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CERTIFICATE OF LIABILITY INSURANCE (330)'4 °® CERTIFICATE OF LIABILITY INSURANCE DAT12 /23 /20'/YWY) 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 (866) 283 -7122 I FAX 800- 363 -0105 (A/C. No. Ext): (A/C. No.): 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 27855 INSURER B: Lloyds Syndicate NO. 2623 AA1128623 INSURER C: 01/01/2016 INSURER D: $2,000,000 INSURER E: CLAIMS -MADE X OCCUR INSURER F: $300,000 :570056316623 • 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 - 1DDLSUBI- INSD WVD - POLICY NUMBER POLICY EFF ((MM/DD/YYYYl POLICY EXP IMM/DDnYW� LIMITS A X A COMMERCIAL GENERAL LABILITY Q.0837663219 /f "*{+ J $ ,' l C- I W 01/01/2015 _ '° 01/01/2016 EACH OCCURRENCE $2,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $300,000 MED EXP (Any one person) $10,000 PERSONAL &ADVINJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY X JET X LOC PRODUCTS - COMP/OP AGG $4,000,000 OTHER: A AUTOMOBILE LIABILITY BAP 831631419: 631 - ",01"/.D1 L-" --- "----. 4 >20)5 -_ ` ", 1 01/01/2016 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 ( ) _ UMBRELLA LAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE AGGREGATE DED I 'RETENTION A EMPLOYERS' LBILIATIONAND A Y/N ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? I N I (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A =wC837663320 01/01/2015 01/01/2016 X IPEATUTE IETH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 E.L. DISEASE- POLICY LIMIT $1,000,000 B Archit &Eng Prof QC1501367 01/01/2015 01/01/2016 per claim aggregate SIR /Deductible $3,000,000 $3,000,000 $100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if 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. AUTHORIZED REPRESENTATIVE Holder Identifier : Certificate No : 570058318823 IcsA ACORD 25 (2014/01) ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 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: 570056316623 CARRIER See Certificate Number: 570056316623 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: 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 (2008101) The ACORD name and logo are registered marks of ACORD ® 2008 ACORD CORPORATION. All rights reserved. H...---s-- VI "' CERTIFICATE OF LIABILITY INSURANCE DATE(MM /OD/YYYY) 12/23/2014 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 Northeast, Inc. Boston MA Office One Federal Street Boston MA 02110 USA CONTACT NAME: PHONE (866) 283 -7122 (NC. No. Ert): I ( 800 - 363 -0105 No ): E -MAIL ADDRESS: - -- - INSURER(S) AFFORDING COVERAGE NAIC C INSURED CDM Smith Inc. ONE CAMBRIDGE PLACE 50 HAMPSHIRE STREET CAMBRIDGE MA 021390000 USA rnvc•wr_re• •••-..•••-•..•-- ...._____ INSURER A: Zurich American Ins CO 27855 INSURER B: Lloyd's Syndicate NO. 2623 AA1128623 INSURER C: EACH OCCURRENCE INSURER D: INSURER E: CLAIMS -MADE X OCCUR INSURER F: $300,000 • ............ 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 ADDll11 INSDI SUBR WVD POLICY NUMBER POLICY EFF MM/DD POUCYEXP MM/D LIMITS A X COMMERCIAL GENERAL LIABILITY GL0837863219 r^ma . ,,, a ' -" '" - �,., 1/21)1M./01. ) ;:... �'" • -9 '� -'1 EACH OCCURRENCE $2,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED $300,000 PREMISES (Ea occurrence) MED EXP (Any one person) $10, 000 PERSONAL &ADVINJURY $2,000,000 GEN'L _ AGGREGATE LIMIT APPLIES PER: POLICY X PRO- X LOC JECT GENERAL AGGREGATE $4,000,000 PRODUCTS- COMP /OPAGG $4,000,000 OTHER:'....ia... A AUTOMOBILE LIABILITY BAP 8371 l,. ,, _ D3 /DI7 5 01/01/2016 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 DED I (RETENTION A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? I " I �j (Mandatory in NH) l If yes, describe under DESCRIPTION OF OPERATIONS below N / A wC837663320 01/01/2015 01/01/2016 X STATUTE I ERH ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 E.L. DISEASE- POLICY LIMIT $1,000,000 B Archit &Eng Prof QC1501367 01/01/2015 01/01/2016 per claim aggregate SIR /Deductible $3,000,000• $3,000,000 $100,000! DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space 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 1 Auto Liability. General Liability evidenced herein is Primary and Non- Contributory to other insurance available to an i 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. 1 CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014/01) 01988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Holder Identifier : xxX Certificate No : 570056318887 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of Clear Water 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 `'�I o� [l' 6 ACORD 25 (2014/01) 01988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Holder Identifier : xxX Certificate No : 570056318887