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CERTIFICATE OF LIABILITY INSURANCE (396)A� °® CERTIFICATE OF LIABILITY INSURANCE page 1 of 2 03/29/2016 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 CONTACT Willis of New York, Inc. c/o 26 Century Blvd. P. O. Box 305191 PHONE FAX 877- 945 -7378 (Ai�,NO) 888- 467 -2378 E -MAIL certificates@willis.com Nashville, TN 37230 -5191 -- INSURER(S)AFFORDING COVERAGE - NAIC # INSURERA:Greenwich Insurance Company 22322 -001 EACHOCCURRENCE .................. — INSURED Atkins North America, Inc. 6:46E Insurance Corporation 39217 -001 _INSURER INSURERC:XL Specialty Insurance Company 37885 -001 2001 NW 107th Avenue Miami, FL 33172 -2507 INSURER D: Underwriter's at Lloyds 15792 -001 INSURER E: M ED EXP (Any one person) $ 10,000 INSURER F: X Contractual_ Liability COVERAGES CERTIFICATE NUMBER: 24277666 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 DDL SUB POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y CGG740901605 4/1/2016 4/1/2017 EACHOCCURRENCE $ 1, 000 000 CLAIMS -MADE OCCUR — pDAAMM&E77 a ENTED occurence) $ 300-000 M ED EXP (Any one person) $ 10,000 X Contractual_ Liability PERSONAL& ADV INJURY $ 11000,000 _ L AGGREGATELIMITAPPLIESPER: . GENERALAGGREGATE $ 2 Q00 000 "' � r7' P OLICY LOC X PRO- JECT PRODUCTS - COMP /OP AGG $ 2 O O 0 , 0 O 0 ___ -. - $ OTHFR' A AUTOMOBILE LIABILITY Y Y iCAH740901705 4/1/2016 4/1/2017 COMBINED SINGLE LIMIT (Ea accident) .. - -- .._._.. - - -... $ 2 - -..2-_ 000 , 000 X ANYAUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED AUTOS AUTOS X BODILY INJURY(Per accident) $ A ED X HIREDAUTOS UTOS X ( )AMAGE (Per $ B X UMBRELLA LIAB X OCCUR Y CCU3977184 4/1/2016 4/1/2017 EACH OCCURRENCE 1$ 11000,000 AGGREGATE $__ ..... 1,..- 000,_000 — .... . EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH) f yes, describe under DESCRIPTIONOF OPERATIONS below N/A Y CWG740901505 4/1/2016 4/1/2017 X STATAC E.L. EACH ACCIDENT __ ......................_.....-.._..-.._..._.. .........- E.L. DISEASE - EA EMPLOYEE $ 1, 000, 000 ..............._.._ -- _..-_......--_.. -- $ 1,000,000 E.L. DISEASE - POLICY LIMIT _ $ 1,000,000 D Professional B080111209P16 4/1/2016 4/1/2017 $1,000,000 Each Claim & Liability - Claims Made $1,000,000 Annual Aggregate 11/11/1961 Retrodate DESCRIPTION OF OPERATIONS/ LOCATIONS/ VEHICLES (ACORD 101, Additonal Remarks Schedule, may be attached if more space is required) Re: City of Clearwater. Greenwich Insurance Company Best Rating: A XV QBE Insurance Corporation Best Rating: A XIV XL Specialty Insurance Company Best Rating: A XV Underwriters at Lloyd's AM Best Rating: A XV Professional Liability olic written on claims -made basis. CERTIFICATE HOLDER CANCELLATION City of Clearwater Engineer of Record 100 S. Myrtle Avenue Engineering - Suite 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 / t n Col1:4875378 Tp1:2041772 Cert:24277666 © 1988- 2014ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD