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CERTIFICATE OF LIABILITY INSURANCE (519) ACS® DATE(M B 2/DOD1/YYYY) CERTIFICATE OF LIABILITY INSURANCE 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 have ADDITIONAL INSURED provisions or 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). CD PRODUCER CONTACTp Aon Risk Insurance Services West, Inc. PHONE FAX Los Angeles CA Office (A/c.No.Ext): (866) 283-7122 (A/c No.): (800) 363-0305 707 Wi 1 shire Boulevard E-MAIL suite 2600 ADDRESS: Los Angeles CA 90017-0460 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURERA: National Union Fire Ins Co of Pittsburgh 19445 Tetra Tech, Inc. INSURER B: AIG Europe Limited AA1120841 5601 Mariner Street, Suite 490 Tampa FL 33609 USA INSURER C: The Insurance Co of the State of PA 19429 INSURER D: American Home Assurance Co. 19380 INSURERE: Lexington Insurance Company 19437 INSURER F: COVERAGES _ CERTIFICATE NUMBER: 570068499763 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. Limits shown are as requested ILTR TYPE OF INSURANCE NSD WVO POLICY NUMBER M /YYY M/DD Y MM DDS LIMITS A X COMMERCIAL GENERAL LIABILITY GL74 1 1 10/01/2016 EACH OCCURRENCE $2,000,000 CLAIMS-MADE XI OCCUR DAMAGE T RENTED — $1,000,000 PREMISES Ea occurrence X X,C,U Coverage MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $2,000,000 GEN'LAGGREGATE LWITAPPLIES PER: GENERAL AGGREGATE $4,000,000 rn POLICY PRO ❑X LOC PRODUCTS-COMP/OPAGG $4,000,000 FOTHER RECEIVED r A rEngin-80-16 0/01/2017 10/01/2018 COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY -k$�tC Ea accident) $2,000,000 u rr ") BODILY INJURY(Per person) 0 X ANYAUTOh'r..4.i b H.1 m,lr V Z OWNED SCHEDULED a..,:L._tl ?�? BODILY INJURY(Per accident) Y AUTOS ONLY AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE ONLY AUTOS ONLY arts en Per accident)w ecritt s C m B X UMBRELLA LIAR X OCCUR CSUS /01/2017 10/01/2018!EACH OCCURRENCE $5,000,000 U EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED I X RETENTION$100,000 C WORKERS COMPENSATION AND WC014629496 1010112017 10/01/2018 X I STATUTE EORH D EMPLOYERS'LIABILITY Y/N WC014629497 1010112017 10/01/2018 ANYPROPRIETOR/PARTNER i EXECUTIVE E.L.EACH ACCIDENT $1,000,000 C OFFICER%MEMBER EXCLUDED? N/A WC014629498 10/01/2017 10/01/2018 C (Mandatory in NH) WC014629499 10/01/2017 10/01/2018 E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIrTION OF OPEPUITIONS bolow E.L.DISEASE-POLICY LIMIT $1,000,000_- E Env Contr Prof 028182375 1010112017 10/01/2019 Each Clain $5,000,000 Prof/Poll Liab Agggregate $5,000,000.- SIR applies per policy terns & conditions DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Reference: City of Clearwater - 2009 Engineer of Record - start Date: 8/10/2009 - End Date: 8/10/2012 The City of Clearwater is y included as Additional insured as required by written contract, but limited to the operations of the Insured under said contract, with respect to the General Liability and Auto Liability policies. General Liability evidenced herein is primary and non-contributory to other insurance available to an additional insured, but only to the extent required by written contract ar—® with the insured. ,:ems CERTIFICATE HOLDER CANCELLATION az SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ;__ 'i.- EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE �y POLICY PROVISIONS. s city of Clearwater AUTHORIZED REPRESENTATIVE Engineering, RFQ #34-15 z. PO Box 4748 ��ii �i Clearwater FL 33758-4748 USA �y �eJ11"411 xee elGfitfazd �c/?t� IL ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD