CERTIFICATE OF LIABILITY INSURANCE (440) C�0 DATE(MM/DD/YYYY)
A
C" CERTIFICATE OF LIABILITY INSURANCE 03/2012017
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 CONTACT
Marsh Risk&Insurance Services NAME: —
PHONE FAX
CA License#0437153 (A/C.No.E
777 South Figueroa Street E-MAIL
Los Angeles,CA 90017 ADDRESS:
Attn:LosAngeles.CertRequest @Marsh.Com INSURERS AFFORDING COVERAGE NAIC#
06510-STND-GAVE-17-18 Tampa GLALP 08 2017 INSURER A:Zurich American Insurance Company 16535
INSURED INSURER B:N/A N/A
AECOM - ---
AECOM Technical Services,Inc. INSURER C:Illinois Union Insurance Co 27960
URS Corporation Southern INSURER D:
7650 W.Courtney Campbell Causeway - —
Tampa,FL 33607-1462 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: LOS-001969631-08 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 ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MMIDDIWYY LIMITS
A X COMMERCIAL GENERAL LIABILITY GLO 5965891 09 04101/2017 04/01/2018 1 EACH OCCURRENCE $ 1,000,000
CLAIMS-MADE OCCUR , DAMAGE TO RENTED
FPREMISES(Ea occurrence $ _ 1;000,000
MED EXP(Any one person) $ 5,000
PERSONAL&ADV INJURY $ 1,000,000
—i--
GENT AGGRJ EGATE LIMIT APPLIES PER: I GENERAL AGGREGATE I $ 2,000,000
POLICY PRO
JECT LOC PRODUCTS-COMP/OP AGG $ — 2,000,000
OTHER: I $
A AUTOMOBILE LIABILITY BAP 5965893 09 04/0112017 04/01/2018 COMBINED SINGLE LIMIT $ 1.000.000
(Ea accident)
X ANY AUTO BODILY INJURY(Per person) $
ALL OWNED ° SCHEDULED j BODILY INJURY(Per accident) $
AUTOS AUTOS _
HIRED AUTOS NON-OWNED I ° PROPERTY DAMAGE
AUTOS ; Per accident
UMBRELLA LIAB OCCUR EACH OCCURRENCE_—_ $
EXCESS LIAB a CLAIMS-MADE
(AGGREGATE ;$
DED RETENTION$ $
WORKERS COMPENSATION ' PER TH-
AND EMPLOYERS'LIABILITY Y/N I .STATUTE OR
ANY PROPRIETOR/PARTNER/EXECUTIVE I 1 E.L.EACH ACCIDENT $
I,OFFICER/MEMBER EXCLUDED? ❑ N/A
f —
(Mandatory in NH) E.L DISEASE-EA EMPLOYEE $
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $
C ARCHITECTS&ENG. EON G21654693 04/01/2017 04/01/2018 Per Claim/Agg $1,000,000
PROFESSIONAL LIAB. "CLAIMS MADE" i Defense Included
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
Re:Contract No.RFQ#34-15 Engineer of Record Agreement;
City of Clearwater is named as additional insured for GL&AL coverages,but only as respects work performed by or on behalf of the named insured. This insurance is primary and non-contributory over any existing
insurance and limited to liability arising out of the operations of the named insured and where required by written contract with respect to the GL&AL coverages. Severability Of Interest/Cross Liability is included for
General Liability coverage.RETROACTIVE DATE:3;12311990—Illinois Union Insurance company.
CERTIFICATE HOLDER CANCELLATION
City of Clearwater
Attention:D.Scott Rice,PEv ' `� a r SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Assistant Engineering Director ACCORDANCE WITH THE POLICY PROVISIONS.
Engineering:RFQ#34-15
P.O.Box 4748
Clearwater,FL 33756 4748 AUTHORIZED REPRESENTATIVE
of Marsh Risk&Insurance Services
James L.Vogel
@ 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD