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CERTIFICATE OF LIABILITY INSURANCE (364)2 ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DDIYYYY) 7/07/2015 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 USI Insurance Services, LLC, 1715 N. Westshore Blvd. Suite 700 Tampa, FL 33607 CONTACT NAME: (A/C No, Ext): 813 321 -7500 FAX 813 321 -7525 IA/C, No): E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC if INSURER A: Phoenix Insurance Company 25623 INSURED Interfiow Engineering, LLC 14499 N. Dale Mabry Hwy., Ste. 290 Tampa, FL 33618 INSURER B : Travelers Casualty and Surety C 19038 INSURER C : XL Specialty Insurance Company 37885 INSURER D $2,000,000 $1,000,000 INSURER E : MED EXP (Any one person) INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X X 6801922L734 06/06/2015 06/06/2016 EACH OCCURRENCE $2,000,000 $1,000,000 PREMISESO(Ea oNccTurrence) MED EXP (Any one person) $10,000 CLAIMS -MADE X OCCUR PERSONAL & ADV INJURY $2,000,000 GENERAL AGGREGATE $4,000,000 PRODUCTS - COMP /OP AGG $4,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES PRO- JECT PER LOC $ A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS X X 6801922L734 06/06/2015 06/06/2016 SINGLE LIMIT CEa OMaccidBINED ent) ( 2 e � 000 000 $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N Y N / A X UB9096Y735 03/12/2015 03/12/2016 X WC STATU- TORY LIMITS 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 C Professional Liability DPS9724407 06/06/2015 06/06/2016 $1,000,000 per claim $1,000,000 annl aggr. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Professional Liability coverage is written on a claims -made basis. REFERENCE: RFQ #34 -15 Certificate holder is an additional insured with respect to the General Liability and Auto Liability policy as required by written contract. CERTIFICATE HOLDER CANCELLATION City of Clearwater Engineering Dept. 100 S. Myrtle Ave., #220 Clearwater, FL 33756 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 04-5.;" ') a-cam Acl, ACORD 25 (2010/05) 1 of 1 #S15752962/M15520250 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD GITEW