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CERTIFICATE OF LIABILITY INSURANCE (305)AC �® CERTIFICATE OF LIABILITY INSURANCE DATE M 3120 3YYY) 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 Northeast, Inc. Boston MA Office One Federal Street Boston MA 02110 USA CONTACT NAME: (A/C. No. Ext): (866) 283 -7122 ( FAX No.): 800- 363 -0105 E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED CDM Smith Inc. ONE CAMBRIDGE PLACE 50 HAMPSHIRE STREET CAMBRIDGE MA 021390000 USA INSURER A: Zurich American Ins CO 16535 INSURER B: Lloyd's Syndicate No. 2623 AA1128623 INSURER C: EACH OCCURRENCE INSURER D: X INSURER E: SIR applies _ u° INSURER F: DAMAGE TO RENTED PREMISES (Ea occurrence) COVERAGES CERTIFICATE NUMBER: 570052216493 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 SUER WM POLICY NUMBER POLICY EFF (MM /DD/YYYY ) POLICY EXP MWDDIYYYY) LIMITS A GENERAL LIABILITY GL0837663218 01/01/2014 s & conditions 'a J r 01/01/2015 EACH OCCURRENCE $2,000,000 X COMMERCIAL GENERAL LIABILITY SIR applies _ u° t DAMAGE TO RENTED PREMISES (Ea occurrence) $300,000 CLAIMS -MADE I X OCCUR MED EXP (Any one person) $10,000 ,! = "+) V'1 ` y- 1 PERSONAL 8 ADV INJURY $2,000,000 GENERAL AGGREGATE $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER 7 POLICY n PF 0. n LOC PRODUCTS - COMP /OP AGG $4,000,000 A AUTOMOBILE LIABILITY {� e -'› "� z BAP 8�hr f.r' C t.k,„,,,,,,,edy(1's' C!. ��, F • ...,,,1 t .V vw 01t''z�014 �qq c� c "' p 01/01/2015 COMBINED SINGLE LIMIT (Ea accident) $2,000,000 X — X ANY AUTO BODILY INJURY ( Per person) ALL OWNED AUTOS HIRED AUTOS — _ X SCHEDULED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE AGGREGATE DEDI RETENTION A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY N I A wC837663319 01/01/2014 01/01/2015 X TORY SMITS II 10TH ANY PROPRIETOR I PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) YIN N I El, EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under D D ESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 B Archit &Eng Prof QC1401367 SIR applies per policy terms 01/01/2014 & conditions 01/01/2015 per claim aggregate $3,000,000 $3,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, i more space is required) RE: City of Clearwater Engineer of Record RFQ # 16 -12. The city of Clearwater itself, its Council, the Community Redevelopment Agency of the City of Clearwater, a Florida governmental agency created pursuant to Part III, Chapter 163, Florida Statue, its duly appointed officers, or public bodies, officers, employees, volunteers, representatives and agents are 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 Automobile Liability Policies. General Liability and Automobile Liability Policies evidenced herein is primary and non - contributory to other insurance available to the The City of Clearwater itself, its Council, the Community Redevelopment Agency of the city of Clearwater, a Florida governmental agency created pursuant to Part CERTIFICATE HOLDER CANCELLATION City of Clearwater Attn: City Clark Po 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. Holder Identifier : Certificate No : 570052216493 AUTHORIZED REPRESENTATIVE c940 §Asetst t A c/IrteZazie c✓ssa ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ACC7RO AGENCY CUSTOMER ID: 10518329 LOC #: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Services Northeast, Inc. NAMED INSURED CDM Smith Inc. POLICY NUMBER See Certificate Number: 570052216493 CARRIER see Certificate Number: 570052216493 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 I Vehicles: III, Chapter 163, Florida statue, its duly appointed officers, or public bodies, officers, employees, volunteers, representatives and agents, but only to the extent required by written contract with the insured. A waiver of subrogation is granted in favor of The City of Clearwater itself, its Council, the Community Redevelopment Agency of the City of Clearwater, a Florida governmental agency created pursuant to Part III, Chapter 163, Florida statue, its duly appointed officers, or public bodies, officers, employees, volunteers, representatives and agents as required by written contract but limited to the operations of the Insured under said contract, with respect to the General Liability and Automobile Liability Policies. ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. `6, °, CERTIFICATE OF LIABILITY INSURANCE DATE2M 320 3YYY) 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 CONTACT Aon Risk Services Northeast, Inc. NAME: PHONE (8663 283 -7122 FAX 800- 363 -0105 Boston MA office (NC. No. Ext): (NC. No.): One Federal Street E -MAIL Boston MA 02110 USA ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Zurich American Ins Co 16535 CDM Smith Inc. INSURER B: Lloyd's Syndicate No. 2623 AA1128623 ONE CAMBRIDGE PLACE 50 HAMPSHIRE STREET INSURER C: CAMBRIDGE MA 021390000 USA INSURER D: INSURER E: INSURER F: • 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 T TYPE OF INSURANCE A ADDL S SUER P POLICY NUMBER ( POLICY EFF P POLICY EXP LIMITS A G GENERAL LIABILITY G GL0837663218 0 01/01/2014 6 61/01/201 E EACH OCCURRENCE $ $2,000,000 X C COMMERCIAL GENERAL LIABILITY $ applies per p polic t terns & • 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 T TYPE OF INSURANCE A ADDL S SUER P POLICY NUMBER ( POLICY EFF P POLICY EXP LIMITS A G GENERAL LIABILITY G GL0837663218 0 01/01/2014 6 61/01/201 E EACH OCCURRENCE $ $2,000,000 X C COMMERCIAL GENERAL LIABILITY $ applies per p polic t terns & DAMAGEIORENTED $300,000 MED EXP (Any one person) $ $10,000 t ° I L `9 2013 P PERSONAL & ADV INJURY $ $2,000,000 GENERAL AGGREGATE $ $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: t PRODUCTS - COMP /OP AGG $ $4,000,000 A A AUTOMOBILE LIABILITY B BAP 837t�qq ir a 6e Yn / / � � COMBINED SINGLE LIMIT (Ea accident) $ $2,000,000 X A ANY AUTO L BODILY INJURY ( Per person) ALL OWNED — — S SCHEDULED BODILY INJURY (Per accident) PROPERTY DAMAGE UMBRELLA LIAB O OCCUR E EACH OCCURRENCE AGGREGATE DEDI RETENTION A W WORKERS C' COMPENSAT ION AND Y 1 N w N I A wC837663319 0 01/01/2014 0 01/01/2015 X X T TORY ST T TH E.L. EACH ACCIDENT $ $1, 000 , 000 E.L. DISEASE -EA EMPLOYEE $ $1,000,000 E.L. DISEASE - POLICY LIMIT $ $1,000,000 CERTIFICATE HOLDER City of Clear water Attn: City Clerk P.O. Box 4748 Clearwater FL 33758 -4748 USA 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. AUTHORIZED REPRESENTATIVE is %'L.e91�fc �straaed c/Cd�` ✓sacs Holder Identifier : XXX Certificate No : 570052212620 nipg ACORD 25 (2010105) 01988- 2010.ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AFRO' CERTIFICATE OF LIABILITY INSURANCE DATE MM //12/13/2013 ) 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 Aon Risk Services Northeast, Inc. Boston MA Office One Federal Street Boston MA 02110 USA CONTACT NAME: PHONE (g66) 283 -7122 I(NC 800- 363 -0105 (NC. No. Eat): (NC. No.): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC 8 INSURED CDM Smith Inc. ONE CAMBRIDGE PLACE 50 HAMPSHIRE STREET CAMBRIDGE MA 021390000 USA INSURER A: Zurich American Ins Co 16535 INSURER B: Lloyd's Syndicate No. 2623 AA1128623 INSURER C: INSURER D: INSURER E: INSURER F: 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 A A TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I X OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: 7 POLICY n JFCT n LOC AUTOMOBILE LIABILITY GL0837663218 SIR app! PCIFIRIC X ANY AUTO ALL OWNED — SCHEDULED AUTOS _ AUTOS X HIRED AUTOS X NON -OWNED — AUTOS BAP 2013 t k ,a1.1i1 yyi 4 ° ,l, r._ � ..r"�ti�Y 6. s�. acs POLICY EFF POLICY EXP MMIDD!YYYY) MM/D ) 1/01/2014 01/01/2 15 & conditions Ash`` LIMITS EACH OCCURRENCE DAMAGE TO R reD PREMISES (Ea occurrence) MED EXP (Any one person) $2,000,000 $300,000 $10,000 PERSONAL & ADV INJURY $2,000,000 GENERAL AGGREGATE $4,000,000 PRODUCTS - COMP /OP AGG $4,000,000 2014 01 /01 /2015 COMBINED SINGLE LIMIT (Ea accident) $2,000,000 BODILY INJURY ( Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE DED I 'RETENTION EACH OCCURRENCE AGGREGATE A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below YIN n N!A WC837663319 01/01/2014 01/01/2015 X I TORY LIMITS I IERH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 B Archit &Eng Prof QC1401367 01/01/2014 01/01/2015 SIR applies per policy terms & condi -ions E L. DISEASE - POLICY LIMIT per claim aggregate $1,000,000 $3,000,000 $3,000,000 DESCRIPTION OF OPERATIONS! LOCATIONS! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace is required) Re: Project: City of Clear Water Reverse Osmosis Plant I Expansion. City PN 09- 0018 -UT. The City of Clear water is included as Additional Insured in accordance with the policy provisions of the General Liability and Auto Liability. General Liability evidenced herein is Primary and Non - Contributory to other insurance available to an Additional Insured, but only in accordance with the policy's provisions. A Waiver of Subrogation is granted in favor of Certificate Holder in accordance with the policy provisions of the General Liability, Automobile Liability policies. CERTIFICATE HOLDER CANCELLATION City of Clear water 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 ey /[si►i c %G.7VfG cJ GiGt1a?d t /OLGid'L7dra J~t 01988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD Holder Identifier : xxx Certificate No : 570052212620 —�i