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CERTIFICATE OF LIABILITY INSURANCE (303)� ® A CERTIFICATE OF LIABILITY INSURANCE DATEO(6MM/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(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 Aon Risk Services South, Inc. Franklin TN Office 501 Corporate Centre Drive Suite 300 Franklin TN 37067 USA CONTACT NAME: PHONE (866) 283 -7122 I FAX 800 - 363 -0105 (NC. No. Ext): (NC. No.): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Arcadis U.S. Inc. 630 Plaza Drive Suite 200 Highlands Ranch CO 80129 USA INSURER A: Steadfast Insurance Company 26387 INSURERS: Lexington Insurance Company 19437 INSURER C: INSURER D: INSURER E: INSURER F: DAMAGE T O PREMISES ne) COVERAGES CERTIFICATE NUMBER: 570054085029 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 MSR LTR TYPE OF INSURANCE ADDL INSD SUER WVD POLICY NUMBER POLICY EFF (MWDD/YYYY) POLICY EXP MUNDMYYrn LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAMS -MDE ❑ OCCUR DAMAGE T O PREMISES ne) MED EXP (Any one person) PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: ii]POLICY ❑ E T LOC OTHER. GENERAL AGGREGATE PRODUCTS - COMP /OP AGG AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) — ANY AUTO BODILY INJURY ( Per person) ALL OWNED AUTOS HIRED AUTOS --SCHEDULED --- __AUTOS AUTOS NON -OWNED BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) UMBRELLA LIAR EXCESS LMB OCCUR CLAIMS -MADE EACH OCCURRENCE AGGREGATE DED I 'RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR / PARTNER / EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A PER SWUM OTH- FR E.L. EACH ACCIDENT E.L. DISEASE -EA EMPLOYEE E.L. DISEASE - POLICY LIMIT A Contractor Poll IPR929693800 Poll. Liability SIR applies per policy terms 06/01/2014 & conditions 06/01/2015 Each Claim Annual Aggregate $2,000,000 $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Project TL011416.0006. Groundwater monitoring well sample collection, and drilling /well installation activities conducted on CGS properties, clearwater, Florida. Clearwater Gas System 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 Pollution Liability policy. A waiver of Subrogation is granted in favor of Clearwater Gas system as required by written contract but limited to the operations of the Insured under said contract, with respect to the Pollution Liability and Professional Liability policies. For Professional Liability coverage, the Aggregate Limit is the total insurance available for claims presented within the policy period for all operations of the insured. The Limit will be reduced by payments of indemnity and expense. Cancellation Provision shown CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014/01) KCI.CI V CLJ ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD JUN 1 9 2014 GAS ADMIN Holder Identifier : Certificate No : 570054085029 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Clearwater Gas system Attn: Mr. Brian Langille 400 N. Mrytle Avenue Clearwater FL 33755 USA EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE .Q/% ` / �- p9e oe t ACORD 25 (2014/01) KCI.CI V CLJ ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD JUN 1 9 2014 GAS ADMIN Holder Identifier : Certificate No : 570054085029 AC 120® AGENCY CUSTOMER ID: 570000005571 LOC #: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk services south, Inc. NAMED INSURED Arcadis u.s, Inc. POLICY NUMBER see Certificate Number: 570054085029 CARRIER See Certificate Number: 570054085029 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 INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YYYY) POLICY EXPIRATION DATE (MM/DD /YYYY) LIMITS OTHER LI Claims -Made jX Professional Liabil IX I and Contractors jX J Pollution Liability ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD ©2008 ACORD CORPORATION. All rights reserved. ACdRL AGENCY CUSTOMER ID: 570000005571 LOC #: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Services South, Inc. NAMED INSURED Arcadis U.S, Inc. POLICY NUMBER See Certificate Number: 570054085029 CARRIER See Certificate Number: 570054085029 NAIC CODE EFFECTIVE DATE: MARKS 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: herein is subject to shorter or longer time periods depending on the jurisdiction of, and reason for, the cancellation. ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. '---1 ® A ORE3 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 06 /11/2014 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 AOn Risk Services South, Inc. Franklin TN Office 501 Corporate Centre Drive Suite 300 Franklin TN 37067 USA CONTACT NAME: (NC.. No. Est): (866) 283-7122 I FAX Nc ): 800-363-0105 E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Arcadis U.S. Inc. 630 Plaza Drive Suite 200 Highlands Ranch CO 80129 USA INSURER A: Steadfast Insurance Company 26387 INSURER B: Lexington Insurance Company 19437 INSURER C: INSURER D: INSURER E: INSURER F: DAMAGE TO RENTED PREMISES (Ea occurrence) COVERAGES CERTIFICATE NUMBER: 570054083963 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 INSD SUER W VD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY -MP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY �-' ,---:,,l ( - -• ... EACH OCCURRENCE CLAIMS -MADE ❑OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY ❑ PR0. LOC OTHER: PRODUCTS COMP /OP AGG AUTOMOBILE LIABILITY ` ,,, "� COMBINED SINGLE LIMIT (Ea accident) - ANY AUTO BODILY INJURY ( Per person) ALL OWNED AUTOS HIRED AUTOS - _ _ SCHEDULED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) UMBRELLA LIAB EXCESS LIAB DED I 'RETENTION OCCUR CLAIMS -MADE EACH OCCURRENCE AGGREGATE WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR / PARTNER / EXECUTIVE Y OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N I A PER I STATUTE I ERH E.L. EACH ACCIDENT E.L. DISEASE -EA EMPLOYEE E.L. DISEASE- POLICY LIMIT A Contractor Poll IPR929693800 poll. Liability SIR applies per policy terms 06/01/2014 & condi 06/01/2015 -ions Each Claim Annual Aggregate $1,000,000 $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: All Operations of the Named Insured. For Professional Liability coverage, the Aggregate Limit is the total insurance available for claims presented within the policy period for all operations of the insured. The Limit will be reduced by payments of indemnity and expense. cancellation Provision shown herein is subject to shorter or longer time periods depending on the jurisdiction of, and reason for, the cancellation. CERTIFICATE HOLDER CANCELLATION City of Clearwater Attn: City Clerk P.O. Box 5748 Clearwater FL 33758 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 Holder Identifier : Certificate No : 570054083983 01988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD d4WIW AGENCY CUSTOMER ID: 570000005571 LOC #: ADDITIONAL REMARKS SCHEDULE of AGENCY Aon Risk Services South, Inc. NAMED INSURED Arcadis u.s, Inc. POLICY NUMBER See Certificate Number: 570054083963 CARRIER See Certificate Number: 570054083963 NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR W VD POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD /YYYY) POLICY EXPIRATION DATE (MM/DD/YYYY) LIMITS OTHER IDC1 ai ms -Made �X I Professional Liabil 1X1and Contractors IX ] Pollution Liability ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD @ 2008 ACORD CORPORATION. All rights reserved. '4 °'eO® CERTIFICATE OF LIABILITY INSURANCE DATE(�M /M/DOD,/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(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 Aon Risk Services South, Inc. Franklin TN Office 501 Corporate Centre Drive Suite 300 Franklin TN 37067 USA CONTACT NAME: PHONE (866) 283 -7122 I FAX 800- 363 -0105 (A/C. No. Ext): (A/C. No.): E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIL # INSURED Arcadis U.S. Inc. 630 Plaza Drive Suite 200 Highlands Ranch CO 80129 USA INSURER A: Steadfast insurance Company 26387 INSURER B: Lexington Insurance Company 19437 INSURER C: INSURER D: INSURER E: INSURER F: DAMAGE TO RENTED PREMISES (Ea occurrence) :570054083969 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 INSD SUER WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP IMM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY 7-, rr, r---,' 77 - ITT :7 ( ) ' i Lam, .. EACH OCCURRENCE CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE POLICY JET LOC OTHER: PRODUCTS - COMP /OP AGG AUTOMOBILE LIABILITY - ■ . -.a .• '' -' "" "" COMBINED SINGLE LIMIT (Ea accident) — ANY AUTO BODILY INJURY ( Per person) ALL OWNED AUTOS HIRED AUTOS — — _AUTOS SCHEDULED AUTOS NON -OWNED BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE AGGREGATE DED I (RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A PER STATUTE OTH- ER E.L. EACH ACCIDENT E.L. DISEASE -EA EMPLOYEE E.L" DISEASE - POLICY LIMIT A Contractor Poll IPR929693800 Poll. Liability SIR applies per policy terms 06/01/2014 & condi - 06/01/2015 ions Each Claim Annual Aggregate $3,000,000 $5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Evidence of Insurance. For Professional Liability coverage, the Aggregate Limit is the total insurance available for claims presented within the policy period for all operations of the insured. The Limit will be reduced by payments of indemnity and expense. Cancellation Provision shown herein is subject to shorter or longer time periods depending on the jurisdiction of, and reason for, the cancellation. CERTIFICATE HOLDER CANCELLATION city of Clearwater Attn: Kathy Bedini (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 c�a�a c`�.�QriG �sLrw� c/�!i ��slet ACORD 25 (2014/01) 01988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Holder Identifier : 10 0 0 Certificate No ACL® AGENCY CUSTOMER ID: 570000005571 LOC #: ADDITIONAL REMARK P AGENCY Aon Risk Services South, Inc. .. NAMED INSURED Arcadis U.S, Inc. POLICY NUMBER See Certificate Number: 570054083969 CARRIER See Certificate Number: 570054083969 NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR W VD POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD /YYYY) POLICY EXPIRATION DATE (MM/DD/YYYY) LIMITS OTHER B Archit &Eng Prof 015448990 Excess Prof /Poll Liabili• SIR applies per policy terms 06/01/2014 & conditions 06/01/2015 Each Claim $2,000,000 EX 1 Claims -Made I Professional Liabil 1X and Contractors EPollution Liability ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD ® 2008 ACORD CORPORATION. All rights reserved. '4 O2°® CERTIFICATE OF LIABILITY INSURANCE DAT06/ /M/2014YYY) 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 AOn Risk Services South, Inc. Franklin TN Office 501 Corporate Centre Drive Suite 300 Franklin TN 37067 USA CONTACT NAME: (866) 283 -7122 I F'C PHONE AIC (A/C. No. Ext): (. No.): 800- 363 -0105 E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Arcadis U.S. Inc. 630 Plaza Drive Suite 200 Highlands Ranch CO 80129 USA INSURER A: Steadfast Insurance Company 26387 INSURER B: Lexington Insurance Company 19437 INSURER c: INSURER D: INSURER E: INSURER F: DAMAGE TO RENTED PREMISES CERTIFICATE NUMBER: 57 • 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 —ADDL INSR LTR TYPE OF INSURANCE INSD SUER WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY D(P (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY �,.- -s '^, � EACH OCCURRENCE CLAIMS -MADE ❑ OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER. PRO GENERAL AGGREGATE - POLICY JECT LOC OTHER: PRODUCTS - COMP /OP AGG AUTOMOBILE LIABILITY .. } . - COMBINED SINGLE LIMIT (Ea accident) — — ANY AUTO BODILY INJURY( Per person) ALL OWNED AUTOS HIRED AUTOS — _ _. SCHEDULED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE AGGREGATE DED I (RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N N/A STATUTE _ IFFRH ANY PROPRIETOR /PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under E.L. EACH ACCIDENT E.L. DISEASE -EA EMPLOYEE DESCRIPTION OF OPERATIONS below E.L. DISEASE- POLICY LIMIT A Contractor Poll IPR929693800 Poll. Liability SIR applies per policy terms 06/01/2014 & condi-ions 06/01/2015 Each claim Annual Aggregate $3,000,000• $5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: PHASE I, 1498 S. GREENWOOD AVE. FOR PROFESSIONAL LIABILITY COVERAGE, THE AGGREGATE LIMIT IS THE TOTAL INSURANCE AVAILABLE FOR CLAIMS PRESENTED WITHIN THE POLICY PERIOD FOR ALL OPERATIONS OF THE INSURED. THE LIMIT WILL BE REDUCED BY PAYMENTS OF INDEMNITY AND EXPENSE. CANCELLATION PROVISION SHOWN HEREIN IS SUBJECT TO SHORTER OR LONGER TIME PERIODS DEPENDING ON THE ' JURISDICTION OF, AND REASON FOR, THE CANCELLATION. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014/01) ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Holder Identifier : 570054083968 Certificate No SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY OF CLEARWATER ATTN: CITY CLERK P.O. BOX 4748 CLEARWATER FL 33758 -4748 USA EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE c •Mvillecest. �ei ACORD 25 (2014/01) ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Holder Identifier : 570054083968 Certificate No AGENCY CUSTOMER ID: 570000005571 LOC #: ADDITIONAL REMARKS SCHEDULE of AGENCY Aon Risk Services South, Inc. NAMED INSURED Arcadis U.S, ^' Inc. POLICY NUMBER See Certificate Number: 570054083968 CARRIER See Certificate Number: A I%fITlA \1 A. w�•• .w•iw 570054083968 NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LTR TYPE OF INSURANCE ADDL INSD SUER WVD POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YYYY) POLICY EXPIRATION DATE (MM/DD/YYYY) LIMITS OTHER B Archit &Eng Prof 015448990 Excess Prof /Poll Liabili- SIR applies per policy terms 06/01/2014 & conditions 06/01/2015 Each Claim $2,000,000 ElClaims -Made I I Professional Liabil JX and Contractors ElPollution Liability ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD ® 2008 ACORD CORPORATION. All rights reserved.