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CERTIFICATE OF LIABILITY INSURANCE (331)A`� °' CERTIFICATE OF LIABILITY INSURANCE 1/1/2016 n /2016 DATE(MM /DD/YYYY) 12/4/2014 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 Lockton Insurance Brokers, LLC 725 S. Figueroa Street, 35th Fl. CA License #0F15767 Los Angeles CA 90017 (213) 689 -0065 CONTACT NAME: PHONE , EXt): I FAX No): E -MAIL ADDRESS: INSURER(SI AFFORDING COVERAGE NAIC # INSURER A : Insurance Company of the State of PA 19429 INSURED AECOM Technology Corporation 1389302 URS Corporation 600 Montgomery Street, 26th Floor San Francisco CA 94111 INSURER B : NOT APPLICABLE INSURER C: INSURER D : $ XXXXXXX INSURER E : $ XXXXXXX INSURER F : CLAIMS -MADE OCCUR CERTIFICATE NUMBER• Izo1Rnn4 VV •Gr\I1V GJ ALV 1 LV I 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. INSR LT - TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX PREMISES (Ea RENTED $ XXXXXXX CLAIMS -MADE OCCUR MED EXP (Any one person) $ XXXXXXX PERSONAL & ADV INJURY $ XXXXXXX GENERAL AGGREGATE $ XXXXXXX GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PE9 LOC OTHER PRODUCTS - COMP /OP AGG $ XXXXXXX $ AUTOMOBILE LIABILITY ANY AUTO AUTOS OWNED HIRED AUTOS SCHEDULED NON -OWNED AUTOS NOT APPLICABLE ((ECOMBINED acc ntSINGLE LIMIT $ XXXXXXX RODIL V INJURY (Per person.) $ XXXXXXX BODILY INJURY (Per accident $ XXXXXXX PROPERTY DAMAGE (Per accident) $ XXXXXXX $ UMBRELLA LIAB EXCESS LIAB _ OCCUR CLAIMS -MADE NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX AGGREGATE $ XXXXXXX $ DED I I RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY OFFICER/MEMBER EXCLUDED? ECUTIVE �T (Mandatory in NH) N If DESCRIPTION OF OPERATIONS below N / A N SEE ATTACHED ACORD 101 1/1/2015 1/1/2016 X I STATUTE OFR E.L. EACH ACCIDENT $ 10,000,000 $ 10,000,000 $ 10,000,000 E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Notice of Cancellation applies per attached endorsement. Evidence of Insurance CERTIFICATE HOLDER CANCELLATION See Attachments 13238004 City of Clearwater 112 South Osceola Avenue Clearwater FL 33766 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 ACORD 25 (2014/01) 7411 D C RPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD Insurer A: The Insurance Company of the State of Pennsylvania The Workers' Compensation coverage shown does not apply in monopolistic states. In the State of ND, OH, WA, and WY Workers' Compensation coverage is provided by the State Fund. In those States, the above reference policies provide Stop -Gap Employers' Liability only. Workers' Compensation policies apply as indicated below: AECOM Technology Corporation WC 028328280 - CA WC 028328281 - FL WC 028328282 - MA,ND,OH,\VA,\VI,WY WC 028328283 - ME \VC 028328284 - AK,AZ,VA WC 028328285 - IL,KY,NC,NH,UT,VT WC 028328286 - NJ, PA WC 028328287 - AL, AR, CO, CT, DC, DE, GA ,HI,IA,ID,IN,KS,LA,MD,MI,MN,MO, MS, MT, NE,NM,NV,NY,OK,OR,RI SC, SD, TN,TX,WV CRS Corporation WC 028328288 - CA \VC 028328289 - FL WC 028328290 - MA,ND,OH,WA,WI,WY WC 028328291 - AL, AR, CO, CT, DC, DE, GA, HI, IA, ID, IN, KS, LA, MD ,MI ,MN ,MO,MS ,MT ,NE,NM,NV,NY,OK, OR, RI, SC, SD,TN,TX,WV WC 028328292 - IL,KY,NC,NH,UT,VT WC 028328293 - NJ ,PA WC 028328294 - AK,AZ,VA WC 028328295 - ME ACORD 101 Miscellaneous Attachment : M503712 Master ID: 1389302, Certificate ID: 13238004 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy). This endorsement, effective 12:01 AM 1/1/2015 forms a part of Policy No. SEE ATTACHED ACORD 101 Issued to AECOM Technology Corporation URS Corporation By The Insurance Company of the State of Pennsylvania LIMITED ADVICE OF CANCELLATION TO SCHEDULED ENTITIES (WORKERS' COMPENSATION ONLY) This policy is amended as follows: In the event that the Insurer cancels this policy for any reason other than non - payment of premium, and 1. the cancellation effective date is prior to this policy's expiration date; 2. the Named Insured or, if applicable, any other employers named in Item 1 of the Information Page is under an existing contractual obligation to notify a certificate holder(s) when this policy is canceled (hereinafter, the "Certificate Holder(s)") and the Named Insured has provided the Insurer, either directly or through its broker of record, either: (a) the name of the entity shown on the certificate, a contact name at such entity and the U.S. Postal Service mailing address of each such entity; or (b) the email address of a contact at each such entity; and 3. prior to the effective date of cancellation, the Named Insured confirms to the Insurer, either directly or through its broker of record, that the persons or organizations set forth in the Schedule below, as well as their respective addresses listed, should continue to be a part of the Schedule and, if not, the names of the persons or organizations that should be deleted, the Insurer will provide advice of cancellation (the "Advice ") to each such Certificate Holder(s) confirmed by the Named Insured in writing to be correctly a part of the Schedule within days after the Named Insured confirms the accuracy of the Schedule below with the Insurer; provided, however, that if a specific number of days is not stated above, then the Advice will be provided to such Certificate Holder(s) as soon as reasonably practicable after the Named Insured confirms the accuracy of the Schedule below with the Insurer. Proof of the Insurer emailing the Advice, using the information provided and subsequently confirmed by the Named Insured in writing, will serve as proof that the Insurer has fully satisfied its obligations under this endorsement. This endorsement does not affect, in any way, coverage provided under this policy or the cancellation of this policy or the effective date thereof, nor shall this endorsement invest any rights in any entity not insured under this policy. The following definitions apply to this endorsement. 1. Named Insured means the first named employer in Item 1 of the Information Page of this policy. 2. Insurer means the insurance company shown in the header on the Information Page of this policy. WC 99 00 58 (Ed. 04/11) Attachment Code : D503695 Master ID: 1389302, Certificate ID: 13238004 — Cec\. nd.- \V\ 1,70SS C<CC-C r\ (1-0S \') 3\Q-sL\(\a i/ \ t L.),,g_ \ \c2,),.��� �c 0-c- bra . 07 sN.,(.\(D 1(ccsu2pc__Q_I w2-4v\L--, \'7>k.o S 3 yin R,cest, Cd3brjv ) ST \� 0---1` rte- • , -/ Him v5- Mct()Ln1525 LO`) \\On-L2 'F)* OCCS` / Z U '\Des3c to-z- : 2-.n Sew n C"( 6tQ4 ' \( / \ \rte ACORb CERTIFICATE OF LIABILITY INSURANCE 1■10.. --- 1/1/2016 DATE(MM /DD/YYYY) 12/1/2014 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 Lockton Insurance Brokers, LLC 725 S. Figueroa Street, 35th Fl. CA License #0F15767 Los Angeles CA 90017 (213) 689 -0065 NAMEACT PHONE FAX (ac, No, Eat): (A/C, No): E -MAIL ADDRESS: INSURERISI AFFORDING COVERAGE NAIC # INSURER A : Insurance Company of the State of PA 19429 INSURED AECOM Technology Corporation 1389241 URS Corporation Southern 7650 W Courtney Campbell Causeway Waterford Plaza - Ste. 700 Tampa FL 33607 -1462 INSURER B : NOT APPLICAB INSURER C INSURER D : $ XXXXXXX INSURER E : $ XXXXXXX INSURER F : CLAIMS -MADE ❑ OCCUR COVERA TE NUMBER: 1321911 REVISION NUMBER: XXXXXXX 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUER WVD POLICY NUMBER POLICY EFF IMM /DD/YYYY) POLICY EXP IMM /DD/YYYY1 LIMITS COMMERCIAL GENERAL LIABILITY NOT APPLICAB t 4°' '`; EACH OCCURRENCE $ XXXXXXX DAMAGE TO RENTED PREMISES (Ea occurrence) $ XXXXXXX CLAIMS -MADE ❑ OCCUR MED EXP (Any one person) PERSONAL & ADV INJURY $ XXXXXXX GENERAL AGGREGATE $ XXXXXXX GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY ❑ JECT LOC OTHER PRODUCTS - COMP /OP AGG $ XXXXXXX $ AUTOMOBILE — LIABILITY ANY AUTO AUT OWNED HIRED AUTOS _ SCHEDULED NON -OWNED AUTOS t !� t` NOT APPLI i °• ° w ' ' - .( COMBINED SINGLE LIMIT (Ea accident) $;XXXXXX BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident $ XXXXXXX PROPERTY DAMAGE (Per accident) $ UMBRELLA LIAB EXCESS LIAB _ OCCUR CLAIMS -MADE NOT APPLICABLE EACH OCCURRENCE $ XXXX)QQ( AGGREGATE $ DED I I RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYIPROPRIE ERPEARTND /EXECUTIVE N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A N SEE ATTACHED ACORD 101 1/1/2015 1/1/2016 PER OTH- X I STATUTE 1 I FR E. L. EACH ACCIDENT $ 10,000,000 E.L. DISEASE - EA EMPLOYEE $ 10,000,000 E.L. DISEASE - POLICY LIMIT $ 1 0,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Not'ce of Cancellation applies per attached endorsement. RE: Engineer of Record Agreement. RFQ 16 -12 CERTIFICATE HOLDER CANCELLATION See Attachments 13219110 City of Clearwater Attn: City Clerk P.O. 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 (2014/01) ©1 8 201 C D C RPORATION. All rights reserved 9 The ACORD name and logo are registered marks of ACORD Insurer A: The Insurance Company of the State of Pennsylvania The Workers' Compensation coverage shown does not apply in monopolistic states. In the State of ND, OH, WA, and WY Workers' Compensation coverage is provided by the State Fund. In those States, the above reference policies provide Stop -Gap Employers' Liability only. Workers' Compensation policies apply as indicated below: AECOM Technology Corporation WC 028328280 - CA WC 028328281 - FL WC 028328282 - MA,ND,OH,WA,WI,WY WC 028328283 - ME \VC 028328284 - AK,AZ,VA WC 028328285 - IL,KY,NC,NH,UT,VT WC 028328286 - NJ, PA WC 028328287 - AL, AR, CO, CT, DC, DE, GA, HI, IA, ID, IN, KS, LA, MD ,MI,MN,MO,MS,MT,NE,NM,NV,NY,OK, OR, RI, SC, SD, TN,TX,WV URS Corporation WC 028328288 - CA WC 028328289 - FL WC 028328290 - MA,ND,OH,WA,uI,WY WC 028328291 - AL, AR, CO, CT, DC, DE, GA, HI, IA, ID, IN, KS, LA, MD, MI, MN, MO, MS, MT, NE, NM ,NV,NY,OK,OR,RI,SC,SD,TN,TX,\VV WC 028328292 - IL,KY,NC,NH,UT,VT WC 028328293 - NJ,PA WC 028328294 - AK,AZ,VA WC 028328295 - ME ACORD 101 Miscellaneous Attachment : M503712 Master ID: 1389241, Certificate ID: 13219110 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy). This endorsement, effective 12:01 AM 1/1/2015 forms a part of Policy No. SEE ATTACHED ACORD 101 Issued to AECOM Technology Corporation URS Corporation Southern By The Insurance Company of the State of Pennsylvania LIMITED ADVICE OF CANCELLATION TO SCHEDULED ENTITIES (WORKERS' COMPENSATION ONLY) This policy is amended as follows: In the event that the Insurer cancels this policy for any reason other than non - payment of premium, and 1. the cancellation effective date is prior to this policy's expiration date; 2. the Named Insured or, if applicable, any other employers named in Item 1 of the Information Page is under an existing contractual obligation to notify a certificate holder(s) when this policy is canceled (hereinafter, the "Certificate Holder(s)") and the Named Insured has provided the Insurer, either directly or through its broker of record, either: (a) the name of the entity shown on the certificate, a contact name at such entity and the U.S. Postal Service mailing address of each such entity; or (b) the email address of a contact at each such entity; and 3. prior to the effective date of cancellation, the Named Insured confirms to the Insurer, either directly or through its broker of record, that the persons or organizations set forth in the Schedule below, as well as their respective addresses listed, should continue to be a part of the Schedule and, if not, the names of the persons or organizations that should be deleted, the Insurer will provide advice of cancellation (the "Advice ") to each such Certificate Holder(s) confirmed by the Named Insured in writing to be correctly a part of the Schedule within days after the Named Insured confirms the accuracy of the Schedule below with the Insurer; provided, however, that if a specific number of days is not stated above, then the Advice will be provided to such Certificate Holder(s) as soon as reasonably practicable after the Named Insured confirms the accuracy of the Schedule below with the Insurer. Proof of the Insurer emailing the Advice, using the information provided and subsequently confirmed by the Named Insured in writing, will serve as proof that the Insurer has fully satisfied its obligations under this endorsement. This endorsement does not affect, in any way, coverage provided under this policy or the cancellation of this policy or the effective date thereof, nor shall this endorsement invest any rights in any entity not insured under this policy. The following definitions apply to this endorsement: 1. Named Insured means the first named employer in Item 1 of the Information Page of this policy. 2. Insurer means the insurance company shown in the header on the Information Page of this policy. WC 99 00 58 (Ed. 04/11) Attachment Code : D503695 Master ID: 1389241, Certificate ID: 13219110