CERTIFICATE OF LIABILITY INSURANCE (247) mDIYYYY)
4`c okra® CERTIFICATE OF LIABILITY INSURANCE o1/D2/2U13( m/3
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
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certificate holder in lieu of such endorsement(s).
AN ME AX-7
Aon Risk services Northeast, Inc,
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!Boston MA Office 4A .No.Ext): (866) 283-7 FA
Na (847) 953-5390 0
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one Federal Street 0
Boston MA 02110 USA AoDREE5!
--------------------
INSURER(S)AFFORDING COVERAGE NAIC#
INSURED INSURER A: Lloyd's of London 0005FI
CDM Smith Inc. —
ONE CAMBRIDGE PLACE INSURER FL Zurich American ins Co 16535
50 HAMPSHIRE STREET 1NINURtR r:
CAMBRIDGE MA 021390000 USA IN
"14URER
INSURER F',
COVERAGES CERTIFICATE NUMBER:570048734768 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. Limits shown are as requested
--------—-------
ADDE SU13H P%' TF "LICY FXP
I
LTR rTPE OF ft'51AANCE 1421LICY NUMBER V YYY WINNEWYYY LIKIS
GtHERAL lJAa%JTY EA0i0WrJRF*WE $2,000,000
COMMERCIAL GENERAL LIABILITY aMAAJG E TO K HT ED $300,000,
CLAIMS'-PAAUE F" ICQAi MED EXP(Anyone person) $10,000
PERSONAL&ADV INJURY $2,000,000 10
GENrRAI,AQCIFGOATE T4,000,000
$4,000,0
41tllft AUGHEl.'�ATt I-IMH APPOITS PLR, PHimucl S-c mpjrA,A6C. 00
ti
POLICY X LOC 0
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AUTOMOBILE IJAWOT'Y BAP 8376631-17 crmRmv 5'Notz, $2,000,000
71 ANY AUTO BODILY INJURY(Per person) 0
z
�ALL OWNED 19111111-DULED BODILY INJURY(Per accident)
ALI I OS Atil OR,
X HIRED AUTOS 1,00,w,-UHNED
T S "T AVIOS
X
UMBRELLA 41A OCCUR LACH OC L)
CJRRLNCL
EXCESS Lim H a,,A11m-,k1AoE
ULU I=�IETLTIirpor,4
8 WoRKERs rampfNsAmN Af4r, wc837663318 7-17777M 77707797M WC TATU-
TORY LIMIT 8H
FWtDyE;R$!LFA811,17y
ANY ffiAAfNF-A r i0u'Awl! $1,000,000
OFIFIr."PMEMSER E901 U00YI N NIA
(mandatory In NH) FlAPI,Q`YFF, $1,000,000
If in
s,describe under 00-0,000
DESCRIPTION OF OPERATIONS below
A J� Archit&Eng Pro QC1301367 1/01/20141per claim/aggregate—55,00 0
aggregate $3,000,000
`cf77 it
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD I41,Additional Remarks Schedule,If More space Is required) .0-L
Pro Utt Name, City of Clear water Reverse osmosis Plant I EXpanSinon. city rAi D9-0010-Lrr, city,of clear water is added as an
S IF Subrogation is qrani:ed in favor of
additional insured in regards L y 1
pards to general liability and auto lability, A Waiver 0
Certificate Holder as required by written contract but limited to th e operations of the Insured under said contract, with
respect to the General Liability, Automobile Liability policie.5. General Liability poli cy evidenced herein is primary to other
insurance available to an additional insured, but only to the extent required by written contract with the insured. XCU
Cqveraqe and contractual Liability are included under the General Liability policy where required by written contract. cross
Liability/severability of Interest is included under the General Liability policy where required by written contract.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE----b=
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE 7
POLICY PRQWSIONS.
City of Clear Water Nil HORII.Erl)REPRESENTATIVE -
Attn: city clerk
P.O. Box 4748
Clearwater FL 33758-4748 USA
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01988-2010 ACORD CORPORATION.All rights reserved.
ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER 10: 1051 8329
Arc IDR& LOC
ADDITIONAL REMARKS SCHEDULE
!SEW,M - _ Page 1 of 1
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A00 Risk Services Northeast, Inc, CEM Stilith Inc.
See Certificate Number: 57004643601
S;ee Certificate Number: 57004684&601 EFFECTt`sE C4TE;
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ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: ACORD 2.5 FORM TITLE: r;c tificat of LiaLility lns eranci
.a_
ti3dilwnel Dnsrn�nor•of Opemtbns P Locations i Veh+crier — _._. ....._.-. __
of r Caen T I l r da c�ttt= , ail l a r1te' i3 f r ,Public 001dies offiCers emplo°�,reu ..
01�wnter re re�ent0 i e are ag r��s, but iarOY tO the extent r�E�uiltd �y° written c��ntract k��t� the i¢tsuwed�
±. ?rs �Lt f'f�7 rP�,t°r�9'8 ?� �'r40ted ifl favor OF The C tks of Cle:orrmvRr 't-s,—aJ�'r 1tb c-unci". t-C'C:' }3a7it?k6Rity
Redevelopment A'4er'�--y Of t'le i, V of C70aMAter, A F o'ri�j r s r r
Chapter 1 • 1"104 da Stattje, i a off' Ablf.ic b ie r4by ice• t r �, e�i:nt r Marti T�It
5 suty a PirCed officers or c�€i0 iaQd� �, offic i"�s employees, volunteers,
r'el)resenta,tives and a ents as r4aqul,rgd by weitten cuntr ct 11vt limited to 00 oper-atiins of tray insured under
said contract, wiiji r'espert to the !General Liabajity and AUmo ojile Liability P61iciesl
i
i
I
ACORD 101 (2008101) O 200E ACORD CORPORATION,All rights reserved.
The ACORD name and logo are registered marks of ACORD