Loading...
CERTIFICATE OF LIABILITY INSURANCE - 2012-2015'A °r CERTIFICATE OF LIABILITY INSURANCE °ATO{MW2014YYY, 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), AUTHORIMD REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT. If the certificate holder Is an ADDITIONAL INSURED, the policy (lim) 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 Aon Risk Insurance services west, Inc. Los Angeles CA office COCONNTTACT PHONE (866) 283 -7122 FAX (800) 363 -0105 IA, .• Exl1 INC. Nu : 707 Wilshire Boulevard Suite 2600 E-MAIL ADDRESS: Los Angeles CA 90017 -0460 USA LIMITS INSURER(S) AFFORDING COVERAGE NAIC 0 INSURED ]INSURER &- Lexington Insurance company 19437 Tetra Tech, Inc. 201 East Pine Street Orlando FL 32841 USA NSLrRERB: National Union Fire Ins CO of Pittsburgh 19445 INSURER C; The Insurance Co of the state of PA 19429 INSURER D: AIG Europe Limited AA1120841 INSURER E: INSURER F: L;WVCKALaCS L:!"KIIF14AIE NUM6EK: b(UUbb:il4t5(1 REVISION NUMBER: THIS 1S 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. Llmits shown are as requested INSR LTR TYPE OF INSURANCE D ywD POLICY NUMBER MIND LIMITS X COMMERCIAL GENERAL LIABILITY GL EACHgCCURRENCE S2,000,000 CLAIMS -MADE gCG1JR PREMISES Ea occurrence $1,000.000 MED EXP (Anyone person) S10 , 000 X XC.0 Coverage PERSONAL 8 ADV INJURY S2 , 000 , G00 �4 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S4,000, PouCY El JFO %]LOC OTHER: p PRODUCTS - COMPlOPAGG $4,000,O0G B AUTOMOBILE LIABILITY CA 5101755 10/01/2014 10 /01/2015 COMBINED SINGLE LIMIT $1,000,000 D; BODILY INJURY ( Per person) ALL OWNED SCHEDULED AUTOS AUTOS R Ix ANY AUTO HIRED AUTOS X AUTOS _ qu BODILY INJURY (Per ac idenQ PROPERTY DAMAGE Per accdden D X UMBRELLA LAB X OCCUR TH1400061 10/01/2014 10 0 2015 EACH OCCURRENCE 1, 000,000 EXCESS LIAR CLAIMS -MADE AGGREGATE S1,000,000 OED I X IRETENTION 1100, ODD C C C WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORI PARTNER EXECUTIVE OFFICEFtMEMBER EXCLUDED? N N)A wCO283 1 WCO29328265 WCO28328166 10 01 2014 1010112014 10/01/2414 10 Ol 10/01/2015 10/01/2015 X PER OTH- STATUTE IFIR E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 C (Me AdateryinNHJ wc028328167 1010112014 10/01/20151 IF yes, desrnbe under DESCRIPTION OF OPERATIONS helow - E:L. DISEASE-POLICY LIMIT $1,00o,000 A Contractor Prof 7– —lip" 028182375 Liab 10/01/2013 10/01/2015 Each Clain Agggregate $1.000,000 f1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be. a0ached if novae space Is nquind) �1 RE: Project Start Date: 10101112. City of Clearwater, Florida is included as Additional insured as required by written contract, but limited to the operations of the Insured under said contract with respect to the General Liability and Automobile Liability policie General Liability evidenced herein is primary and non - contributory to other insurance available to the city Of Clearwate I Florida, its officers, officials, employees, or volunteers but only to the extent required by written contract with the insured. A waiver of Subrogation 1s granted in favor of City of Clearwater, Florida as required by written contract but limi d to the operations of the insured under said contract, with respect to the General Liability and Automobile iN Liability policies. Cross Liahility/Severability of Interest is lnclu ed under the General Liability policy where required by IQ nd -a0 # 5 r nn+r44- - CERTIFICATE HOLDER CANCELLATION 0 SHOULD ANY OF THE ABOVE DESCRIBED POL#CIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WALL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, city of Clearwater, Florida AUTHOR ED REPRESENTATIVE 100 South Myrtle Avenue Clearwater FL 33756 USA &L 9"W"JL6>Ealm r aL 01888- 2014ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD -`' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDn1YYYY) 09!2512015 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(iesj must be endorsed. If SUBROGATION 18 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 Aon Risk insurance services West, Inc. Las Angeles CA office 707 Wilshire Boulevard suite 2600 CONTACT NAME: P [866) 283 -7122 FAX (800) 363 -0105 sA'C• H °. Exq: WC. No.): BAWL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIL# Los Angeles CA 90017 -0460 USA INSURED INSURER A: National union Fire Ins CO of Pittsburgh 19445 Tetra Tech, Inc. INSURER B: The Insurance Co of the State Of PA 19429 201 East Pine Street Suite 1000 INSURER C: AIG Europe Limited AA1120841 INSURER D: Lexington Insurance company 19437 Orlando FL 32801 USA INSURER E: PREMISES Ea occurrence INSURER F- X MED ExP (Any one person) COVERAGES CERTIFICATE NUMBER: 570059578124 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- Limits shown are as requested TR TYPE OF INSURANCE I. WYD POUCYNUMBER MwD p LIMITS X COMMERCIAL GENERAL LIABILITY GL EACH OCCURRENCE $2,0007000 CLAIMS -MADE FX1 OCCUR PREMISES Ea occurrence S1,000,000 X MED ExP (Any one person) $10,000 X,C,U Coverage PERSONAL &ADVINJURY $2,000,000 GENT AGGREGATE LIMIT APPLIES PER POLICY = JE O- [X] LOC GENERAL AGGREGATE $4,000,000 PRODUCTS - COMPlOP AGG S4,000,000 OTHER: i4 AUTOMOBILE LIABILITY CA 3194397 1016112015 10/01/2016 COMBINED SINGLE LIMIT Ea a n $.1, 000, Qoo BODILY INJURY ( Per person) x ANY AUTO BODILY INJURY {Per a(cident) ALL OWNED ED AUTOS X HIRED AUTOS ED [Ix PROPERTY DAMAGE Per acoldent C x UMBRELLA LIAS R TH1500079 10/91/2015 10 41 2016 EACH OCCURRENCE 1,000,000 EXCESS LIAR S -MADE AGGREGATE $1,000P000 DIED I X RETENTION S100,DOC B B B B EMPLOYERS'MPENS yIONAND YIN ANY PROPRIETOR I PARTNER! EXECUTIVE 0T:F10ERiMEM6rR EXCLUOEd E] (Mandatory in NH) If yes- describe under DESCRIPTION OF OPERATIONS below NIA WC014267906 WC014267908 WC014267907 WC014267912 10/01 2[)15 10 /01/2015 16/01/2015 10/01/2015 10/01/2016 10/01/2016 10/01/2016 10/01/2016 )( STATUTE ERH E.L. EACH ACCIDENT $1, Q00,000 E.L DISEASE -EA EMPLOYEE $1,000,000 E.L DISEASE -FOLICY LiMiT $1,000,000 D Contractor Prof 029182375 1D/01/2015 1010112017 Each Clain $1,000,000 Prof /Poll Liab Agggregate $1,000,000 SIR applies per policy ter s & car ions DESCRIPTION of OPERATIONS I LOCATIONS 1 VEHICLES IACORD 101, Additional Remarks Schedule. wry be attached if more space 6 required) Project Start Date: 08110112, lob: Engineer of Record. City of Clearwater is included as Additional insured as required by written contract, but limited to the operations of the Insured under said contract, with respect to the General Liability and Automobile Liability policies. Genera and Automobile Liability policies evidenced herein is primary and non - contributory to other insurance available to an, but only to city of Clearwater, its officers, officials, employees and volunteers the extent required by written contract with the insured. severability of interest is included under the General Liability policy where required by written contract. should General Liability, Automobile Liability and Workers' compensation described policies be cancelled before the expiration date thereof, the policy provisions will govern how notice of -ate m w C M v_ d a 0 X ry no ti tv W) O z .m+ ep V I:. tr' m L.1 CERTIFICATE HOLDER - CANCELLATION L SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ( EXPIRATION DATE THEREOF, NOTICE WILL BE DELWRED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of Clearwater water AUTHORIZED REPRESENTATIVE 100 south myrtle Avenue Clearwater FL 33755 USA e34 e�JfLta� Yallix9 !e`er JL 01988 -2014 ACORD CORPORATION, All rights reserved. ACORD 25 (2014101 )1 The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE DsrzsrzDr4 I DATE (MM,DDIYYYY) 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 Aon Risk Insurance services west, -Inc. Los An el es CA Office CONE PHONE C856} 283 -7122 FAX CBiID} 3fi3 -Oi05 (+�• No• Et): AID. No. 707 Wilshire Boulevard suite 2500 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC M Los Angeles CA 90017 -0450 USA INSURED INSURER A: Lexington Insurance Company 19437 Tetra Tech, Inc. 201 East Pine Street Orlando FL 32801 USA INSURER B: National union Fire Ins Co of Pittsburgh 19445 INSURER C: The Insurance Co of the state of PA 19429 INSURER D: AIG Europe Limited AA1120841 INSURER E: PREMISES s occurrerLCe S1, 000, 004 INSURER F: MED EXP (Wry one pemW $10,000 COVERAGES CERTIFICATE NUMBER: 570055324864 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. Limits shown are as requested LTR TYPE OF INSURANCE I N POLICY NUMBER aim UL py LKF LIMITS X COMMERCIAL GENERAL LABILITY GL EACH OCCURRENCE $2,000,000 CLAIMS -MADE 7X OCCUR PREMISES s occurrerLCe S1, 000, 004 X MED EXP (Wry one pemW $10,000 X,C,U Coverage PERSONAL & ADV INJURY S 2.000, 000 GEN'L AGGREGATE Li PAT AP PLIES PE R: GENERAL AGGREGATE $4,000,000 POLICY [fl PRO- � LOC ECT PRODUCTS - COMPIOP AGG 54 , 000, 0DQ OTHER! B AUTOMOBILE LIABILITY CA 51017S5 10/01/2014 10/01/2015 COMBINED SINGLE LIMIT a accfde I S1,000,000 BODILY INJURY ( Per person} ANY AUTO BODILY INJURY (Per acdkierkt) ALL OWNED SCHEDULED AUTOS AUTOS AUTOS 11 HIRED AUTOS X NON -0OWNED PROPERTY DAMAGE Per accident) D x UMBRELLAL OCCUR TH1400061 10/01/2014 10/01/2015 EACH OCCURRENCE 51, 000, 000 E%CEII LIAR CLAIMS -MADE AGGREGATE $1.000,000 RBTENTION 1100 ,ODD C c O C WORKERS COMPENSATION AND EMPLOYRRS'LULBIL.ITY rrN ANY PROPRIETOR I PARTNER I EXECUrIVE OFFICER+MEMBER EXCLUDED? (Mandatary in NH) If yes descrbe under DESCRIPTION OF OPERATIONS below NIA WCO 8328161 WCO28328165 WCO28328166 WCO28328167 10 01 251410/01/2015 10/01/2914 15/01/2014 1010112014 10/01/2015 10/01/2015 10/01/2015 x PER F STATUTE E. L. EACH ACCIDENT $1,000,000 E .L. DISEASE -EA EMPLOYEE $1,000, 00o E.L. DISEASE- POLICY LIMIT 11, 000, 000 A Contractor Prof 028182375 10/01/2013 10/01/2515 Each Clain $1,000,000 Prof/PolI Liab Agggregate $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS! VEHICLES (ACORD 101, Ad*flonaI Renwrks Sche"le, may be atwehad it more space is required) Project start Date- 08 10/12, Job: Engineer of Record. City of Clearwater is included as Additional insured as required by written contract but �imited to the operations of the Insured under said [antract, with respect to the General Liability and Automobile Liability policies. General Liability and Automobile Liability policies evidenced herein is primary and non - contributory to other insurance available to an, but only to City of Clearwater, its officers, officials, employees and volunteers the extent required by written contract with the insured. Severability of interest is included under the General Liability policy where required by written contract. Should General Liability, Automobile Liability and workers' Compensation described policies. be cancelled before the expiration date ther of, the policy provisions will govern how notice of ao CERTIFICATE HOLDER CAHCELLATION Mill TF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED 1N ACCORDANCE WITH THE POLICY PROVISIONS. City of Clearwater AUTHORIZED REPRESENTATIVE 100 South myrtle Avenue Clearwater FL 33755 USA 7�661fRALffi 9Yei 01988 -2614 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD