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CERTIFICATE OF LIABILITY INSURANCE - RFQ 34-15 (25) Client#: 25361 GEOSCONS DATE(MM/DD/YYYY) ACORDT. CERTIFICATE OF LIABILITY INSURANCE 6/01/2018 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Carly Underwood Greyling Ins. Brokerage/EPICPHONE 770.552.4225 FAX 866.550.4082 A/C,No,Ext: (A/C,No): 3780 Mansell Road,Suite 370 E-MAIL unerwoore Iln ADDRESS: cart y• dd@g Y g•com Alpharetta, GA 30022 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:National Union Fire Ins.Co. 19445 INSURED INSURER B:New Hampshire Ins.Co. 23841 Geosyntec Consultants, Inc. llianz 36420 INSURERC:AUnderwriters Insurance 900 Broken Sound Parkway NW,Suite 200 INSURER D Boca Raton, FL 33487 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 18-19 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 CONTRACTOR 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. ADDLSUBR LTR TYPE OF INSURANCE NSR WVD POLICY NUMBER POLICY EFF POLICY EXP/YLIMITS (MM/DDYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY 5268179 04/01/2018 04/01/2019 EACH OCCURRENCE $1,000,000 CLAIMS-MADE 4 OCCUR PREMISESOEaoccurrDence $500,000 MED EXP(Any one person) $25,000 PERSONAL&ADV INJURY $1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY 1 JECT X LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: $ BID A AUTOMOBILE LIABILITY 4489673(AOS) 04/01/2018 04/01/201 E°accS ldentINGLELIMIT $1,000,000 A X ANY AUTO 4489674(MA) 04/01/2018 04/01/2019 BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY Per accident $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION 015893709(AOS) 04/01/2018 04/01/2019 X ISPTEARTUTE EERH AND EMPLOYERS'LIABILITY Y/N A ANY PROPRIETOR/PARTNER/EXECUTIVE 015893710(CA) 04/01/2018 04/01/201 E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N/A B (Mandatory in NH) 015893711 (ME) 04/01/2018 04/01/2019 E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 C Professional Liab U51_00010218 04/01/2018 04/01/201 Each /Contractors Incident $2,000,000 Pollution Liab Aggregate$2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re: Professional Engineer of Record Agreement-21 July 2015. City of Clearwater, Engineering RFQ#34-15 and its Council,the Community Redevelopment Agency of the City of Clearwater,a Florida governmental agency created pursuant to Part III, Chapter 163, Florida Statute, its duly appointed officers, or other public bodies, officers,employees,volunteers, representatives and agents are named as Additional Insureds with respects to General &Automobile Liability where required by (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION Cit of Clearwater, Engineering SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City g g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN RFQ#34-15 ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 4748 Clearwater, FL 33758 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S 1085378/M1056601 C U N D 1 DESCRIPTIONS (Continued from Page 1) written contract. The above referenced liability policies with the exception of workers compensation and professional liability are primary& non-contributory where required by written contract. SAGITTA 25.3(2016/03) 2 of 2 #S1085378/M1056601 POLICY NUMBER-- 5268179 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.. ADDITIONAL INSURED - OWNERS, LESSEES O CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY C0VERAGE FART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations ANY PERSON OR ORGANIZATION WHOM YOU PER THE CONTRACT OR AGREEMENT. BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTERED INTO. l 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 than which you are required by the contract include as an additional insured the person(s) or or agreement to provide for such additional organization(s) shown in the Schedule, but only insured. with respect to liability for "bodily injury".. B. With respect to the insurance afforded to these "property damage" or "personal and advertising additional insureds; the following additional injury" caused, in whole or in part, by exclusions apply:. 1 Your acts or omissions; or This insurance does not apply to "bodily injury 2. The acts or omissions of those acting on or "property damage" occurring after: your behalf,- 1. All work, including materials, parts or in the performance of your ongoing operations equipment furnished in connection with such for the additional insured(s) at the locationls} work, on the project (other than service, designated above. maintenance or repairs) to be performed by or on behalf of the additional insured(s) at However; the location of the covered operations has 1. The insurance afforded to such additional been completed; or insured only applies to the extent permitted 2. That portion of "your work" out of which by law; and the injury or damage arises has been put to 2.. If coverage provided to the additional its intended use by any person or insured is required by a contract or organization other than another contractor or agreement, the insurance afforded to such subcontractor engaged in performing additional insured will not be broader than operations for a principal as a part of the same project_ CG 20 10 04 13 Insurance Services Office, Inc., 2012 Page 1 of 2 0 C. With respect to the insurance afforded to these 2. Available under the applicable Limits of additional insureds, the following is added to Insurance shown in the Declarations; Section III - Limits Of Insurance- whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the required by a contract or agreement, the most applicable Limits of Insurance shown in the we will pay on behalf of the additional insured is the amount of insurance: Declarations. 1. Required by the contract or agreement; or Page 2 of 2 * Insurance Services Office, Inc., 2012 CG 20 10 04 13 0 POLICY NUMBER: 5268179 COMMERCIAL GENERAL LIABILITY CG 20 37 04 13 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 0 Additional Insured Person(s) Location And Description Of Completed Operations Or Orgarrization(s) ANY PERSON OR ORGANIZATION WHOM PER THE CONTRACTOR AGREEMENT YOU BECOME OBLIGATED TO INCLUDE AS AN ADDITIONAL INSURED AS A RESULT OF ANY CONTRACT OR AGREEMENT YOU HAVE ENTEREDINTO. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A, Section 11 - Who Is An Insured is amended to which you are required by the contract or include as an additional insured the person(s) or agreement to provide for such additional organization(s) shown in the Schedule, but only insured. with respect to liability for "bodily injury" or B. With respect to the insurance afforded to these property damage" caused, in whole or in part, additional insureds, the following is added to by "your work" at the location designated and Section III - Limits Of Insurance: described in the Schedule of this endorsement If coverage provided to the additional insured is performed for that additional insured and required by a contract or agreement, the most included in the "products-completed operations we will pay on behalf of the additional insured hazard". is the amount of insurance: However: 1. Required by the contract or agreement; or 1. The insurance afforded to such additional 2. Available under the applicable Limits of Insu- insured only applies to the extent permitted ranee shown in the Declarations; by law; and whichever is less. 2. If coverage provided to the additional insured is required by a contract or agree- This endorsement shall not increase the appli- ment, the 'insurance afforded to such addi- cable Limits of Insurance shown in the Decla- lional insured will not be broader than that rations, CG 20 37 04 13 * Insurance Services Office, Inc., 2012 Page 1 of 1 This page has been left blank intentionally. POLICY NUMBER.- 5268179 COMMERCIAL GENERAL LIABILITY CG 20 01 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - OTHER INSURANCE CONDITION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART The following is added to the Other Insurance policy provided that: Condition and supersedes any provision to the (11 The additional insured is a Named Insured contrary; under such other insurance; and Primary And Noncontributory Insurance J2)You have agreed in writing in a contract This insurance is primary to and will not or agreement that this insurance would seek contribution from any other insurance be primary and would not seek contribu- available to an additional insured under your tion from any other insurance available to the additional insured. GG 20 01 44 13 0 Insurance Services Office, Inc., 2012 Page 1 of I This page has been left blank intentionally.