CERTIFICATE OF LIABILITY INSURANCE
ACORDm
CERTIFICATE OF LIABILITY INSURANCE Page 1 of 2 04/20;72007
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
877-945-7378
PRODUCER
willis North America, Inc.
26 Century Blvd.
P. O. Box 305191
Nashville, TN 372305191
INSURERS AFFORDING COVERAGE
NAIC#
INSURED
URS Corporation
600 Montgomery Street, 25th Floor
San Francisco, CA 94111
INSURER A: National Union Fire Ins Co of Pittsburgh 19445-100
INSURERB: American International South Insurance Co 40258-001
INSURERC: Insurance Company of the State of PA 19429-100
INSURERD: Lloyd's of London/A.F. Beazley Syndicate 15792-200
INSURERE: Lexin ton Insurance Com an 19437-000
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I~~: ~~~ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
-A-- ----- """'C"A' 'A""'~ ~:-9807 51!/2007 __ 5/1/2008 EACH OCCURRENCE $ 1. 000.000
--_._--
---------.---.----" ----. PREMISES rEa occurenc;;;- .--
X COMMERCIAL GENERAL LIABILITY $ 1-.0-0-0-:-01f0 e--
I CLAIMS MADE UU OCCUR MED EXP (Anyone person) $ 10 000
..x.. XCU, BFPD PERSONAL & ADV INJURY $ 1 000.000
JLContractual Liability GENERAL AGGREGATE $ 2.000.000
~'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COM PlOP AGG $ 2 000 000
POLICY !Xl- .~rR,: (c::r LOC
A ~TOMOBILE LIABILITY CA826-2672 5/1/2007 5/1/2008 COMBINED SINGLE LIMIT
CA826-2675 5/1/2007 5/1/2008 (Ea accident) $ 2,000,000
A JL ANY AUTO
- ALL OWNED AUTOS BODILY INJURY
$
SCHEDULED AUTOS (Per person)
-
- HIRED AUTOS BODILY INJURY
$
NON-OWNED AUTOS REef" (Per accident)
- fED
- PROPERTY DAMAGE $
(Per accident)
RRAGE LIABILITY MAY 1 [j 2 07 AUTO ONLY. EA ACCIDENT $
ANY AUTO EA ACC $
OTHER THAN
OF ~/r-I^' --- AUTO ONLY: AGG $
EXCESS LIABILITY LEe: SLAT/VI: SRVC . AND EACH OCCURRENCE $
O' OCCUR 0 CLAIMS MADE DEPT AGGREGATE $
$
R DEDUCTIBLE $
RETENTION $ $
A -WORKERS-COMPENSATION ANlJ------ WC7181903 .- .... 1/#2%'7 -- 11-1/2008 ---- X 1~~I!rr,\;!;" I IO!,tI-
EMPLOYERS' LIABILITY --
B ANY PROPRIETOR/PARTNER/EXECUTIVE WC7181935 1/1/2007 1/1/2008 E.L. EACH ACCIDENT $ 1.000 000
C OFFICER/MEMBER EXCLUDED? WC7181937 1/1/2007 1/1/2008 E.L. DISEASE - EA EMPLOYEE $ 1 000 000
C If yes, describe under WC7181904/WC7181936 1/1/2007 1/1/2008 1 000 000
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $
D OTHER MMP 0005 5/1/2007 5/1/2008
E Professional Liability 1156494 E&O 5/1/2007 5/1/2008 $1,000,000. Each Claim
w/Limited Contractual - $1,000,000. Aggregate
Claims Made policv
DESCRIPTION OF OPERATlONSlLOCATlONSlVEHICLESlEXCLUSIONSADDED BY ENDORSEMENTISPECIAL PROVISIONS
Clearwater City Property - Brownfield Rehabilitation 901-927 Cleveland St. Project No. : 12002390
State of Florida is an Additional Insured as respects General & Auto Liability.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
City of Clearwater
112 South Osceola Avenue
Clearwater, FL 33766
ACORD 25 (2001/08)
Coll:1967856 Tpl:627065
Page 2 of 2
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
-:---""'---"'_.~~
-_.,----,.-<.----,._~'
,..,. '_.... - -..-.---... - -,..- '..-;"~~ ~."",~. ".---.>' ,_:
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
. ------------ ----------------.-- --------_.--_.~,_._._--
ACORD 25 (2001/08)
Coll:1967856 Tpl:627065 Cert:8891378
~
...
ACORDru CERTIFICATE OF LIABILITY INSURANCE Page 1 of 2 I DATE
01/02/2008
PRODUCER 877-945-7378 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Willis North America, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
26 Century Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P. o. Box 305191
Nashville, TN 372305191 INSURERS AFFORDING COVERAGE NAIC#
INSURED URS Corporation INSURER A: National Union Fire Ins Co of Pittsburgh 19445-100
600 Montgomery Street, 25th Floor INSURERB: American Home Assurance Company 19380-100
San Francisco, CA 94111
INSURERC: Insurance Company of the State of PA 19429-100
INSURERD: Lloyd's of London/A.F. Beazley Syndicate 15792-200
I INSURER E: Lexinaton Insurance ComDanv 19437-000
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I~~ ~~~ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
A ~NERALLIABILITY GL197-9807 5/1/2007
X COMMERCIAL GENERAL LIABILITY
,-DCLA;;;S~ADE(iJ;;cCUR - - '-',' --<-~. ~__c___ ,--' -"..
JL XCU, BPPD
JLContractual Liabilitv
~'L AGGREGATE LIMIT AP~S PER:
I POLICY -Gel P'~R;: I I LOC
I DEDUCTIBLE
I RETENTION $
A WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
,~ ~. -AN'f-PReP,RiHORIPARTNERlEXEGUTNE
A OFFICER/MEMBER EXCLUDED?
If yes. describe under
C SPECIAL PROVISIONS below
D OTHER
E Professional Liability
w/Limited Contractual -
Claims Made Policu
DESCRIPTION OF OPERATlONSlLOCATlONSNEHICLESJEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Clearwater City Property - Brownfield Rehabilitation 901-927
COVERAGES
A
A
B
~TOMOBILE LIABILITY
JL ANY AUTO
_ ALL OWNED AUTOS
f-- SCHEDULED AUTOS
_ HIRED AUTOS
I--- NON-OWNED AUTOS
-
nAGE LIABILITY
11 ANY AUTO
~ESSlUMBRELLA LIABILITY
.---J OCCUR 0 CLAIMS MADE
5/1/2008
CA826-2672
CA826-2675
CA826-2674
5/1/2007
5/1/2007
5/1/2007
5/1/2008
5/1/2008
5/1/2008
LIMITS
$
$
$
$
$
PRODUCTS - COMP/OP AGG $
1.000.000
1 000.000
10 000
1 000 000
2 000 000
2 000 000
RECIIVED
JAN 2' 2008
-
IOFf' (:IAL ....~( 11"'" H;'JL.I
LEGISLATIVE ~ RVeS DEPT
WC1593661
WC1593662
WC1593663
WC1593665/WC1593666
MMP 0005
1156494 E&O
1/1/2008
1n12008~
1/1/2008
1/1/2008
571/2007
5/1/2007
1/1/2009
1/1/2009--- .
1/1/2009
1/1/2009
5/1/2008
5/1/2008
EACH OCCURRENCE
~~~~~~~9E~~~J';;~nce)
MED EXP (Anyone person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
COMBINED SINGLE LIMIT $ 2,000,000
(Ee accident)
BODILY INJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
(Per accident)
AUTO ONLY - EAACCIDENT $
OTHER THAN EA ACC $
AUTO ONLY: AGG $
EACH OCCURRENCE $
AGGREGATE $
$
$
$
X I T"X~~T~I,~~ I IOJ~-
,F I FACfV,CClDENT .$
E.L. DISEASE - EA EMPLOYEE $
E.L DISEASE - POLICY LIMIT $
1- 000000
1.000.000
1 000-000
$1,000,000. Each Claim
$1,000,000. Aggregate
Cleveland St. Project No.: 12002390
State of Florida is an Additional Insured as respects General & Auto Liability.
CERTIFICATE HOLDER
City of Clearwater
112 South Osceola Avenue
Clearwater, FL 33766
ACORD 25 (2001/08)
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
RE RESENTATlVES.
U RIZED REPRESE~
Coll:2214050 Tpl:725207
~
.
Page 2 of 2
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
_ _______________------ __ __________DISCLAlMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
-
- f------- ----------------
ACORD 25 (2001/08)
Coll:2214050 Tpl:725207 Cert:l0124410