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CERTIFICATE OF LIABILITY INSURANCE (261)�'`,°R°� CERTIFICATE OF LIABILITY INSURANCE 6/1/2014 DASI24�ZO��) 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 condiUons 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 Lockton Companies, LLC-1 Kansas City • 444 W. 47th Street, Suite 900 ac No EXt : ac No : Kansas City MO 64112-1906 E-MAIL (816) 960-9000 ' INSURED HDR ENGINEERING, INC. 1013472 8404 INDIAN HILLS DRIVE OMAHA NE 68114-4049 : Hartford Fire Insurance Company . St. Paui F've and Marine Insurance Compeny : Sentinel Insurance Company, Ltd • Zurich American Insurance Comi COVERAGES HDRIN01 CERTIFICATE NUMBER: 10609419 REVISION NUMBER: XXXXXX:K THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INS�FRED 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 NUMBER PO�ICY EFF POLICY EXP LIMITS fj GENERAL LIABILITY rJ N 37CSEQU0950 6/1/2013 6/U2014 EACH OCCURRENCE 1 �0� �� DAMAGE TO RENTED 1 OOO OO�� X COMMERCIAL GENERAL LIABILITY � PREMI E a occurren CLAIMS-MADE X� OCCUR � p,� �;� �'� °�� MED EXP M one rson 1 O OOO X Contractual Liab. ��' PERSONAL & ADV INJURY $ 1 OOO OO�,J g�� GENERAL AGGREGATE $ 2 OOO OOU GEN'L AGGREGATE LIMIT APPLIES PER: ��A'� � ��t� i� PRODUCTS - COMP/OP AGG $ 2 OOO OO�� P X E � }� L $ A AUTOMOBILE LIABIUTY N N 37CSEQU09 f4(�S� S�:{ ;� f�� ' Gf.1/2014 Ea aB�NED SINGLE LIMIT $ 2 OOO OO�,J «6 A 37CSE U09 qA��•�, 1,� 6/1/2014 X}(}{](XXX A X ANYAUTO 37MCP�UII�T�°5''�� `+iZ�l�a.,:, �/1/2014 BODILYINJURY(Perperson) $ AUTOS NED AUTOSULED BODILY INJURY (Per axident $ XXXXX}� NONA WNED PROPERTY DAMAGE g XX�(XXXX X HIRED AUTOS X AUTOS Per accident $ ��XXXXX B }{ UMBRELLA LIAB X OCCUR N N ZUP-1OR64084-13-NF 6/1/2013 C/1/2014 EACH OCCURRENCE $ 1 �� EXCESS LIAB CLAIMS-MADE (EXCLUDES PROF. LIAB) AGGREGATE $ I OOO OO�.) DED X RETENTION $O $ XXXXXXX WORKERS COMPENSATION WC STATU- OTH- C AND EMPLOYERS' LIABILITY N 91WEOH1000 AOS) 7/1/2013 7/1/2014 X T RY LIMI 1 Al C ANYPROPRIETORlPARTNEWEXECUTIVE Y�N 91WBOH1760�HI) %II%ZO�3 %IIIZOI4 E.L.EACHACCIDENT $ 1 OOOOO�U OFFICER/MEMBER EXCLUDED? . N❑ N� A (ManAatory in NH) E.L. DISEASE - EA EMPLOYEE 1 OOO OO�� DESCRIPTION OF OPERATIONS below E.L. DISEASE • POLICY LIMIT 1 OOO OOO D ARCHS & ENGS rJ rJ EOC9260026-06 6/1/2013 6/1/2014 PER CLAIM: $1,000,000. AGG: PROFESSIONAL $1,000,000. LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES /(Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: 2009-2012 CITY OF CLEARWATER - ENGINEER OF RECORD AGREEMENT FOR PROFESSIONAL SERVICES. THE CITY OF CLEARWATL=iR, FLORIDA ARE NAMED AS ADDITIONAL INSURED ON GENERAL AUTOMOBILE, AND EXCESS LIABILITY AS PER WRITTEN CONTRACT, ON A PRIMARY, NON-CONTRIBUTORY BASIS. WAIVER OF SUBROCiATION APPLIES WHERE APPLICABLE BY LAW. SEVERABILITY OF INTERESTS APPLIES. CERTIFICATE HOLDER CANCELLATION See Attachments SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10609419 AUTHORIZED REPRESENTATIVE CITY OF CLEARWATER, FLORIDA ATTN: CITY CLERK PO BOX 4748 CLEARWATER FL 33754 ACORD 25 (2010/05) O 9 8-2010 AC ORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 37CSEQU0950 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED --- OWNERS, LESSEES OR CONTRACTORS -- SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: AS PER WRITTEN CONTRACT, ON A PRIMARY, NON-CONTRIBUTORY BASIS (Information required to complete this Schedule, if not shown above, will be shown in the Declarations.) A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "p4,rsonal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operarions for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. 'That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in perfornung operations for a principal as a part of the same project. CG 20 10 07 04 Miscellaneous Attachment : M5509 Certificate ID : 10609419 POLICY NUMBER: 37CSEQU0950 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: ANY PERSON OR ORGANIZATION WITH WHOM YOU HAVE AGREED, THROUGH WRITTEN CONTRACT, AGREEMENT OR PERMIT, EXECUTED PRIOR TO THE LOSS, TO PROVIDE ADDITIONAL INSURED COVERAGE FOR COMPLETED OPERATIONS. Location And Description of Completed Operations: ANY LOCATION WHERE YOU HAVE AGREED, THROUGH WRITTEN CONTRACT, AGREEMENT OR PERMIT, EXECUTED PRIOR TO THE LOSS, TO PROVIDE ADDITIONAL INSURED COVERAGE FOR COMPLETED OPERATIONS. Information required to complete this Schedule, if not shown above will be shown in the Declarations. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products- completed operations hazard". CG 20 37 07 04 Miscellaneous Attachment : M5509 Certificate ID : 10609419 POLICY NO. 37CSEQU0951 HARTFORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED AND RIGHTS OF RECOVERY AGAINST OTHERS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM A. Any person or organization whom you are required by contract to name as additional insured is an "insured" for LIABILITY COVERAGE but only to the extent that person or organization qualifies as an "insured" under the WHO IS AN INSURED provision of Section II - LIABILITY COVERAGE. B. For any person or organization for whom you are required by contract to provide a waiver of subrogation, the Loss Condition - TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US is applicable. Name of Additional Insured Person(s) of Organization(s): Blanket coverage as required by written contract. Hartford Form #HA9913 Miscellaneous Attachment : M6986 Certificate ID : 10609419 ACORLb® CERTIFICATE OF LIABILITY INSURANCE 6/1/2014 L.,�� 6/1/2010 7/3/2013 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 Lockton Companies, LLC -1 Kansas City 444 W. 47th Street, Suite 900 Kansas City MO 64112 -1906 (816) 960-9000 CON NAME CT PHONE IFAX (A/C No Ext): (A/C, No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Hartford Fire Insurance Company 19682 INSURED HDR ENGINEERING, INC. 1013472 8404 INDIAN HILLS DRIVE OMAHA, NE 681144049 INSURER B : St. Paul Fire and Marine Insurance Company 24767 INSURER C : Sentinel Insurance Company, Ltd. 11000 INSURER D : Zurich American Insurance Company 16535 INSURER E : $ 1,000,000, $ 10.000 INSURER F : COVERAGES HDRINO1 CERTIFICATE NUMBER: 11297544 REVISION NUMBER: XXXXXXX 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 INSR SUBR POLICY NUMBER POLICY EFF (POLIC EFF (POLIC EXP POLICY EXP LIMITS A GENERAL X LIABILITY COMMERCIAL GENE BILITY N N 37CSEQUO950 6/1/2013 6/1/2014 EACH OCCURRENCE S 1.000.000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 1,000,000, $ 10.000 CLAIMS -MADE OCCUR MED EXP (Any one person) X Contractual Liab. PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2.000.000 PRODUCTS - COMP /OP AGG $ 2. 000.000 GEN'L AGGREGATE 7 POLICY X LIMIT APPLIES FM X PER: LOC $ A A A AUTOMOBILE — X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _AUTOS SCHEDULED AUTOS NON - OWNED N N 37CSE%U0951 (AOS) 37CSE U0952 (HD ( 37MCP U1160 (MA) 6/1/2013 6/1/2013 6/1/2013 6/1/2014 6/1/2014 6/1/2014 COMBINED SINGLE LIMIT (Ea accident) $ 2.000.000 $ XXXXXXX BODILY $ XXXXXXX $ XXXXXXX BODILY INJURY (Per accident) PROPERTY DAMAGE (Per acnidantl $ XXXXXXX B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE N N ZUP- 10R64084 -13 -NF (EXCLUDES PROF. LIAB) 6/1/2013 6/1/2014 EACH OCCURRENCE $ 1 000 000 AGGREGATE $ 1.000.000 DED X RETENT ON $ $0 $ XXXXXXX C C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? N (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A N 91WEOH1000 AOS) 9IWBOH1760(HI) 7/1/2013 7/1/2013 7/1/2014 7/1/2014 X WC STATU- I TORY LIMIT OTH- ER E.L. EACH ACCIDENT $ 1.000.000 $ 1,000,000 E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ 1.000.000 D ARCHS & ENGS PROFESSIONAL LIABILITY N N E0C9260026 -06 6/1/2013 6/1/2014 PER CLAIM: $1,000,000. AGG: $1,000,000. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: CITY OF CLEARWATER, 2009 ENGINEER OF RECORD. 4. ?; n CERTIFICATE HOLDER CANCELLATION 11297544 CITY OF CLEARWATER P.O. BOX 4748 CLEARWATER FL 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 ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 1988-2010 CORPORATION. All rights reserved