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CERTIFICATE OF LIABILITY INSURANCE - RFQ 16-12, RFQ 34-15Client#: 1048507 G RI MAC RA ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD /YYYY) 1 1012112015 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 # X INSURERA: 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 : INSURER D INSURER E 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 CONTRACTOR 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. LTR TYPE OF INSURANCE ADDLSUBR NSR WVD POLICY NUMBER POLICY EFF (MM /DD /YYYY) POLICY EXP (MM /DD /YYYY) LIMITS • X COMMERCIAL GENERAL LIABILITY X X 680528OL540 1011412015 101141201 EACH OCCURRENCE $2,000,000 CLAIMS -MADE L* OCCUR PREMISES (ERENTED rrrence ) $1,000,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 PRO - POLICY X JECT LOC PRODUCTS- COMP /OPAGG $4,000,000 $ OTHER: • AUTOMOBILE LIABILITY X X BA220M6366 1113012014 111301201 idenINGLELIMIT Eeaccc S $1,000,000 X BODILY INJURY (Per person) $ ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED AUTOS X NON -OWNED AUTOS UMBRELLA LAB EACH OCCURRENCE $ HOCCUR AGGREGATE $ EXCESS LAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N/A PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ B Professional ARM 12007001 0512912015 051291201 $2,000,000 per claim Liability $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 ACORD 25 (2014/01) 1 of 1 #S16515875/M16515864 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 0 ')I. 0 - -Wl- .la © 1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MRLEW Client#: 1048507 G RI MAC RA ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD /YYYY) 1 1012112015 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 # X INSURERA: 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 : INSURER D INSURER E 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 CONTRACTOR 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. LTR TYPE OF INSURANCE ADDLSUBR NSR WVD POLICY NUMBER POLICY EFF (MM /DD /YYYY) POLICY EXP (MM /DD /YYYY) LIMITS • X COMMERCIAL GENERAL LIABILITY X X 680528OL540 1011412015 101141201 EACH OCCURRENCE $2,000,000 CLAIMS -MADE L* OCCUR PREMISES (ERENTED rrrence ) $1,000,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 PRO - POLICY X JECT LOC PRODUCTS- COMP /OPAGG $4,000,000 $ OTHER: • AUTOMOBILE LIABILITY X X BA220M6366 1113012014 111301201 idenINGLELIMIT Eeaccc S $1,000,000 X BODILY INJURY (Per person) $ ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ HIRED AUTOS X NON -OWNED AUTOS UMBRELLA LAB EACH OCCURRENCE $ HOCCUR AGGREGATE $ EXCESS LAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N/A PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ B Professional ARM 12007001 0512912015 051291201 $2,000,000 per claim Liability $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 RFQ34 -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 ACORD 25 (2014/01) 1 of 1 #S16515874/M16515864 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 0 ')I. 0 - -Wl- .la © 1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MRLEW