CERTIFICATE OF LIABILITY INSURANCE (890) C DATE IMMIDDIYYYY�TIFIC T LI ILITY I
05!26017
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE NOES 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 cor-ifer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER T
"Marsh USA,Inc NAME:
_K.....,_...
PHONE iFAX.
1166 Avenue of the Americas A S�osik__. IAIC.No#:
New York.NY 14636 EMAIL
Attu Atlanta.Cemequest@marsh.com
INSURERS I AFFORDING.,COVERAGE .. .�. ,NAIC
342881-FL-WC-17.16 5661 INSURER A:Illinois National Insurance Company 23817
1NSt1REn -- --
7ecisi7nHR I it ; INSURER B - —
11101 Roos4,:ut=1l Blvd N INSURER C
. .�..,u�.. _._.._..._....... .-_...
----- — .............._..�.._...._.,�.........,..
St.Petersburg,FL 33715 INSURER D
INSURER E
INSURER F:
COVERAGES CERTIFICATE NUMBER; ATL-003888207.14 REVISION NUMBER:1
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.
ILTR POLICY EFF POLICY FJtP
TYPE OF INSURANCE POLICY NUMBER MMr 1YYYY - MQD1YYYY LIMITS
I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE
CLAIMS-MADE F-1 OCCUR � PREMISE Ea uccurr�e�,:� •__•. ..$.
MEO EXP{Any one person) ,.�.. .
�`
.—... j y PERSONAL&ADV INJURY .
,..GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGG REGATE� ��'�1'�. I � �..$ .
1 '
PRO-
POLICY JECT LOG S I PRODUCTS COMPIOP AGG s
k1
OTHER $
: f ` {�, k'
AUTOMOBILE LIABILITY _ COMBINED SINGLE LIMIT . .
TS Ea accident
POP
ANY ALL AUTO SCHEDULED s U 1T WF ;iGC`.._ BODILY INJURY(Per person) $ _._._. .
AUTOS AUTOS �;$Y"~•.: BODILY INJURY(Per accident)s,$
NON-OWNED PROPERTY QAMAGE
HIRED AUTOS AUTOS Pere n
UMBRELLA LIAR 3.
�,.... I I OCCUR EACH OCCURRENCE mm.. :..
EXCESS LIAB j CLAWSWADE I AGGREGATE
1 DED] � RETENTIONS $
A WORKERSCOMPENSAT50N --..!034165306 06X112017 476f{I1018 }( PER _. CJTFI-...Tl
AND EMPLOYERS'LIABILITY ER _-] E L EACH AccIDENT ER $
ANY NR(;iI'kI ,TUFt7HAEtiNrR'z'F U11VE
OFFICERIMEMBER EXCLUDED' N N r A
IMandatory In NH) I E L.DISEASE EA EMPLOYE ,r.. 1,000 600
If yes,descr be under r _ 1,990,69(}
DESGRIPTIpN.OF OPERATIONS below !E.L.DISEASE-POLICY LIMIT
I
f
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may he attached It more Space IS required)
Coverage Is provSded for only those employees leased to but not subounlractors of BlllerRelnhart Engineering Grodp Inc
CERTIFICATE HOLDER CANCELLATION
City of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Engineering.RFQ#34-15 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
P-0.Box 4748 ACCORDANCE WITH THE POLICY PROVISIONS.
Clearwater,FL 33753
AUTHORIZED REPRESENTATIVE
of Marsh USA Inc.
Henry L.Whiting ; --
Ge 1988.2014 ACORD CORPORATION. All!,rights reserved.
ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD