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CERTIFICATE OF LIABILITY INSURANCE (343)'4R iJ CERTIFICATE OF LIABILITY INSURANCE ;A�oi2o15") 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 Greyling Insurance Brokerage 3780 Mansell Road Suite 370 Alpharetta GA 30022 CONTACT Carly Underwood jgcoNr0 Ed): (770) 552 -4225 (A/C. Not (866) 550 -4082 E -MAIL Carl underwood(4 re lin com ADDRESS: Y • g Y g INSURER(S) AFFORDING COVERAGE NAIC # INsuRERANational Union Fire Ins Co 19445 INSURED Geosyntec Consultants, Inc. 900 Broken Sound Parkway NW Suite 200 Boca Raton FL 33487 INSURER a :Libert y Insurance Corporation 42404 INSURER CNew Hampshire Insurance Company 23841 INSURER DAIG Specialty Insurance Company 26883 INSURERE: $ 500, 000 INSURERF: COVERAGES CERTIFICATE NUMBER:15 -16 ( Geosyatec Main) THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVNTHSTANDING 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 INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP IMM/DD/YYYYI LIMITS A GENERAL X UABIUTY COMMERCIAL GENERAL LIABILITY David Collings /CARLY ......(f:::::?.......-..:... 5302659 4/1/2015 4/1/2016 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 500, 000 CLAIMS -MADE X OCCUR MEDEXP(Anyoneperson) $ 25,000 X Contractual Liability PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENII AGGREGATE LIMIT APPLIES PER: 7 POLICY X I Fin- n LOC PRODUCTS - COMP /OP AGG $ 2 , 000 , 000 $ A A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED NON -OWNED AUTOS 6403892 (AOS) 6403893 (CA) 4/1/2015 4/1/2015 4/1/2016 4/1/2016 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA UAB EXCESSLIAB X OCCUR CLAIMS -MADE TH7- 651- 291560 -015 4/1/2015 4/1/2016 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED I X RETENTON$ 10,000 $ C A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory lnNH) If yes, describe under DESCRIPTION OF OPERATIONS below y / N N N/A 039901411 (AOS) 039901412 (CA) 4/1/2015 4/1/2015 4/1/2016 4/1/2016 I WCSTATU -1 (0TH - X TORY LMITS I 11 FR E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 D Professional Liability Contractors Poll. Liab. COPS 1951904 4/1/2015 4/1/2016 Per Claim $8,000,000 Aggregate $10,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedu e, If more space Is required) The City of Clearwater is named as an Additional Insured on the above referenced liability policies with the exception of workers compensation & professional liability where required by written contract. CERTIFICATE HOLDER CANCELLA City of Clearwater Engineering, RFQ #34 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 4748 -15 AUTHORIZED REPRESENTATIVE Clearwater, FL 33758 David Collings /CARLY ......(f:::::?.......-..:... ACORD 25 (2010/05) INS025 mmnnn) 01 © 1988-2010 ACORD CORPORATION. All rights reserved. The AC APn name anri Innn arc rcnietcrcrl marlre of ACC -1Rn