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CERTIFICATE OF LIABILITY INSURANCE (37) r -, ACORDTM DATE(MM/bD/Y't'Y't') OS/29/2007 PRODUCER Aon Risk services, Inc. of Tennessee 501 Corporate Centre Drive Suite 300 Franklin TN 37067 USA THIS CERTIFICATE IS ISSUED AS A MATTER OF IN FORMA TION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PHONE. (866 283-7122 FAX- 847 953-5390 INSllRERS AFFORDING COVERAGE NAIC # INSURED ARCADIS U.S., Inc. formerly ARCADIS G&M, Inc. 630 plaza Dr. Ste 200 Highlands Ranch CO 80129-2379 USA INSURER A: Lexington Insurance company 19437 .. .. I: ;: c .. "I: .. .. .. "I: C ::z: INSURER B: INSURER C: INSURER D: INSURER E: 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 MAYBE 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. INSR ADD' LTR INSRD n'PE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE(MM\DDlYY) DATE(MM\DD\YY) LIMITS ~ERAL LIABILITY COMMERCIAL GENE.' RAL LIABILITY CLA1MS MADE D OCCUR EACH OCCURRENCE DAMAGE TO RENTEIJ PREMlSES (Ea occurence) ED (Anv one person) GENERAL AGGREGATE ,..., ..... C ex: ex: ~ '" '" C C ..... Lr PERSONAL & ADV INJURY GENL AGGREGATE LIMIT APPLIES PER: D POLICY D PRO- D LOC JECT PRODUCTS - COMPIOP AGG AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OV.'NED AUTOS COMBINED SINGLE LfMlT (Ea accident) c :2 , '" , , to: ;: . . c. GARAGE LIABILITY B ANY AUTO EXCESS /UMBRELLA LIABILITY D OCCUR D CLAIMS MADE QFFl tAL RECORD AND EPT BODILY INJURY ( Per person) ",,:.:, ! BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY EA ACC AGG EACH OCCURRENCE AGGREGATE DDEDUCTlBLE DRETENTION WORKERS COMPESSA T10N AND EMPLOYERS' LL\BILln' ANY PROPRIETOR I PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below OTH- ER E.L DISEASE-EA EMPLOYEE E.L DISEASE-POLICY LfMlT III ~ ~ $5,000,000 ;::..J $5,000,000 ~ ...... ~ -... ~ ~ '-J 5t=! ~ ~_l Z1 L~ ~ . A OTHER COn1:ractor poll 5766028 Prof Liab - Contractors 06/01/07 1 08 Each Claim Annual Aggregate DESCRIPTION OF OPERATIONS/LOCATIONS/VEHlCLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: PHASE I, 1498 S. GREENWOOD AVE. FOR PROFESSIONAL LIABILITY COVERAGE, THE AGGREGATE LIMIT IS THE TOTAL INSURANCE AVAILABLE FOR CLAIMS PRESENTED WITHIN THE POLICY PERIOD FOR ALL OPERATIONS OF THE INSURED. THE LIMIT WILL BE REDUCED BY PAYMENTS OF INDEMNITY AND EXPENSE. CANCELLATION PROVISION SHOWN HEREIN IS SUBJECT TO SHORTER CITY OF CLEARWATER ATTN: CITY CLERK P.O. BOX 4748 CLEARWATER FL 33758-4748 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFf, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ~ ~ S~. '}"''''- "'If 7.....",..-....." ? ...~ Attachment to ACORD Certificate for ARCADIS u.s., Inc. The terms, conditions and provisions noted below are hereby attached to the captioned certificate as additional description ofthe coverage afforded by the insurer(s). This attachment does not contain all terms, conditions, coverages or exclusions contained in the policy. INSURER INSURED ARCADIS U.S., Inc. formerly ARCADIS G&M, Inc. 630 Plaza Dr. Ste 200 Highlands Ranch co 80129-2379 USA INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. ADD'L POLICY NUMBER POLICY POLICY INSR INSRD TYPE OF INSURANCE POLICY DESCRIPTION EFFECTIVE EXPIRATION LIMITS LTR DATE DATE OTHER [9 Claims-Made [] professional L ia~ [9 and Contractors [9 pollution Liabili .. - DESCRIPTION OF OPERA TlONSILOCA TlONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS OR LONGER TIME PERIODS DEPENDING ON THE JURISDICTION OF, AND REASON FOR, THE CANCELLATION. Certificate No : 570022688071 A CORDT' 'CERrr;IFacA TE OF;LI~BILIT1iYld~SURAN~~ '~ll,[6ATEi~%~%b6';Y) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY Aon Risk services, Inc. of Tennessee 501 corporate Centre Drive AND COl'iFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS Suite 300 CERTIFICATE DOES NOT AMEND, EXTEND OR AL TER THE Franklin TN 37067 USA COVERAGE AFFORDED BY THE POLICIES BELOW. PHONE.(866) FAX - (847) 953-5390 INSURERS AFFORDING COVERAGE NAIC # 283-7122 INSURED INSURER A: Lexington Insurance company 19437 ARCADIS U.S. , Inc. 11'; SURER B: formerly ARCADIS G&M, Inc. 630 Plaza Dr. Ste 200 INSURER c: Highlands Ranch co 80129-2379 USA INSURER D: INSURER E: .: .ih:;:,'A[:.. i',' ..' "Y;':.': SIR'Mav':Aoo Iv 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 CER TIFICA TE MAYBE 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. INSR ADD'I POLiCY EFFECTIVE POLICY EXPIRATION LTR INSRI TYPE OF INSURANCE POLiCY NUMBER DATE(MMIDD\YY) DA TE(MM\DD\YY) LIMITS g"" ',M.am EACH OCCURRENCE COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED CLAIMS MADE D OCCUR PREMISES (Ea occurcnce) MED EXP (Anyone person) PERSONAL & ADV INJURY D GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG D POLICY D PRO- D LOC JECT AUTOMOBILE LIABILITY COMBINED SlliGLE LIMIT - ANY AUTO (Ea accident) - ALL OWNED AUTOS BODILY INJURY - SCHEDULED AUTOS ( Per person) - HIRED AUTOS - BODILY INJURY NON OWNED AUTOS (Per accident) - PROPERTY DAMAGE - (Per accident) GARAGE LIABILITY AUTO ONLY - LA ACCIDENT B ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGG EXCESS /UMBRELLA LIABILITY EACH OCCURRENCE D OCCUR 0 CLAIMS MADE AGGREGATE ,..." .. -- BDEDUCTIBLE RETENTION WORKERS COMPENSATION AND Iwc STAT~-I I~JH- EMPLOYERS' LIABILITY E.L. EACH ACCIDENT ANY PROPRlETOR / PARTNER / EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE-EA EMPLOYEE If yes, describe under SPECIAL PROVISIONS E.L. DISEASE-POLICY LIMIT below A 5766028 06/01/07 06/01/08 Each cl a; m $1,000,000 OTHER Prof Liab / pollution L i Aggregate $1,000,000 Contractor poll DESCRlPTlON OF OPERATlONS/LOCATIONS!VEHICLES/EXCLUSIONS ADDED BY ENDORSEMEc;T/SPECIAL PROVISIONS Evidence of Insurance. For Professi onal Liability coverage, the Aggregate L i mi t is the total insurance available for cl ai ms presented within the policy period for all operations of the insured. The L i mi t wi 11 be reduced by payments of indemnity CERTIFICATE:HOLDER . : .... ..n .. . i.';.' ;,'1 ' [:'CANCELLATION .", .'J'j'.:::.: '::.: .'i.e ":::'" .... :....n city of clearwater SHOULD ANY OF THE ABOVE DESCRlBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Attn: Kathy Bedi ni (City cl erk) DATE THEREOF, THE ISSUING INSURER \\1LL ENDEAVOR TO MAIL P.O. Box 4748 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. clearwater FL 33758-4748 USA BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ...4- ~ s~. 'J~",. "'6' 7_~__ ..:;:W'A,:e:,' ,..he" ... '" S .... J:: '" 'C ..... ... '" 'C '0 ::I1 00 00 M M 00 "<l" Lrl N o o "- Lrl o Z '" .... " '" :s .... ... '" U - ... ~ ==-== ::...JI ~ ....... ~ ~ ~ :::....ii ~= i,i; ~ --=0 ~ ......- .....=- .::.....:: r.... ~ -lJtr ~ - Attachment to ACORD Certificate for ARCADIS u.s., Inc. The terms, conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the coverage afforded by the insurer(s). This attachment does not contain all terms, conditions, coverages or exclusions contained in the policy. INSURER INSURED ARCADIS u.s., Inc. formerly ARCADIS G&M, Inc. 630 Plaza Dr. Ste 200 Highlands Ranch co 80129-2379 USA INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. ADD'L POLICY NUMBER POLICY POLICY INSR INSRD TYPE OF INSURANCE POLICY DESCRIPTION EFFECTIVE EXPIRATION LIMITS LTR DATE DATE DESCRlPTION OF OPERATIONS/LOCAT10NSNEH1CLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPEC1AL PROV1S10NS and expense. Cancellation prOV1Slon shown herein is subject to shorter or longer time periods depending on the jurisdiction of, and reason for, the cancellation. Certificate No : 570025483188