CERTIFICATE OF LIABILITY INSURANCE (374)ACCMV DA rE gMMrDDf'(YYY(
CERTIFICATE
tOi 18120 15
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(les) must be endorsed. If SUBROGATION IS WAI'VEO„ 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 endorsernent s .
PRODUCER CONTACT
NAME:
Hylarat Orlando PHONE 07 40. �fi ,(AAIC No) :407 -740-5522
250 International Pkwy, Ste 330 MAIL
Lake Mary FL 32745
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Clearwater Engineering ACCORDANCE WITH THE POLICY PROVISIONS.
P.0, Box 4748
RFQ #34-15 AUTHORIZED REPRESENTATIVE
Clearwater FL 33758
1588 -2010 ACORD CORPORATION, All rights reserved.
ACORD 25 (201010 r) The ACORD name and logo are registered marks of ACORD
INSURER A :Sentinel Insurance Company Ltd.(?
INSURED REISENG -01
INSURER e: t..Paul Fire & Marine Ins,,. o _. .......
2.4787 ._.....
Reiss Engineering Inc.
INSURER C •Certain UW at Lloyds & Brkr of Prof
& Reiss Environmental Inc.
1015 Spring Villas Pt
INSURER D
Winter Spriings FL 32708
INSURER
INSURER F
COVERAGES CERTIFICATE NUMBER: 139023610 REVISION NUMBER:
__ _ _ . -. -. -... � � � ._ _
1"h'IOTF IS T GERT'IFY 1'hIAT THE, POLICIES OF INS�JRAYwIC LISA 1ED BILLOW HAVE BEEN ISSt�ED TO "PHI:: INhLRED NAMED ABOVE FOR THE. POLICY Nl I�IUIJ
NDICATED, NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT
TO WHICH THIS
r, ",F'R I-IFICA'T'E 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 HAVF BEEN t +. "ED IBY PAID CLAIMS.
SUES ' , Y EXF... ...
I POLICY
LI R TYPE OF INSURANCE NSIR �fi9lpi�tl E &1 PA r N ?V y Y d MM+DDVYYYY LIMITS
,„�.,,� I L_ MID
_„�
,� 0 ILq
"4 83
/'4 GENERAL LIABILITY Y ' ` `r ' " 12V2016 EACH OCCURRENCE
.... .....
S 1,000.000
X DAMAGE TO RENTED
4
.... ....
COMMMERCIAL. GENERAL LIABILITY
.. PREMIS(w5 {Ea ac urrence
$1 Ia00 000
Cl-AIMS-MADE S•RADE CGGJR D EXP one P er q
n
S10,000
PERSONAL INJURY
1,000.000
GENERAL AGGREGATE
$2,000000
GEN L AGGREGATE LI MIT APPLIES PER: � � '. �n PRODUCTS - COMB OP AGG
a i u�":" _
_ $2,000,000
R 1
POLICY LOC ,.�����
�}
TY 21 UEcL U^iJ".�t70 912v2015 9/2112016 (Ea acF id n ��� '. I
A AUTCE LIABILITY
..1$1 00("') 000
X ANY AUTO BODILY INJURY ;Per per, on)
$,
ALL OWNED SCHEDULED
B DILY INJURY IPpr accidgr!'•
AUTOS AUTOS .....
X X NON -OWNED PROPERTY DAMAGE
"r'OS
HIRED AU AUTOS (Per ac icent) I _...
$
B X UMBRELLA LIAR X OCCUR CUP20150911 9/2112015 9/21/2016 EACH OCCURRENCE
$151000,000
EXCESS LIAS CLAIMS-MADE AGGREGATE
.._.. _.._.$
$Cm 000 000
___. _._ _..
CS
DE... X RETENTIONS10,000
A WORKERS COMPENSATION 21WBCAP9558 9/21/2015 9121/2016 X WCST'ATU• BOTH.
AND EMPLOYERS' LIABILITY Y f N TORY LIMIT$......... EF?,......._.
...... _... ..
ANY!aRGPRIETOR�PARTNERIE: ECUTIVE E L EACH ACCIDENT
$ 1,000,000
OPF'GER'- MEMBER' EXCLUDED'] FN D'] 1 A
._. _...... ..
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE. $ 1.000,0.00
It s. d,esce ibe runcer
.... ..........
(e
C:AFSCRI4'•r'T 10N OF 0PERAT "IO�ITS bl5!o %v E.L. DISEASE POLICY LIL�IIT
$1,000,000
C Professional Liability PGIARK0541700 9121/2015 9121/2016 Per Claorn
Z00,0,000
Retro: Frill Prior Acts Aggregate
2,000,000
Retention
25.000
DESCRIPTION OF OPERATIONS N LOCATIONS? VEHICLES (Attach ACORD 101, Additional Remarks Schedule,. If more space Is required)
City of Clearwater is an Additional Insured as respects General Liability. General Liability is primary and non - contributory. All
of the above is
applicable when required by written contract subject to the terms, Conditions and exclusions of the policy.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Clearwater Engineering ACCORDANCE WITH THE POLICY PROVISIONS.
P.0, Box 4748
RFQ #34-15 AUTHORIZED REPRESENTATIVE
Clearwater FL 33758
1588 -2010 ACORD CORPORATION, All rights reserved.
ACORD 25 (201010 r) The ACORD name and logo are registered marks of ACORD