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CERTIFICATE OF LIABILITY INSURANCE (382)Client #: 1048507 GRIMACRA ACORDT. CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD/YYYY) 10/21/2015 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: PHONE FAX ( o, Ext): 813 321 -7500 (A/C, No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Phoenix Insurance Company 25623 INSURED Grimail Crawford, Inc. 4600 W. Cypress St., Suite 550 Tampa, FL 33607 INSURER B : Wesco Insurance Company 25011 INSURER C : 10/14/2016 INSURER D $2,000,000 INSURER E : INSURER F : X COVERAGES CERTIFICATE 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 X COMMERCIAL GENERAL LIABILITY X X 6805280L540 10/14/2015 10/14/2016 EACH OCCURRENCE $2,000,000 CLAIMS -MADE X OCCUR PREMISESO(Ea RENTED ence) $1,000,000 $10 000 MED EXP (Any one person) PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE POLICY OTHER: v LIMIT APPLIES JECOT PER: LOC GENERAL AGGREGATE $4,000,000 PRODUCTS - COMP /OP AGG $4,000,000 $ A AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS MOWN ED AUTOS X X BA220M6366 RECEDE 11/30/2014 11/30/2015 COMBIN (Ea accident) ED SINGLE LIMIT $ 1 000 000 s BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE OCT ((� j pA tt OF�!n�ys¢ciAL'�CQRDS 2 ! 2O1 jj��°�� EACH OCCURRENCE $ AGGREGATE $ DED RETENT ON $ /'9i�D $ WORKERS COMPENSATION AND EMPLOYERS' LIILITY EMPLOYERS' LIABILITY A ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A d� S 1 ° a+ r i r i STATUTE EERH E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ B Professional Liability ARA112007001 05/29/2015 05/29/201 $2,000,000 per claim $2,000,000 annl aggr. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Professional Liability coverage is written on a claims -made basis. RE: Engineer of Record RF034 -15. The City of Clearwater is an Additional Insured as respects the Commercial General Liability policy where required by a written contract prior to a loss per policy terms and conditions. CERTIFICATE HOLDER CANCELLATION City of Clearwater Attn: City Clerk PO 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 0LA40 ''L ACORD 25 (2014/01) 1 of 1 #S16515874/M16515864 © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MRLEW RIMACRA ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM /D D /YYYY) DA TE(MMDo15 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: PHONE 813 321 -7500 FAx (A C, No, Ext): (A/C, No): E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Phoenix Insurance Company 25623 INSURED Grimail Crawford, Inc. 4600 W. Cypress St., Suite 550 Tampa, FL 33607 INSURER B : Wesco Insurance Company 25011 INSURER C : 10/14/2015 INSURER D : EACH OCCURRENCE INSURER E : PREMISESO(Ea RENTED 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 ADDLSUBR INSR WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY X X 6805280L540 10/14/2015 10/14/2016 EACH OCCURRENCE $2,000,000 $1,000,000 $10,000 $2,000,000 PREMISESO(Ea RENTED CLAIMS-MADE X OCCUR MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE $4,000,000 GE 'L AGGREGATE POLICY OTHER: X LIMIT APPLIES JECPRO- T PER: LOC PRODUCTS - COMP /OP AGG $4,000,000 $ A AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS — X SCHEDULED AUTOS AUTOSWNED X X BA220M6366 RECEIVED OCT 2 7 2015 11/30/2014 11/30/2015 SINGLE LIMIT $1,000,000 $ BODILY INJURY (Per person) BODILY INJURY (Per accident) $ (Per DAMAGE erraccident $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE OFFICIAL RECORDS LEGISLATIVE E SRV S AND DEPT EACH OCCURRENCE $ AGGREGATE $ $ DED I RETENT ON $ 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 N / A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ B Professional Liability ARA112007001 05/29/2015 05/29/201 $2,000,000 per claim $2,000,000 annl aggr. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Professional Liability coverage is written on a claims -made basis. RE: Engineer of Record RFQ16 -12. The City of Clearwater is an Additional Insured as respects the Commercial General Liability policy where required by a written contract prior to a loss per policy terms and conditions. CERTIFICATE HOLDER CANCELLATION City of Clearwater Attn: City Clerk PO 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 of 1 #516515875/M16515864 ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MRLEW USI INSURANCE SERVICES CERTIFICATE RETURN MAIL PROCESSING P.O. BOX 5007 NOVATO, CA 94948 -5007 CITY OF CLEARWATER ATTN: CITY CLERK PO BOX 4748 CLEARWATER FL 33758 -4748