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CERTIFICATE OF LIABILITY INSURANCE (397)lient #: 39357 HWLOC ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE 4/25/2016 (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 Construction - Remegi Team Mesirow Insurance Services 353 N. Clark Street Chicago, IL 60654 CONTACT Jennie Fronczak NAME: PHONE 312 595 -8242 FAX 312 595 -6381 (A/C, No, Ext): (A/C, No): E -MAIL mesirowfinancial.com ADDRESS: jfronczak@mesirowfinancial.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Travelers Property Casualty Co. 25674 INSURED H. W. Lochner, Inc. 225 West Washington 12th Floor Chicago, IL 60606 INSURER B : Travelers Indemnity Co. of Amer 25666 INSURER C 05/01/2017 # INSURER 0: $1,000,000 $500,000 $ 5,000 INSURER E INSURER F : X 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 ADDL INSR SUBR WVD POLICY NUM .., POLICY EFF (MM /DDIYYYY) POLICY EXP /Y (MM /DDYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY 6308451 B87716 v' 9 ` FI C( 1 �t - az J." I a °/ 6L;' ai 6 ,a = :,.� r':` .- 05/01/2017 # EACH OCCURRENCE $1,000,000 $500,000 $ 5,000 CLAIMS -MADE X OCCUR PREMISESO(Ea occur ante) MED EXP (Any one person) PERSONAL & ADV INJURY $1,000,000 $2,000,000 GEN'L AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT PER: LOC GENERAL AGGREGATE PRODUCTS - COMP /OPAGG $2,000,000 $ A AUTOMOBILE X X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS Drive Oth Car X SCHEDULED AUTOS NON -OWNED AUTOS 8108451B87716 ..4 &.... 05/01/2016 05/01/2017 COMBI(Ea accideNED nt) SINGLE LIMIT $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE ZUP10P6385416NF 05/01/2016 05/01/2017 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 DED X RETENT ON $10,000 $ B WORKERS COMPENSATION EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y I N N N / A PHUB8976P38716 05/01/2016 05/01/2017 X 'MUTE STATUTE ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 $1,000,000 E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Lochner Project No. 7830. City of Clearwater Engineer of Record RFQ 16 -12. The following are included as Additional Insureds on the General Liability and Autmobile Policies per written contract: City of Clearwater. CERTIFICATE HOLDER CANCELLATION City of Clearwater 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 #S2055457/M2054730 © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD JQF HWLOCHN -01 BAKERRY A� R�� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 4/28/2016 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 Willis of Illinois, Inc. c/o 26 Century Blvd P.O. Box 305191 Nashville, TN 37230 -5191 NAME: ACT Willis Towers Watson Certificate Center PHONE 877 945 -7378 AX 888 467 -2378 IA/C, No, Extl: ( ) ( FA/C, No): (888) E -MAIL certificates @willis.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Lexington Insurance Company 19437 INSURED H.W. Lochner, Inc. 225 West Washington, Suite 1200 Chicago, IL 60606 INSURER B : ', s ! t ,el% a s'. ; INSURER C : r; •. 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIC ES 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-SUBR INSD WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY ', s ! t ,el% a s'. ; " g , - r; •. EACH OCCURRENCE $ CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ GE MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $ 'L AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT PER: LOC GENERAL AGGREGATE $ PRODUCTS - COMP /OPAGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS r It , r, .'s - �_ ..- `' (Ea acccidentSINGLELIMIT $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ UMBRELLA LIAB EXCESS LIAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ 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 $ A Professional Liab. 044177432 05/01/2016 05/01/2017 Per Claim /Aggregate: 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Master 7830; City of Clearwater Engineer of Record RFQ 16 -12 CERTIFICATE HOLDER CANCELLATION City of Clearwater Attn: City Clerk PO O Box x 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) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 9 c 1 b Q: -R--/1(0_5 u5-6 4 ((o,s,te a&(‘0_,QA\ scv5- itr/ 6(s's 2v(-- 12e4