Loading...
CERTIFICATE OF LIABILITY INSURANCE (252) A`°R°® CERTIFICATE OF LIABILITY INSURANCE 4/1/2013Y) 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 CONTACT Jerr NoyOla NAME: y Greyling Insurance Brokerage PHONE (770)552-4225 A/C No: (866)550-4082 No xt,. 450 Northridge Parkway E-MAIL DRESS:Jerry.noyola @greyling.com Suite 102 INSURER(S)AFFORDING COVERAGE NAIC# Atlanta GA 30350 INSURERA:National Union Fire Ins. Co. 19445 INSURED INSURER B:Commerce & Industry Insurance 19410 Kimley-Horn and Associates, Inc. INSURERC:New Hampshire Insurance Company 23841 P.O. Box 33068 INSURER D:Lexin ton Insurance Company 19437 INSURER E: Raleigh NC 27636 INSURER F: COVERAGES CERTIFICATE NUMBER:13-14 (Kimley Sharda) 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY X Y EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 500 000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ A I CLAIMS-MADE FxI OCCUR GL 9645227 4/1/2013 4/1/2014 MED EXP(Any one person) $ 25,000 X Contractual Liability PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X PRO X LOC $ AUTOMOBILE LIABILITY X COMBINED SINGLE LIMIT Ea accident $ 1,000,000 A X ANY AUTO BODILY INJURY(Per person) $ ALL OWN ED SCHEDULED A 4982985 4/1/2013 4/1/2014 BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident X UMBRELLA LAB X OCCUR X Y EACH OCCURRENCE $ 5,000,000 B EXCESS LAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED I X I RETENTION$ 10,000 BE 016395110 4/1/2013 4/1/2014 $ C WORKERS COMPENSATION Y WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N X TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) C 018112556 4/1/2013 4/1/2014 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 D Professional Liability Y 016017332 12/1/2012 4/1/2014 Per Claim $2,000,000 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Re: RFQ 16-12, General Engineering Services; Nizar Jetha. The City of Clearwater is named as an Additional Insured on the above referenced liability policies with the exception of workers compensation & professional liability where required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Clearwater ACCORDANCE WITH THE POLICY PROVISIONS. City Clerk P.O. BOX 4748 AUTHORIZED REPRESENTATIVE Clearwater, FL 33758 David Collings/JERRY Syr ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. IN S025 ommnss m The AenRn name and Innn arc renietererl manta of ArnPn