Loading...
CERTIFICATE OF LIABILITY INSURANCE (16)'```� °tl CERTIFICATE OF LIABILITY INSURANCE 6/1/2017 DATE (MM /DD/YYYY) 5/25/2016 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 Lockton Companies 444 W. 47th Street, Suite 900 Kansas City MO 64112 -1906 (816) 960 -9000 CONTACT NAME: PHONE . EM): I FA , No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Hartford Fire Insurance Company 19682 INSURED HDR ENGINEERING, INC. 1013472 8404 INDIAN HILLS DRIVE OMAHA NE 68114 -4049 INSURER B: Travelers Property Casualty Co of America 25674 INSURER C : American Zurich Insurance Company 40142 INSURER D : Lexington Insurance Company 19437 INSURER E : CLAIMS -MADE OCCUR X INSURER F : X E • ..—I\. .1 ,.A1111/1 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 INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY N N 37CSEQUO950 6/1/2016 6/1/2017 EACH OCCURRENCE $ 1,000,000 $ 1,000,000 CLAIMS -MADE OCCUR X DAMAGE TO RENTED PREMISES (Ea occurrence) X CONTRACTUAL LIAB INC MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X JECT x LOG OTHER GENERAL AGGREGATE $ 2,000,000 PRODUCTS- COMP /OPAGG $ 2,000,000 $ A A A AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON- OSWNED N N 37CSEQU099� (AL)S) 37CSEQU09� (H) - 37CSEQU1160 MA) 6/1/2016 6/1/2016 6/1/2016 16/1/2017 6/1/2017 6/1/2017 {Ee a idea SINGLE LIMIT $ 2,000,000 BODILYINJURY(Perperson) $ XXXXXXX BODILY INJURY (Per accident $ XXXXXXX PROPERTY DAMAGE (Per accident) $XXXXXXX $ XXXXXXX B B X UMBRELLA LIAB EXCESS LIAB X — OCCUR CLAIMS -MADE N N ZUP- 10R64084 -16 -NF (EXCLUDES PROF LIAB) 6/1/2016 6/1/2016 6/1/2017 6/1/2017 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 DED I I RETENTION $ $ XXXXXXX C AND ANY OFFICER/MEM (Mandatory If yes, DESCRIPTION EMPLOYERS' LIABILIITY YIN ER EXCLUDED? CECUTIVE N in NH) describe under OF OPERATIONS below NIA N 0381127 7/1/2016 7/1/2017 X I STATUTE I 10TH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 D ARCHS & ENGS PROFESSIONAL LIABILITY N N 061853691 6/1/2016 6/1/2017 PER CLAIM: $1,000,000 AGGREGATE: $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: 2009 -2012 CITY OF CLEARWATER - ENGINEER OF RECORD AGREEMENT FOR PROFESSIONAL SERVICES. THE CITY OF CLEARWATER, FLORIDA ARE NAMED AS ADDITIONAL INSURED ON GENERAL, AUTOMOBILE, AND EXCESS LIABILITY AS PER WRITTEN CONTRACT, ON A PRIMARY, NON - CONTRIBUTORY BASIS. WAIVER OF SUBROGATION APPLIES WHERE APPLICABLE BY LAW. SEVERABILITY OF INTERESTS APPLIES. CANCELLATION See Attachments 10609419 CITY OF CLEARWATER, FLORIDA ATTN: CITY CLERK PO BOX 4748 CLEARWATER FL 33754 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) ©19'$8 -2014 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 37CSEQUO950 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - -- OWNERS, LESSEES OR CONTRACTORS -- SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: AS PER WRITTEN CONTRACT, ON A PRIMARY, NON - CONTRIBUTORY BASIS (Information required to complete this Schedule, if not shown above, will be shown in the Declarations.) A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 20 10 07 04 Miscellaneous Attachment : M5509 Certificate ID : 10609419 POLICY NUMBER: 37CSEQUO950 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: ANY PERSON OR ORGANIZATION WITH WHOM YOU HAVE AGREED, THROUGH WRITTEN CONTRACT, AGREEMENT OR PERMIT, EXECUTED PRIOR TO THE LOSS, TO PROVIDE ADDITIONAL INSURED COVERAGE FOR COMPLETED OPERATIONS. Location And Description of Completed Operations: ANY LOCATION WHERE YOU HAVE AGREED, THROUGH WRITTEN CONTRACT, AGREEMENT OR PERMIT, EXECUTED PRIOR TO THE LOSS, TO PROVIDE ADDITIONAL INSURED COVERAGE FOR COMPLETED OPERATIONS. Information required to complete this Schedule, if not shown above will be shown in the Declarations. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products- completed operations hazard ". CG 20 37 07 04 Miscellaneous Attachment : M5509 Certificate ID : 10609419 POLICY NO. 37CSEQUO951 37CSE000952 37CSEQU 1160 HARTFORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED AND RIGHTS OF RECOVERY AGAINST OTHERS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM A. Any person or organization whom you are required by contract to name as additional insured is an "insured" for LIABILITY COVERAGE but only to the extent that person or organization qualifies as an "insured" under the WHO IS AN INSURED provision of Section II - LIABILITY COVERAGE. B. For any person or organization for whom you are required by contract to provide a waiver of subrogation, the Loss Condition - TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US is applicable. Name of Additional Insured Person(s) of Organization(s): Blanket coverage as required by written contract. Hartford Form #HA9913 Miscellaneous Attachment : M6986 Certificate ID : 10609419