CERTIFICATE OF LIABILITY INSURANCE (271) ACCO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
�,� 6/1/2014 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).
CONCT
PRODUCER Lockton Companies,LLC-I Kansas City NAME
444 W.47th Street,Suite 900 PHONE FAX
Kansas City MO 64112-1906 E MAILo Ext: A/c No
(816)960-9000 ADDRESS:
INSURER(S)AFFORDING COVERAGE NAIC#
INSURER A:Hartford Fire Insurance Company 19682
INSURED HDR ENGINEERING,INC. INSURER B:St.Paul Fire and Marine Insurance Company 24767
1013472 8404 INDIAN HILLS DRIVE INSURER C:Sentinel Insurance Company,Ltd. 11000
OMAHA,NE 68114-4049 INSURER D:Zurich American Insurance Company 16535
INSURER E:
INSURER F:
COVERAGES HDRIN01 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 SUBR POLICY EFF POLICY EXP LIMITS
LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY
A GENERAL LIABILITY N N 37CSEQUO950 6/1/2013 6/1/2014 EACH OCCURRENCE s 1-000-000
DAMAGE TO RENTED
X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ 1,000,000
CLAIMS-MADE OCCUR MED EXP(Any one person) $ 10,000
X Contractual Liah. PERSONAL&ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2.000,000
GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000
POLICY X PRO- $
JECT X LOC
A AUTOMOBILE LIABILITY N N 37CSEQUO951 AOS) 6/1/2013 6/1/2014
A 37CSEQU0952 HI) 6/1/2013 6/1/2014 (Ea accident) $ 2,000,000
A X ANY AUTO 37MCPQU1160(MA) 6/1/2013 6/1/2014 BODILY INJURY(Per person) $ XXXXXXX
ALL OWNED SCHEDULED BODILY INJURY Per accident $ XXXXXXX
AUTOS AUTOS
X X NON-OWNED PROPERTY DAMAGE $ XXXXXXX
HIRED AUTOS AUTOS (Per acc dent)
$ xxxxx x
B X UMBRELLA LIAB X OCCUR N N ZUP-IOR64084-13-NF 6/1/2013 6/1/2014 EACH OCCURRENCE $ 1,000,000
EXCESS LAB CLAIMS-MADE (EXCLUDES PROF.LIAB AGGREGATE $ 1,000,000
DED I X I RETENTION$ $0 $ XXXXXXX
WORKERS COMPENSATION N 91WEOHI000 AOS O WC STATU
7/1/2013 7/1/2014 X RY L MITS O
C AND EMPLOYERS'LIABILITY ( ER
C ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N N/A
91WBOH1760(HI) 7/1/2013 7/1/2014 E.L.EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) 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 ARCHS&ENGS N N 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:CITY OF CLEARWATER,2009 ENGINEER OF RECORD.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
11297544 AUTHORIZED REPRESENTATIVE
CITY OF CLEARWATER
P.O.BOX 4748
CLEARWATER FL
ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD (91988-2010 APOFf5 CORPORATION.All rights reserved