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CERTIFICATE OF LIABILITY INSURANCE (468)...'--, ® ACO�,RQ9 CERTIFICATE OF LIABILITY INSURANCE ` DATE (MMDDIYYYY) 12/07/2017 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(les) 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). PRODUCER Marsh Risk & Insurance Services CA License #0437153 777 South Figueroa Street Los Angeles, CA 90017 Attn: LosAngeles.CertRequest@Marsh.Com 06510 -STND-GAUE-17-18 Added 127 04 2019 CONTACT NAME: PHONE FAX (NC. No. Ext): (NC, No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Zurich American Insurance Company 16535 INSUREDINSURER AECOM URS Corporation Southern 7650 West Courtney Campbell Causeway Tampa, FL 33607 B : NIA NIA INSURER C : Illinois Union Insurance Co 27960 INSURER D : SEE ACORD 101 $ 2,000,000 INSURER E : $ 1,000,000 INSURER F : CERTIFICATE NUMBER: LOS -002152410-21 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 LTR TYPE OF INSURANCE ADSL INSD SUER yYVD POLICY NUMBER (MM/DDYEFF /YYYY) (MM DDYEXP /YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY GLO 596589109 - OFF 04/01/2017 ^ 91� 04/01/2018 EACH OCCURRENCE $ 2,000,000 PDAMAGE REM SESTO(EaRENTED occurrence) $ 1,000,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 2'000' 000 GENERAL AGGREGATE $ 2,000,000 GE 'L AGGREGATE POLICY OTHER: LIMIT APPLIES PRO JECT PER: LOC PRODUCTS 2,000,000X $ A AUTOMOBILE X LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY SCHEDULED AUTOS NON -OWNED AUTOS ONLY BAP 5965893 09"•— -- 04101 -NR i. 04/01/2018 COMBINED SINGLE LIMIT (Ea accident) $ 2,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA UAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ D WOR KERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNERJEXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A SEE ACORD 101 01/01/2018 01/01/2019 X PER STATUTE OTH- ER E. L. EACH ACCIDENT $ 2,000,000 E . DISEASE - EA EMPLOYEE $ 2,000,000 E . DISEASE - POLICY LIMIT $ 2,000,000 C ARCHITECTS & ENG. PROFESSIONAL LIAB. EON G21654693 "CLAIMS MADE" 04/01/2017 0410112018 Per ClaimlAgg Defense Included $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may Be attached If more space Is required) Re: Engineer of Record Agreement. RFQ 16-12. The General Liability policy includes a Severability of Interest clause where required by written contract. City of Clearwater is included as Additional Insured as respects the General Liability and Automobile Liability policies, where required by written contract. Such insurance shall be primary insurance with respect to the interest of the additional insureds and any other insurance maintained by the additional insured shall be excess and not contributing with the insurance required hereunder. Waiver of Subrogation applies in favor of the Additional Insured as respects General Liabilit) and Automobile Liability, where required by written contract. City of Clearwater Attn: City Clerk PO Box 4748 Clearwater, FL 33758-4748 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh Risk & Insurance Services James L. Vogel ACORD 26 (2016/03) © 1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORO® AGENCY CUSTOMER ID: 06510 LOC #: Los Angeles ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY Marsh Risk & Insurance Services NAMED INSURED AECOM URS Corporation Southem 7650 West Courtney Campbell Causeway Tampa, FL 33607 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Workers Compensation/Employer Liability cont. Policy Number Insurer States Covered WC 014629525 American Home Assurance Company - NAIC #19380 CA WC 014629526 The Insurance Company of the State of Pennsylvania - NAIC #19429 AK, AL, AR, AZ, CO, CT, DC, DE, GA, HI, IA, ID, IL, IN, KS KY, LA, MD, MI, MN, MO, MS, MT, NC, NE, NH, NJ, NM, NV, NY, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WV WC 014629527 The Insurance Company of the State of Pennsylvania - NAIC #19429 MA, WI (ND, OH, WA, WI, WY - Covered for Stop -Gap EL only) WC 014629528 The Insurance Company of the State of Pennsylvania - NAIC #19429 FL WC 014629529 The Insurance Company of the State of Pennsylvania - NAIC #19429 ME XWC 0910717 Nat'l Union Fire Ins Co - NAIC #19445 OH, Ohio Qualified Self Insured (QSI) - SIR: $500,000; Only applicable to specific qualified entities self-insured in the state of Ohio Waiver of Subrogation is applicable where required by written contract with respect to WC. If the insurer for the Workers Compensation policy cancels its policy for any reason other than for non-payment of premium, the insurer will provide 30 days notice of cancellation to those Certificate Holders that require it by written contract. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AECOM and Its Subsidiaries RAP 5965893-09 Eff 04/01/2017 A/DI 1 POLICY NUMBER: BAP 5965893-09 COMMERCIAL AUTO CA 20 481013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: AECOM and Its Subsidiaries Endorsement Effective Date: 04/01/2017 SCHEDULE Name Of Person(s) Or Organization(s): Only those where required by written contract. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section 1 — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 0 Insurance Services Office, Inc., 2011 Page 1 of 1 AECOM end Its Subsidiaries GLO 5965891.09 Eft 04/0112017 CiAIOLC1 POLICY NUMBER: GLO 5965B91-09 COMMERCIAL GENERAL LIABILITY CG20100413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organizalion(s) Location(s) Of Covered Operations Only those where required by written contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", 'property damage" or "personal and advertising injury" caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the locations) designated above. However: 1. The insurance afforded to such adultfonal insured only applies to the extent permitted by law; and 2. If coverage provided to the adcitional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exd usions apply: This insurance aloes not apply to "bodily injury" or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished In connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations tor a principal as a part of the same project. CG 201004.13 © Insurance Services Office, Inc-, 2012 Page 1 of 2 C. With respect to the insurance afforded to these additional insureds, the following is added to Section 111- Limits Of insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Ded arations. Page 2 of 2 ®insurance Services Office, Inc., 2012 CG 20 100413 POLICY NUMBER: GLO 5965891-09 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 G/RICO 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations ONLY THOSE WHERE REQUIRED BY WRITTEN CONTRACT Information required to complete this. Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 37 04 13 B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. c7 Insurance Services Office, Inc., 2012 Page 1 of 1 0004174 SP 0747 -C01 -P041761 City of Clearwater Attn: City Clerk PO Box 4748 Clearwater, FL 33758-4748