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CERTIFICATE OF LIABILITY INSURANCE (518)__...-1 ® A CCP Fr /2' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/26/2016 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). PRODUCER Aon Risk Services South, Inc. Frank/ i n TN Office 501 Corporate Centre Drive Suite 300 Franklin TN 37067 USA CONTACT NAME: PHONE (866) 283-7122 FAX 800-363-0105 (A/C. No. Ext): (A/C. No.): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED Malcolm Pirnie, Inc. 44 South Broadway 9th Floor White Plains NY 10601 USA INSURER A: XL Insurance America Inc 24554 INSURER B: XL Specialty Insurance Co 37885 INSURER C: Greenwich Insurance Company 22322 INSURER D: INSURER E: $1,000,000 INSURER F: CERTIFICATE NUMBER: 570074390687 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 INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY1 POLICY EXP MM/DD/YYYY)) LIMITS C X COMMERCIAL GENERAL LIABILITY GECOO1O76117 01 01/201910/01/2019 `� EACHA OCCURRENCEO $1,000,000 CLAIMS -MADE X OCCUR General Ll dblllty\r/ SIR applies po l & C ions DAMAGE TO RENTED PREMISES (Ea occurrence) $1,000,000 per MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMITAPPLIES PER: DEC 312018 GENERAL AGGREGATE $2,000,000 POLICY X PRO- JECT X LOC PRODUCTS - COMP/OP AGG $2,000,000 OTHER: OFFICIAL RECORDS lA�l*�1, B AUTOMOBILE LIABILITY AAEc00010 A075817 L G'C) A't'I1,jE0 Lt7`iLl`11Iy6 �'/ edit dnyW { /2019 [r COMBINED SINGLE LIMIT (Ea accident) $1'000'000 X ANY AUTO BODILY INJURY ( Per person) OWNED AUTOS ONLY '-- SCHEDULED AUTOS BODILY INJURY (Per accident) HIRED AUTOS ONLY NON -OWNED AUTOS ONLY PROPERTY DAMAGE (Per accident) B X UMBRELLALIAB X OCCUR UEC001075917 01/01/2019 10/01/2019 EACH OCCURRENCE $1,000,000 EXCESS LIAB — CLAIMS -MADE umbrella AGGREGATE $1,000,000 DED X RETENTION $10 000 A WORKERS EMPLOYERCOMPEN COMPENSATION AND Y/N RWD943516313 AOS 01/01/2019 10/01/2019 X PER UTE ETH B ANY OFFICEOPRIETOR ER/FICC /EXCLPARTNER / UDED? N N/A RWR943516713 01/01/2019 10/01/2019 E.L. EACH ACCIDENT $1,000,000 (Mandatory in NH) If yes, describe under AK , WI E.L. DISEASE -EA EMPLOYEE $1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: All operations of the Named Insured. City of Clearwater is 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, Auto Liability and Umbrella Liability policies. General Liability and Auto Liability evidenced herein is primary and non-contributory to other insurance available to the Additional Insured, but only to the extent required by written contract with the insured. A waiver of Subrogation is granted in favor of Additional Insured as required by written contract but limited to the operations of the Insured under said contract, with respect to the General Liability, Auto Liability, Umbrella Liability and Workers' Compensation policies. CERTIFICATE HOLDER City of Clearwater Attn: City Clerk P.O. Box 4748 Clearwater FL 33758 USA CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Holder Identifier : 570074390687 Certificate No AUTHORIZED REPRESENTATIVE Chi M;a c9fv, ifGw tfee, fi eXec, ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ARCADIS TO: All Certificate Holders on File for Arcadis U.S., Inc. Subject: Short -Term Renewal Certificates of Insurance for 2019 policy term Dear Client: Enclosed please find the renewal certificate for Arcadis US Inc. or one of its affiliated entities. We have renewed ourinsur'ance policies for a short-term which will be expiring on 10/01/2019. Please have your records updated accordingly to reflect the new expiration dates. Updated certificates will be sent again to you later in the year. Sincerely, Arcadis U.S., Inc. Insurance Team H:\Client Information\Construction Accounts\Active Clients\Tennessee\Arcadis\01.01.19 to 20 - SHORT TERM Arcadis Letterhead.docx Arcadis U.S., Inc. 630 Plaza Drive Suite 100 Highlands Ranch Colorado 80129 Tel 720 344 3500 Fax 720 344 3535 www.arcadis.com Design & Consultancy for natural and built assets Date: December 21, 2019 Contact: Susan Berndt Phone: 720-344-3756 Email: Susan.berndt@arcadis.com Our ref: Page: 1/1