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CERTIFICATE OF LIABILITY INSURANCE (329)A�RL7® CERTIFICATE OF LIABILITY INSURANCE DATE 2MM/rD20D'/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. Est): (A/C. No.): E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Malcolm Pirnie, Inc. 44 South Broadway 15th Floor white Plains NY 10601 USA INSURER A: Greenwich Insurance Company 22322 INSURER B: XL Specialty Insurance Co 37885 INSURER C: Ul/01/2016 INSURER D: $1,000,000 INSURER E: INSURER F: DAMAGE TO RENTED PREMISES (Ea occurrence) • 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 POLICY EXP iMM/DD/YYYYJ LIMITS A X COMMERCIAL GENERAL LIABILITY GEC0010 /6113 General Lia *^rte ><"'�' ' i o 4 a,T 1/01/201 �• - ". -,, '-v' Ul/01/2016 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $1,000,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GENII_ AGGREGATE LIMIT APPLIES PER P GENERAL AGGREGATE $2,000,000 — POLICY X JECT i X I LOC PRODUCTS - COMP /OP AGG $2,000,000 OTHER: B AUTOMOBILE LIABILITY xy' AEC0010A11 r'''''''' .+ Auto (AO6 •� n o F, . Wr.e L.', . <iw. w., . 01/Qif-2115 (.�' 6-9,—' ° 01/01/2016 COMBINED SINGLE LIMIT (Ea accident) S1,000,000 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) B X UMBRELLALIAB EXCESSLIAB X OCCUR CLAIMS -MADE UEC001075913 Umbrella 01/01/2015 01/01/2016 EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 DED I X'RETENTION 510 000 B WORKERS C LIABILITY Y/N COMPENSATION N / A RWD943516309 01/01/2015 01/01/2016 v STATUTE PER ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under „, N EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached ' ( y if more space is required) Re: All Operations of the Named Insured. If required by written agreement, the Certificate Holder is included as additional insured as it pertains to the work or services performed for the certificate holder (except for wc) subject to all terms, exclusions and conditions of such policies. If specifically required by written agreement, the policies of the Insured will provide for Contractual Liability, waiver of Subrogation, or separation of insureds /severability of Interests. If required by written agreement, the WC /EL, General, Auto & umbrella /Excess liability policies of the Insured will be primary and non - contributory with any other insurance as it pertains to the work or services performed for the certificate holder. The "xCU” exclusion has been removed for General Liability insurance. CERTIFICATE HOLDER CANCELLATION City of Clearwater Attn: City Clerk PO 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 c,5z 78 c���ILt CrO V J 7LQ. Holder Identifier : Certificate No : 570056151111 ACORD 25 (2014/01) ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD '`'�"" CERTIFICATE OF LIABILITY INSURANCE DATE`MM /DD/YYYY) ,2/17/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. HOLDER. THIS BY THE POLICIES AUTHORIZED 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. F ranklin TN Office 501 Corporate Centre Drive Suite 300 Franklin TN 37067 USA CONTACT NAME: PHONE ) (g66) 283 -7122 FAX A/C. No. Est): I No ): 800 - 363 -0105 E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Malcolm Pirnie, Inc. 44 South Broadway 15th FlOOr White Plains NY 10601 USA INSURER A: Greenwich Insurance Company 22322 INSURER B: XL Specialty Insurance Co 37885 INSURER C: EACH OCCURRENCE INSURER D: INSURER E: OCCUR INSURER F: $1,000,000 $10,000 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 AGM INSD SUER WVD POLICY NUMBER POLICY EFF ((MM/DD/YYYYl1aMM POLICY EXP /DDlYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY GE000107611T General Liability �,:. �. .. mr 01/01/20151)3/01 -' `-.' ,A r 1' /2016 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) $1,000,000 $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L --{I AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY X JE 0. X LOC PRODUCTS - COMP /OP AGG $2,000,000 OTHER: B AUTOMOBILE LIABILITY AEC001075813 Auto (Aos) - •• , -, ' { V; a . . 01/0V20,15,01/01/2016 y �.- 01/01/2016 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) PROPERTY DAMAGE (Per accident) B X — UMBRELLALIAB EXCESS LIAR X — OCCUR CLAIMS -MADE UEC001075913 Umbrella 01/01/2015 01/01/2016 EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 DED f X (RETENTION 510 000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N N / A RWD943516309 01/01/2015 01/01/2016 X PER STATUTE 0TH - IER ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? N E.L. EACH ACCIDENT $1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -EA EMPLOYEE $1,000,000 E.L. DISEASE- POLICY LIMIT $1,000,000 . i DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: All Operations of the Named Insured. City of Clearwater 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, Auto Liability and Umbrella Liability policies. General Liability and Auto Liability evidenced herein is primary and non - contributory to other i insurance available to the Additional Insured, but only to the extent required by written contract with the insured. A waiver t of subrogation is granted in favor of Additional Insured as required by written contract but limited to the operations of the r Insured under said contract, with respect to the General Liability, Auto Liability, umbrella Liability and workers' Compensation policies. 1 CERTIFICATE HOLDER CANCELLATION city of Clearwater Attn: City Clerk P.O. Box 4748 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 c34. , i %�cJcr sG /� c/ S ✓na Holder Identifier Certificate No : 570056142964 ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD NO