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CERTIFICATE OF LIABILITY INSURANCE (348)'`"CJKL' CERTIFICATE OF LIABILITY INSURANCE 4- V DATE(MMIDOIYYYY) 07/06/2015 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 Mutual Insurance Inc 1900 1st Ave North PO Box 12350 St Petersburg FL 33713- CONTACT William Warless ext 2213 NAME: PHONE e F ,t). (727)896 -0006 FAX No). (727)821 -7483 EDDRLSS wwanless @mutualinsuranceinc.com INSURERISI AFFORDING COVERAGE NAIC # INSURER A : ATS/Admiral Ins Co LIABILITY COMMERCIAL GENERAL LIABILITY INSURED Compass Engineering & Surveying Inc Deuel & Associates 565 S Hercules Ave Unit 11 & 12 Clearwater FL 33764 - INSURER B: Auto Owners Insurance Co 18988 INSURER C :SUM/Bridgefield Cas Ins 10/13/2015 INSURER D : Southern Owners Ins 10190 INSURER E : $ 300 000 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. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR wun POUCY NUMBER POLICY EFF (MM/DD/YYYYL POUCY EXP IMM/DD/YYYYI LIMITS D GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X X 2068939114 10/13/2014 10/13/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PRFMISFS (Fa occurrence) $ 300 000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 10,000 PERSONAL 8, ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE 7 POUCY X LIMIT APPLIES PF O- PER: LOC PRODUCTS - COMP /OP AGG $ 1,000,000 $ B AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS — X SCHEDULED AUTOS NON -OWNED AUTOS X X 4699170300 10/13/2014 10/13/2015 COMBINED SINGLE LIMIT 1,000,000 BODIILYINJURY (Per person) $ BODILY (Per ( ) $ PROPERTY DAMAGE (Per accident) $ B X UMBRELLA UAB EXCESS LIAB X OCCUR CLAIMS-MADE x X 4700541901 10/13/2014 10/13/2015 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' UABIUTY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below .I N N /A X 019615870 08/01/2014 08/01 /2015 X WC STATU- TORY LIMITS 0TH - ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,00 A Architects & Engineers Professional Liability - Claims Made $5,000 Deductible E000000904608 06/15/2015 06/15/2016 Each Occurrence 1,000,000 9g g A re ate 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, N more space Is required) 30 days notice of cancellation except for 10 day days notice for non - payment of premium. City of Clearwater is an additional insured with waiver of subrogation on a primary basis with respects to the General Liability, Auto Liability & Umbrella Policies. A wavier of subrogation in favor of the City of Clearwater applies to the Workers Compensation Policy. The Aggregate Limits, for the General Liability Policy, include a one time reinstatement. LDER CANCELLATION Al 021931 City of Clearwater Engineering RFQ #34 -15 P 0 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 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD '- .�vi "' CERTIFICATE OF LIABILITY INSURANCE DAT /06 /2DIYYYY) 07/06/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. THIS POLICIES 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 Mutual Insurance Inc 1900 1st Ave North PO Box 12350 St Petersburg FL 33713- CONTACT William Wanless ext 2213 NAMF: PHONE (Alf` No, Ex }). (727)896-0006 (AIC.. N0)•(727)821 -7483 E-MAIL wwanless@mutualinsuranceinc.com ADDRESS. @ utualinsuranceinc.com INSURERISI AFFORDING COVERAGE NAIC # INSURER A :ATS /Admiral Ins Co X 18988 INSURED Compass Engineering & Surveying Inc Deuel & Associates 565 S Hercules Ave Unit 11 &12 Clearwater FL 33764- INSURER B : Auto Owners Insurance Co INSURER C : SUM /Bridgefield Cas Ins EACH OCCURRENCE INSURER D :Southem Owners Ins 10190 INSURER E INSURER F : CLAIMS -MADE • - -' - "' ". ..—'-..". . . REvioluIV raurntSCK: 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 MICR SUBR wvn POLICY NUMBER POLICY EFF (MMIDDIYYY'Q POLICY EXP !MM/DDIYVY`a LIMITS D GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X X 2068939114 10/13/2014 10/13/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PRFMISFS (Fa ono manna) $ 300 +000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE —1 POLICY X LIMIT APPLIES PF O PER: LOC PRODUCTS - COMP /OPAGG $ 1,000,000 $ B AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS — X — SCHEDULED AUTOS NON -OWNED AUTOS x X 4699170300 10/13/2014 10/13/2015 (Cra acciden SINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE x X 4700541901 10/13/2014 10/13/2015 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 DFn RFTENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N N / A X 019615870 08/01/2014 08/01/2015 X WC STATU- TQRV I WITS OTH- ER E.L. EACH ACCIDENT $ 1 +000,000 E.L. DISEASE - EA EMPLOYEE $ 1 +000 +000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Architects & Engineers Professional Liability - Claims Made $5,000 Deductible E000000904608 06/15/2015 06/15/2016 Each Occurrence 1,000,000 gg g A re ate 1,000,000 DESCRIPTION OF OPERATIONS /LOCATIONS ! VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) 30 days notice of cancellation except for 10 day days notice for non - payment of premium. City of Clearwater is an additional insured with waiver of subrogation on a primary basis with respects to the General Liability, Auto Liability & Umbrella Policies. A wavier of subrogation in favor of the City of Clearwater applies to the Workers Compensation Policy. The Aggregate Limits, for the General Liability Policy, include a one time reinstatement. ATE HOLDER CANCELLATION Al 021931 City of Clearwater Engineering RFQ #34 -15 P 0 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 (45Vdevrif2006 ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD