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CERTIFICATE OF LIABILITY INSURANCE (14)ACORO® CERTIFICATE OF LIABILITY INSURANCE ‘...--,--- DATE(MM /DD/YYYY) 1/3/2014 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 Brown & Brown Insurance - Clearwater P.O. Box 2456 Suite 660 Clearwater FL 33757 -2456 NAME: Jennifer Suttles (A/CC N . Exe:727 -461 -6044 FAA/c, Ne):727- 442 7695 E-MAIL E-MAIL Rss1 suttles bb inellas.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :Valley Forge Insurance Company INSURER B :Transportation Insurance Co 20508 20494 20443 INSURED King Engineering Assoc., Inc. 4921 Memorial Hwy Ste 300 Tampa FL 33634 INSURER CContinental Casualty Co. INSURER D: C2066728229 JAN 0 9 JAN ® v 07 r'�S R�RD LEGISLA SVCS INSURER E 1/1/2015 INSURER F : $1,000,000 COVERAGES CERTIFICATE NUMBER: 346712576 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN M ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR W VD POLICY NU `�,i' FF M /YYYY) POLICY EXP (MM /DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY C2066728229 JAN 0 9 JAN ® v 07 r'�S R�RD LEGISLA SVCS 1/1/2014 2014 AND DE 1/1/2015 EACH OCCURRENCE $1,000,000 DAMAGE PREMISES O(Ea occurrence) $500,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $5,000 PERSONAL 8 ADV INJURY $1,000,000 X GENERAL AGGREGATE $2,000,000 Broad Form PD PRODUCTS - COMP/OP AGG $2,000,000 GEN'L AGGREGATE 7 POLICY X LIMIT APPLIES jgT PER: LOC $ A AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS C2066728232 1/1/2014 1/1/2015 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ i $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE C2066728246 1/1/2014 1/1/2015 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 $ DED X RETENT ON $0 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A WC1063672015 1/1/2014 1/1/2015 X ORS LIMITS 0TH- E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 C Professional Liability AEH113805181 1/1/2014 1/1/2015 Per Claim 2,000,000 Per Aggregate 4,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Professional: covers services as an architect, engineer, land surveyor, landscape architect, construction manager, scientist or technical consultant CERTIFICATE HOLDER CANCELLATION City of Clearwater Attn: City Clerk PO 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) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD