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CERTIFICATE OF LIABILITY INSURANCE (239)Client#: 6108 GRIMCRA3 ACORD� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYY1� 10/15/2012 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 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 p`� NAME: SunCoast Insurance, div of USI a�" a E,� , 813 289-5200 F�, No ; 813 289-4561 P.O. BOX ZZGGS E-MAIL ADDRESS: Tampa, FL 33622-2668 Ro 813 289-5200 CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Ph0@I11X I11SU�811C@ COIlip811j/ 25623 Grimail Crawford, Inc. 4600 W. Cypress St., Suite 550 �NSUReR B: XL Specialty Insurance Company 37885 INSURER C : Tampa, FL 33607 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFlCATE 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. INSR TypE OF INSURANCE DDL UBR pOLICY NUMBER MM/DD EFF MM/DD �P LIMITS A GENERAL LIABILITY 6805280L540 10/14/207 2 10/14/201 EACH OCCURRENCE $2 0�� DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $� �OOO OOO CLAIMS-MADE � OCCUR MED EXP (Any one person) $� �,�� PERSONAL & 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 11/30/2012 11/30/201 COMBINED SINGLE LIMIT (Ea accident) $� Q�� QO X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS �� BpDILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ X HIREDAUTOS Q�� (Peraccident) $ X NON-OWNED AUTOS $ UMBRELLA LIAB OCCUR p �;°�`�� j �� qp ' �� '�� y��'6u.� EACH OCCURRENCE $ EXCESS LIAB `�"°"� ,'� iJL: o�d+' f�,,� g,/�� j� AGGREGATE $ CLAIMS-MADE 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 5/29/2012 05/29/201 $2,000,000 per claim Liabili $2,000,000 annl a r. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additlonal Remarks Schedule, If more space is required) Professional Liability coverage is written on a claims-made and reported basis. RE: City of Clearwater Engineering of Record City of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE En ineerin De t. St@. 200 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN J� g P ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Susan Chase PO Box 4748 AUTHORIZED REPRESENTATNE Clearwater, FL 33758-4748 pG.i� m pt�..c�L.o ,�---. � 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #S414532/M414523 AGB Client#: 6108 GRIMCRA3 ACORD�, CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYI� 10/15/2012 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 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 � A NAME: SunCoast Insurance, div of USI PHONE g13 289-5200 ac, N, : 813 289-4561 ac No �t : P.O. BOX ZZGGS E-MAIL ADDRESS: Tampa, FL 33622-2668 CUSTOMER ID #: R1� 9RQ.s�nn INSURED Grimail Crawford, Inc. 4600 W. Cypress St., Suite 550 Tampa, FL 33607 INSURER(S) AFFORDING COVERAGE NAIC �F iNSUReRa: Phoenix Insurance Company 25623 �NSUReR 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. INSR TypE OF INSURANCE D UBR pOLICY NUMBER MM/DD EFF MM/DD EXP LIMITS A GENERAL LIABILITY 6805280L540 10/74/2012 10/14/201 EACH OCCURRENCE $Z 0�� 0 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $� OOO OOO CLAIMS-MADE � OCCUR MED EXP (My one person) $� 0,�00 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 11/30/2012 11/30/201 COMBINED SINGLE LIMIT $ ��cccppp � (Ea accident) � 00� �� X ANYAUTO �� W'�,�� BODILYfNJURY(Perperson) $ ALL OWNED AUTOS �� BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ X HIREDAUTOS ��T � � 2�� (Peraccident) X NON-OWNED AUTOS $ r,^ � �,�..��g... $ UMBRELLA LIAB OCCUR ��.��e,�� ^" �' EACH OCCURRENCE $ .,da� �� : � 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 5/29/2012 05/29/201 $2,000,000 per claim Liabilit $2,000 000 annl a r. DESCRIPTION OP OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 701, Additlonal Remarks Schedule, if more space Is required) 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 Attn: City Clerk 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 pL9.Jm �. p�p..ot.� .�•-----. � 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 Of 2 The ACORD name and logo are registered marks of ACORD #S414533/M414523 AGB