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CERTIFICATE OF LIABILITY INSURANCE (421) DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 9/8/2016 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). CONTACT PRODUCER NAME: Hylant - Orlando FAX PHONE 407-740-5550407-740-5522 (A/C, No): (A/C, No, Ext): 250 International Pkwy, Ste 330 E-MAIL rachel.dobbs@hylant.com Lake Mary FL 32746 ADDRESS: INSURER(S) AFFORDING COVERAGENAIC # Sentinel Insurance Company Ltd11000 INSURER A : REISENG-01Hartford Casualty Insurance Co29424 INSURED INSURER B : Reiss Engineering Inc. Hartford Accident and Indemnity Com22357 INSURER C : & Reiss Environmental Inc. Lloyds of London (UK) INSURER D : 1016 Spring Villas Pt Winter Springs FL 32708 INSURER E : INSURER F : 1063833600 COVERAGESCERTIFICATE 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. ADDLSUBR POLICY EFFPOLICY EXP INSR TYPE OF INSURANCELIMITS POLICY NUMBER (MM/DD/YYYY)(MM/DD/YYYY) LTRINSDWVD AY21SBABX83469/21/20169/21/2017 COMMERCIAL GENERAL LIABILITY X 1,000,000 EACH OCCURRENCE$ DAMAGE TO RENTED 1,000,000 CLAIMS-MADEOCCUR$ PREMISES (Ea occurrence) 10,000 MED EXP (Any one person)$ 1,000,000 PERSONAL & ADV INJURY$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- X 2,000,000 POLICYLOCPRODUCTS - COMP/OP AGG$ JECT $ OTHER: COMBINED SINGLE LIMIT C 9/21/20169/21/2017 $ AUTOMOBILE LIABILITY 21UECHV3040 1,000,000 (Ea accident) X BODILY INJURY (Per person)$ ANY AUTO ALL OWNEDSCHEDULED BODILY INJURY (Per accident)$ AUTOSAUTOS NON-OWNED PROPERTY DAMAGE XX $ HIRED AUTOS AUTOS (Per accident) $ AXX21SBABX83469/21/20169/21/2017 UMBRELLA LIAB 5,000,000 EACH OCCURRENCE$ OCCUR EXCESS LIAB 5,000,000 CLAIMS-MADEAGGREGATE$ $ DEDRETENTION$ PEROTH- WORKERS COMPENSATION B21WBCAQ26199/21/20169/21/2017 X STATUTEER AND EMPLOYERS' LIABILITY Y / N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVEE.L. EACH ACCIDENT$ N / A OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 1,000,000 E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below D Professional LiabilityPGIARK05417009/21/20169/21/2017Per Claim5,000,000 Aggregate5,000,000 Retention25,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Clearwater is an Additional Insured as respects General Liability. General Liability is primary and non-contributory. All of the above is applicable when required by written contract subject to the terms, conditions and exclusions of the policy. CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Clearwater Engineering THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O. Box 4748 ACCORDANCE WITH THE POLICY PROVISIONS. RFQ #34-15 Clearwater FL 33758 AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01)The ACORD name and logo are registered marks of ACORD