Houston Tx 77056 USA qlSINtED TBE Group, Inc. Cardno TBE 380 PARK PLACE BLVD., SUITE 300 CLEARWATER FL 33579 USA (866) 283-7122 E-M/JL noor�ss: (847) 953-5390 INSURER(S) AFFORDING COVERAGE NAIC t ws�rtn: New Hampshire tns Co 23841 arsu�ree: Chartis Specialty insurance Company 26883 a�surteRC: Commerce & tndustry Ins Co 19410 nrsurtErto: Ironshore Specialty insurance Company 25445 MSURER E: MISUtER F: .. DVEfiAGES CERTIFICATE NUMBER: 570047679461 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 CONDRIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shdwn are as roqusste TYPE OF MSURIWCE POLICY NUMBER LIIARg GENERAL W16LRY PR P EACH OCCURRENCE S1,OOO,OQ X COANdERCULL GENERAL LL4BILRY �E E 3OO , OQ PREN6SES Ea ocwRe ClA1MS-MADE n OCCUR WED EXP (My one pe�son) S1O , OQ GEML ACiGREGATE LIMR APPLIES PER: � POLICY n PR� n LOC AUrOMOBILE LUIBILR1f Auto X ANYAUTO ALLOWNED SCHEDULED AUTOS B AlJlOS X HIREDAUTOS X NON-0WNED ° X UIBRELLA LIAB X OCCUR EXCEES LJAB CWI�-�AADE DED RE7pN710N 510,000 A NIORI�RS COMPENSAiION AND EI�LOYERS• LIABILrtY Y / N ANY PROPRIETOR / PARTNER I IXECUTNE A OFFIC6�MEMBER IXCLUDED4 N N/ A (�M�dNaY k� ►B9 . M res. dsecriba undx D A05 025842892 FL OC� � � 207 ���� �` �V INJURY GENERALAGGREGAiE ^' w� �nR� A 1�1� PRODUCTS - CObP/OP AGG t �1� BODILY INJURY ( Per persm) BOD0.Y IWURY (Per accident) EACH OCCURRENCE AGORECV�TE 09/30/2012109/30/2013 E.L.EACHACCIDENT E.L. DISEASEFA EI�LOYEE E.L. DISEASE�OLICY LIMIT � � `m a c m v � � 0 _ 51,000,000 52,000,000 � 52,000,000 � � � 51,000,000 O 2 � � m SS,000,000 V 55,000,000 51,000,000 SZ�000��� 51,000,000 _ SS,OOD,OOU � includes Pollution Liabil Aggregate SS,OOO,C StR applies per policy ter s& condi ions 5irt 5250,( CWPTION OF OPERATIONS / LOCATIONS / VEHICLES (Apaeh ACORD 707. Additlonal R�marks ScMduN� M mon spau k nqulr�d) . y of Clearwater is listed as additional insured with respect to the �eneral, nuto and Excess �iability policies. waiver of rogation in favor of the additional insured applies to the General, nuto and Excess �iability policies. This insurance is mary and non-contributory over any other insurance maintained by certificate holder. CERTIFICATE HOLDER city of Clearwater attn: City Clerk PO Box 4748 Clearwater FL 33758-4748 Usn ACORD 25 (2010/05) CANCELLATION ... � SNOULD MIY OF T!E ABOVE DESCRIBED PaIC�B BE CANCELLEO BEFORE� �TFE EXPIRATION DATE TIEREOF. NOTICE WLL BE DELNERED !1 AL:CORDANCE WITFI TFE POLICY PROV1510NS. /URHORRED REPRESENTATNE �� �� i i � / �'1888-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Attachment to ACORD Certificate for,-BE �ro�p, �nc. cardno TBE The terms, conditions and provisions noted below aze hereby attached to the captioned certificate as additional description of the coverage afforded by the insurer(s). This attachment does not contain all terms, conditions, coverages or exclusions contained in the policy. INSURED TBE G�OUp, Int. CdrdnO TBE 380 PARK PLACE BLVD., SUITE 300 CLEARWATER F� 33579 USA INSURER INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. IIVSR ADDL SUBR POLiCY NUMBER/ POLICY EFF POLICY EXP LTR TYPE OF PISURANCE IIY3R W VD POLICY DESCRICfIO1V (MM/DD/YYYI� (MM/DD/YYY1� LIINIT3 WORKERS COMPENSATION � N/A wc 025842891 9/30/2012 09 30/2013 wc cn _ OTHER X tncludes Pollution CertiScate No : 570047679461 '� � DATE(MM/DD/YYW) '°`� ° CERTIFICATE OF LIABILITY INSURANCE o9,28,20,2 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 m the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the w certificate holder in lieu of such endorsement(s). c PRODUCER CONTACT � A00 rtisk Services SOUthW25t, I�C. pNNpNE FpX �' HoustOn TX Offi C2 (ac. No. F�ce): �866) 283-7122 (,yC. No. :�847) 953-5390 � 5555 5an Felipe e-Mw� o Suite 1500 ADDRESS: _ Houston rx 77056 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURERA New Hampshi re Ins Co 23841 TBE Group, Inc. Cardno Tse INSURERB: Chdf'tl5 Specialty Insurance Company 26883 380 PARK PLACE BLVD., SUITE 300 CLEARWATER FL 33579 USA �NSURERC: Commerce & Industry Ins Co 19410 iNSUeeRO: Ironshore Specialty insurance Company 25445 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570047679461 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 $Y PAID CLAIMS. Limits shown are as requested LTR TYPE OF INSURANCE INSR NND POLICY NUMBER �p LIMRS B GENERAL LWBILfTY PROP EACH OCCURRENCE Sl, OOO, OOO X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurtence S 300 , 000 CLAIMS-MADE ❑X OCCUR OCT 0 9 20i �D EXP (My one person) $1� � ��� PERSONAL&ADVINJURY $1,000,000 ip GENERALAGGREGATE SZ,OOO,OOO � GEN'L AGGREGATE LIMIT APPLIES PER: °��• `��'" `� `�"�'�✓� /"� `is..> PRODUCTS - COMPIOP AGG S2 , OOO , OOO � POLICY X PRo- LOC ���� �� � � A AUTOMOBILE LWBILRY 3582949 09 30 201 1 COMBINED SINGLE LIMIT � AUtO Ee aceident $1, 000 , 000 .. 7( ANY AUTO � � BODILY INJURY ( Per person) Z ALL OWNED SCHEDULED BODILY INJURY (Per accident) d AUTOS AUTOS PROPERTY DAMAGE � X HIREDAUTOS X NON-0WNED Peraceident � AUTOS � m B X UMBREUAUAB X oCCUR PROU117$1566 09/30/2012 09/30/2013 Ep,CHOCCURRENCE $5,000,000 V EXCESS LIAB CLAIMS-MADE AGGREGATE S 5, OOO , OOO DED RETENTION 510,000 A WORKERSCOMPENSATIONAND wC 025842893 09/30/2012 09/30/2013 WC STATU- OTH- EMPLOYERS' LIABILITY X TORY LIMITS ER ANY PROPRIETOR / PARTNER / EXECUTIVE v� N WC AOS E.L. EACH ACCIDENT S Z� OOO � OOO A OFFICER/MEMBEREXCLUDED7 � NIA wC 025842892 09/30/2012 09/30/2013 (Mandatory in NFQ � WC FL � E.L. DISEASE-EA EMPLOYEE $1, ���, ��� If yes, describe under E.L. DISEASE-POLICY LIMR $1, 000, 000 � DESCRIPTION OF OPERATIONS bebw u Archit&Eng Pro 001181901 10/13/2012 10/13/2013 Each Claim 55,000,000 — includes Pollution Liabil Aggregate 55,000,000 � siR applies per policy ter s& condi ions SIR 5250,000 � DESCRIPTION OF OPERATIONS / LOCATIONS / VEXICLES (Attaeh ACORD 701, Additlonal Rema�lcs Seheduk, H more space is required) �; City of Clearwater is listed as additional insured with respect to the General, Auto and Excess Liability policies. waiver of � subrogation in favor of the additional insured applies to the General, a,uto and Excess Liability policies. This insurance is ,� primary and non-contributory over any other insurance maintained by certificate holder. � de-: �: � J � CERTiFICATE HOLDER CANCELLATION ��..-_ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TXE EXPIRATION DATE THEREOF, NOTICE NIILL BE DELNERED IN ACCORDANCE WfTH THE POLICY PROVISIONS. Clty of Clearwater AUTHpRIZEDREPRESENTATIVE � Attn: City Clerk PO Box 4748 � "�x „�� ������ Clearwater FL 33758-4748 US/+ ��' 01988-2070 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Attachment to ACORD Certificate for TBE �roup, rnc. cardno TBE The terms, conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the coverage afforded by the insurer(s). This attachment does not contain all terms, conditions, coverages or exclusions contained in the policy. INSURED Tse Group, rnc. Cardno TBE 380 PARK PLACE BLVD., SUITE 300 CLEARWATER FL 33579 USA ADDITIONAL POLICIES INSURER INSURER INSURER INSURER INSURER If a policy below does not include limit inforxnation, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR POLICY NUMBER/ POLICY EFF POLICY EXP L� TYPE OF INSURANCE INSR W VD POLICY DESCRIPTION (MM/DD/YYYY) (MM/DD/YYY]7 LIMITS WORKERS COMPENSATION C N/A wc 025842891 9/30/2012 09/30/2013 WC CA OTHER X rncludes Pollution Certificate No : 570047679461 A� �� DAT 09A/28/Y01�) �- CERTIFICATE OF LIABILITY INSURANCE 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, certaln policies may require an endorsemerrt. A statemerN on this certificate does not confer rlghts to the certificate holder in lieu of such endorsement(s). PRODUCER . CONTACT Aon Risk 5ervices Southwest, Inc. Nnh�E: Houston TX Offi ce �pHj�NNo, ���; C866) 283-7122 aC. No.: (847) 953-5390 5555 53� Fel i pe E-MAIL Suite SSOO aoDRESS: Hnuctnn TX 77(15A IIS� �� TBE Group, Inc. Cardno TBE 380 PARK PLACE BLVD., SUITE 300 CLEARWATER FL 33579 USA INSURER A: INSURER B: INSURER C: INSURER D: INSURER E: INSURER F: INSURER�S) AFFORDING COVERAGE New Hampshire Ins Co Chartis Specialty rnsurance Company Commerce & industry Ins Co rronshore Specialty rnsurance Company NAIC # 3841 5445 � � � �. m � .. c m a '�O O _ COVERAGES CERTIFICATE NUMBER: 570047679461 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POL�CY 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 Y HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested LTR TYPE OF INSURANCE INSR NND POLICY NU M�p LIMITS B GENERAL LIABILITY PR�P EACH OCCURRENCE S1, OOO, OOO X COMMERCIALGENERALLIABILITY OCT O� �O�L PREMISES Eaoccurrence 5300,000 CLAIMS-MADE X❑ OCCUR MED EXP (Any one person) $10 , 000 PERSONAL&ADVINJURY $Z,OOO,OOO m �� ����� � ��� , � GENERAL AGGREGATE EZ � OOO, OOO � GEN'L AGGREGATE LIMIT APPLIES PER: e����� �� �`�� �� PRODUCTS-COMP/OPAGG EZ,OOO,OOO g POLICY X PRO- LOC �• 5{ y� Z•-' `S' p r A` AUTOMOBILE LIABILITY 3582949 09 30 2 12 0 0 2 13 COMBINED SINGLE LIMIT El, Op�, p�� � AUtO a ci� nt X ANY AUTO BODILY INJURY ( Per person) Z ALL OWNED SCHEDULED BODILY INJURY (Per axident) m AUTOS �' AUTOS PROPERTY DAMAGE � X HIREDAUTOS X NON-OWNED Peraccident � AUTOS � m B X UMBRELLALIAB X OCCUR PROU117$1566 09/30/2012 09/30/2013 Ep,CH OCCURRENCE $5,000,000 V EXCESS LU1B CLAIMS-MADE AGGREGATE S S, OOO , OOO DED RETENTION E10,000 A WORKERS COMPENSATIONAND wC 025842893 09/30/2012 09/30/2013 WC STATU- OTH- EMPLOYERS' LIABILIT/ X TORY LIMITS ANY PROPRIETOR / PARTNER / EXECUTIVE Y/ N WC AOS E.L. EACH ACCIDENT SZ � OOO � OOO A OFFICER/MEMBEREXCLUDEDI � N/A WC �Z$g42$92 09/30/2012 09/30/2013 (Mandatory in NFq WC FL E.L. DISEASE-EA EMPLOYEE El, 000, OOO Ii yes, describe under E.L. DISEASE-POLICY LIMIT �1, 0�� , �0� � DESCRIPTION OF OPERATIONS below _ � Archit&Eng Prof 001181901 10/13/2012 10/13/2013 Each Claim $5,000,000 rncludes Pollution Liabil Aggregate 55,000,000 � Srrt applies per policy ter s& condi ions SIR E250,000 � DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Alfach ACORD 707, Additional Remarks Sehedule, if more space is required) � City of Clearwater is listed as additional insured with respect to the General, nuto and Excess Liability policies. Waiver of � subrogation in favor of the additional insured applies to the General, Auto and Excess Liability policies. rhis insurance is ,� primary and non-contributory over any other insurance maintained by certificate holder. � t: � � J � CERTIFICATE HOLDER CANCELLATION � SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH TME POLICY PROVISIONS. Clty of Clearwater AUTHORIZED REPRESENTATIVE - Attn: City Clerk PO Box 4748 � "�x _�� ������ Clearwater FL 33758-4748 USn �� ACORD 25 (2070/05) 01988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Attachment to ACORD Certificate for TBE �ro�p, Inc. Cardno TBE The terms, conditions and provisions noted below are hereby attached to the captioned certificate as additional descriprion of the coverage afforded by the insurer(s). This attachment does not contain a11 terms, condirions, coverages or exclusions contained in the policy. INSURED TBE Group, Inc. Cardno TBE 380 PARK PLACE BLVD., SUITE 300 CLEARWATER FL 33579 USA ADDITIONAL POLICIES INSURER INSURER INSURER INSURER INSURER If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR ADDL SUBR POLICY NUMBER/ POLICY EFF POLICY EXP LTR 7'YPEOFINSURANCE [rySR WVD pOLICYDESCRIPTION (MM/DD/YYIY) (MM/DD/YYYY) LIMCfS WORKERS COMPENSATION C N/n wc o258a2s91 9/30/2012 09/30/2013 WC CA OTHER X includes Pollution Certificate No : 570047679461 A` O/T° CERTIFICATE OF LIABILITY INSURANCE DATE(MM /2013YW) 09/12/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. HOLDER. THIS BY THE POLICIES AUTHORIZED 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 AOn Risk Services Southwest, Inc. Houston TX Office 5555 San Felipe Suite 1500 Houston TX 77056 USA CONTACT NAME: PHONE (866) 283 -7122 FAX (A/C. No. Ext): I (NC. No.): (800) 363 -0105 E•MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED TBE Group. Inc. Cardno TBE 380 PARK PLACE BLVD SUITE 300 CLEARWATER FL 33759 USA rnvenw• .....�...- ........__--- - - --- INSURER A: ironshore Specialty Insurance Company 25445 INSURER B: Insurance Co of the State of PA 19429 INSURER C: National Union Fire Ins Co of Pittsburgh 19445 INSURER D: New Hampshire Ins Co 23841 INSURER E: Chartis Specialty Insurance Company 26883 INSURER F: $10,000 • 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. Limits shown are as requested INSR LTR TYPE OF INSURANCE ADDL INSR SUER WVD POLICY NUMBER POLICY EFF MM/DDIYYYY( POLICY EXP IMM/DDmY) LIMITS E GENERAL LIABILITY _ PR0P11781522 j , -- - ': I i- " °` - - 149,y3O/2013 ,_/ L- ' - 09/30/2014 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR PREMISES Ea occurrence) $300, 000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY n PST [1 LOC PRODUCTS - COMP /OP AGG $2,000,000 B C AUTOMOBILE LIABILITY CA 3582949 C - - '', Auto 13-14 (AOS) CA 2714604 Auto 13 -14 (MA) 9N30y2O13 09/30/2013 04/30/2014 09/30/2014 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X — X ANY AUTO BODILY INJURY ( Per person) ALL OWNED AUTOS HIRED AUTOS — _ X — SCHEDULED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) E X UMBRELLALIAB EXCESS LIAR X OCCUR CLAIMS -MADE PROU11781566 09/30/2013 09/30/2014 EACH OCCURRENCE $5,000,000 AGGREGATE S5,000,000 DED I (RETENTION $10 000 D D WORKERS COMPENSATION AND EMPLOYERS' LIABILT, Y/N N / A WC039901297 SIR applies per policy terms wC039901296 SIR applies per policy terms 09/30/2013 & conditions 09/30/2013 & conditions 09/30/2014 09/30/2014 X i WC sTATB I 0TH ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? N E.L. EACH ACCIDENT $1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 A Archit &Eng Prof 001181902 Includes Pollution Liabil SIR applies per policy terms 10/13/2013 & condi-ions 10/13/2014 Each Claim Aggregate SIR $5,000,000: $5,000,0001 $250,000' i DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, I mom space is required) City of Clearwater is listed as additional insured with respect to the General, Auto and Excess Liability policies. waiver of subrogation in favor of the additional insured applies to the General, Auto and Excess Liability policies. This insurance is primary and non - contributory over any other insurance maintained by certificate holder. CERTIFICATE HOLDER CANCELLATION City of Clearwater Attn: city Clerk PO Box 4748 Clearwater FL 33758 -4748 USA 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 sd. c`% : L' t�sZE c.lAfLl�atf[.el7G ✓ s Holder Identifier : 158115 Certificate No : 570051232709 ACORD 25 (2010/05) ©1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORO AGENCY CUSTOMER ID: 570000051836 LOC #: RKS SCHEDULE Page _ of _ AGENCY Aon Risk Services Southwest, Inc. NAMED INSURED TBE Group, Inc. Cardno TBE POLICY NUMBER See Certificate Number: 570051232709 CARRIER See Certificate Number: 570051232709 NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER TYPE OF INSURANCE INSURER SUBR WVD INSURER POLICY EFFECTIVE DATE (MM/DD/YYYY) INSURER LIMITS ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. R LT LT R TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YYYY) POLICY EXPIRATION DATE (MM/DD /YYYY) LIMITS WORKERS COMPENSATION D N/A wc039901295 SIR applies per policy teums 09/30/2013 & conditions 09/30/2014 D N/A wc039901294 SIR applies per policy terms 09/30/2013 & conditions 09/30/2014 D N/A WCO25842892 SIR applies per policy terms 09/30/2013 & conditions 09/30/2014 B N/A WCO25842891 SIR applies per policy teums 09/30/2013 & conditions 09/30/2014 D N/A WC012055045 SIR applies per policy terms 09/30/2013 & conditions 09/30/2014 OTHER EIncludes Pollution ACORD 101 (2008101) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved.