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CERTIFICATE OF LIABILITY INSURANCE (270)Client #: 1048878 METZGWIL2 ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 6/24/2013 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 USI Insurance Services, LLC, 1715 N. Westshore Blvd. Suite 700 Tampa, FL 33607 FIROIACT PHONE (NC, Eat): 813 321 -7500 No); 813 321 -7525 Lo, ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Phoenix Insurance Company 25623 INSURED Metzger & Willard, Inc 8600 Hidden River Parkway Suite 550 Tampa, FL 33637 INSURER B: Travelers Indemnity Company 25658 INSURER C: Travelers Casualty and Surety C 31194 INSURER D : XL Specialty Insurance Company 37885 INSURER E : Travelers Indemnity Co. of Amer 25666 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 INSR SWVD POLICY NUMBER (MM /DDJ (MM /DDY/YYYY) LIMITS A GENERAL X UABIUTY COMMERCIAL GENERAL LIABILITY 6805984L291 `, i 1/291 i - ", _�) , .! .y ° ' ') ... _ 1/01/2013 j +. OCCURRENCE $1,000,000 PEACH PREMI O RENTED �SFEST (Ea occrrence) $1,000,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $10,000 $1,000,000 PERSONAL & ADV INJURY GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES 7 POLICY —1 ECT PER: LOC;�. PRODUCTS - COMP /OP AGG $2,000,000 $ E AUTOMOBILE X X UABIUTY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X _ SCHEDULED AUTOS NON -OWNED AUTOS BA2978L856 S ,;n P5 , - �{�j �,(�,. c) t iWiit,98/4 t f 0/2 01 31 COMBINED SINGLE LIMIT (Ea accident) $1,000, 00 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ B X UMBRELLAUAB EXCESS UAB _ OCCUR CLAIMS -MADE CUP7602Y745 11/01/2012 11/01/2013 EACH OCCURRENCE $1,000,000 $1,000,000 AGGREGATE DED X RETENTION $10000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY yy �/ tN� ANY PROPRIETOR/PARTNE EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/ A UB7602Y628 11/01/2012 11/01/2013 X Wclavi ue TS FORH E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE $500,000 E.L. DISEASE - POLICY LIMIT $500,000 D Professional Liability DPS9708854 06/27/2013 06/27/2014 $1,000,000 per claim $1,000,000 annl aggr. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space s required) Professional Liability is written on a claims made and reported basis. Re: Engineer of Record RFQ #16 -12. CERTIFICATE HOLDER CANCELLATION City of Clearwater Attn: City Clerk P.O. 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 ACORD 25 (2010/05) 1 of 1 #S10345586/M10345563 © 1988-2010 ACORD CORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD AGBEW USI INSURANCE SERVICES CERTIFICATE RETURN MAIL PROCESSING PO BOX 5007 NOVATO, CA 94948 -5007 City of Clearwater Attn: City Clerk P.O. Box 4748 Clearwater, FL 33758 -4748 This page has been left blank intentionally: