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CERTIFICATE OF LIABILITY INSURANCE (486)'°`� C., CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/28/2018 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER Aon Risk Services Northeast, Inc. Boston MA Office 53 State Street Suite 2201 Boston MA 02109 USA CONTACT NAME: PHONE (866) 283-7122 FAX 800-363-0105 (A/C. No. Eat): (A/C. No.): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED CDM Smith Inc. 75 state Street, suite 701 Boston MA 02109 USA INSURER A: Liberty Mutual Fire Ins Co 23035 INSURER B: Liberty Insurance Corporation 42404 INSURERC: LM Insurance corporation p 33600 INSURER D: Lloyd's Syndicate No. 623 AA1126623 INSURER E: INSURER F: CLAIMS -MADE I X I OCCUR COVERAGES CERTIFICATE NUMBER: 570074495839 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 INSD SUBR MD POLICY NUMBER POLICY EFF (MM/DD POLICY EXP 1/IX. LIMITS B X COMMERCIAL GENERAL LIABILITY TB76116$T8Z60 /�g� b1/01/201 1 /! EACH OCCURRENCE $2,000,000 CLAIMS -MADE I X I OCCUR „ RECEIVED D DAMAGE TO REN fED PREMISES (Ea occurrence) $500,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: JAN 072019 GENERAL AGGREGATE $4,000,000 POLICY X PRO- JECT LOC PRODUCTS-COMP/OPAGG $4,000,000 OTHER: OTHER: OFFICIAL RECORnS tAA11,��[ tU� A AUTOMOBILE LIABILITY A52-611-�Z Q�(�TI►/E (pt yrQ},/LLILLUI9 err•/ I � RVe.t (UUEEFOJT 01/01/2020 LIMIT (Ea acBINED cident) $2,000,000 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) _ UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS -MADE AGGREGATE DED RETENTION C WORKERS EMPLOYERS' LIABILTYIONAND WA561DB8T8z6019 01/01/2019 01/01/2020 X (STATUTE I IEPER ORH C ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER/MEMBEREXCLUDED? Y / N N N/A AOS wc561168T8z6029 01/01/2019 01/01/2020 E.L. EACH ACCIDENT $1,000,000 (Mandatory in NH) If describe WI E.L. DISEASE -EA EMPLOYEE $1,000,000 yes, under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 D Archit&Eng Prof PSDEF1900033 Professional/Claims Made 01/01/2019 01/01/2020 Each Claim Aggregate $3,000,000 $3,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Project: City of Clear Water Reverse Osmosis Plant I Expansion. City PN 09 -0018 -UT. The city of Clear water is included as Additional Insured in accordance with the policy provisions of the General Liability and Auto Liability. General Liability evidenced herein is Primary and Non -Contributory to other insurance available to an Additional Insured, but only in accordance with the policy's provisions. A Waiver of Subrogation is granted in favor of Certificate Holder in accordance with the policy provisions of the General Liability, Automobile Liability policies. CERTIFICATE HOLDER City of Clear Water Attn: City Clerk P.O. Box 4748 Clearwater FL 33758-4748 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. AUTHORIZED REPRESENTATIVE 't�. .5:Att ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Holder Identifier : h Certificate No ACCORD AGENCY CUSTOMER ID: 10518329 LOC #: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Services Northeast, inc. NAMED INSURED CDM Smith Inc. POLICY NUMBER See certificate Number: 570074495839 CARRIER See certificate Number: 570074495839 NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YYYY) POLICY EXPIRATION DATE (MM/DD/YYYY) LIMITS WORKERS COMPENSATION B N/A WA7610B8T8z6039 MA & PR 01/01/2019 01/01/2020 ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved.