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CERTIFICATE OF LIABILITY INSURANCE (282).4 C �® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 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(les) 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 Aon Risk Insurance Services West, Inc. Los Angeles CA Office 707 Wilshire Boulevard ' -� Suite 2600 Los Angeles CA 90017 -0460 USA _ - -- CONTACT PHON. PHONE No. Est): (866) 283 -7122 I FAX No.): (800) 363 -0105 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Tetra Tech, Inc. 201 East Pine Street Orlando FL 32801 USA - -- - INSURER k. National Union Fire Ins Co of Pittsburgh 19445 INSURER B: Insurance Co of the State of PA 19429 INSURER C: Lexington Insurance Company 19437 INSURER D: AIG Europe Limited AA1120841 INSURER E: DAMAGE TO RENTED PREMISES (Ea occurrence) INSURER F: MED EXP (Any one person) COVERAGES CERTIFICATE NUMBER: 570051361057 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 INSR LTR TYPE OF INSURANCE ADDL INSR, SUBR WVD POLICY NUMBER POLICY EFF (MWDD POLICY EXP (MWDpmY� LIMITS '4 GENERAL LIABILITY GL5142623 10/01/2013 10/01/2014 EACH OCCURRENCE $2,000,000 X X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X,C,U Coverage DAMAGE TO RENTED PREMISES (Ea occurrence) $1,000,000 _ MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $2,000,000 GENERAL AGGREGATE $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 7 POLICY n PST n LOC PRODUCTS - COMP /OP AGG $4,000,000 A AUTOMOBILE LIABILITY CA 327 52 65 10/01/2013 10/01/2014 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X — X ANY AUTO BODILY INJURY ( Per person) ALL OWNED AUTOS HIRED AUTOS — X _ SCHEDULED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) -- (Per oaccident)AMAGE D X UMBRELLALIAB EXCESS LIAR X OCCUR CLAIMS -MADE TH1300027 10/01/2013 10/01/2014 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 DED' X'RETENTION $100,000 B a B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY N/A WC15656017 WC15656011 WC15656012 10/01/2013 10/01/2013 10/01/201310/01 10/01/2014 10/01/2014 /2014 I WC STATU- I lam- X TORY LIMITS IER Y/ N OFFICER/MEM EREXCUDED ?EXECUTIVE N (Mandatory In NH) E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 , desc i under OPERATIONS below DESCRIPTION If Es, describN under E.L. DISEASE- POLICY LIMIT $1, 000 , 000 C Contractor Prof 028182375 Prof /Poll Liab 10/01/2013 10/01/2014 Each Claim Agggregate $5,000,000 $5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) City of Clearwater, Florida is included as Additional Insured as required by written contract, but limited to the operations of the Insured under said contract, with respect to the General Liability and Auto Liability policies. General Liability and Auto Liability evidenced herein is primary and non - contributory to other insurance available to the City of Clearwater, Florida, its officers, officials, employees, and volunteers, but only to the extent required by written contract with the insured. A Waiver of Subrogation is granted in favor of Certificate Holder as required by written contract but limited to the operations of the Insured under said contract, with respect to the General Liability and Auto Liability policies. Cross Liability /Severability of Interest is included under the General Liability policy where required by written contract. Stop Gap Coverage for the CERTIFICATE HOLDER CANCELLATION City of Clearwater, Florida Attn: City Clerk P.O. Box 4748 Clearwater FL 33758 -4748 USA 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 e018 ✓Gr�iJ NN d 9�4 elst�t�iCLRO !/Ei0( ✓ 9sli Holder Identifier : No : 5700513 ACORD 25 (2010/05) ©1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AC RO 0® AGENCY CUSTOMER ID: 570000036654 LOC #: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Insurance services west, Inc. NAMED INSURED Tetra Tech, Inc. POLICY NUMBER see Certificate Number: 570051361057 CARRIER see Certificate Number: 570051361057 NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Additional Description of Operations / Locations / Vehicles: following states: OH, WA, WY. ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved.