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CERTIFICATE OF LIABILITY INSURANCE (255) Client#: 1048486 ADVANENG4 ACORD., CERTIFICATE OF LIABILITY INSURANCEDATE IMMIDDrYYYY) 1 6/14/2019 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 any rights to the certificate holder In lieu of such endorsement(s). PRODUCER c3lilrACT NAME: USI Insurance Services, LLCPHONE 813 321-7500 i FAX (Arc,No,Ext}: PUC,Not: 2502 N Rocky Point Drive E-MAIL ADDRESS: Suite 400 INS URER(S)AFFORDING COVERAGE MAIC N Tampa, FL 33607 ....... 402311 INSURER A�Old D— — —Ca lrl—1I. INSURED INSURERS:T,­IrsCas..lty­d5u.MyC..fAms 31194 Advanced Engineering&Design, Inc. _INSURER.C:Liberty Intematronal Unde—hors Inc 19917 3931 68th Avenue North Pinellas Park, FL 33781 JNBUREf1 R, INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO"rHE 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 HERE#N IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSIR PE OF INSURANCE ADDL:SUBR POLICY EFF � POLICY EXP LTR TY IN's-R WVD POLICY NUMBER (MMIDDfYYYY).JMMlP .........------ LIMITS • X COMMERCIAL GENERAL LIABILITY X BPG2647A 02/1612019102/1612020 EACH OCCURRENCE $1,000,000 RAMAG SJ TO RENTED CLAIMS-MADE X OCCUR REM S,IE.,00curre ce� s500,000 ME D EX,,(Any one WWI) S10,000 _PERSONAL&ADV WJURY $1,000,000 GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE s2,000,000 PRD --------- POLICY jECT LOG PRODUCTS-COMP/OP AGO 52,000,000 OTHER ............... COMBINED SINGLE LIMIT 1-,600,000- • AUTOMOBILE LIABILITY X BPG2647A 02116/204 {0211612020 .(Ea accrd nth .......... ANY AUTO BODILY INJURY(Per persony S OWNED BODILY INJURY IPer accident) 5 AUTOS ONLY f AUT 5 -PROPERTY DAMAGE X HIRED N.20VINED $ AUTOS ONLY I yX AUTOS ONLY (Per acadenl) UMBRELLA LIAR OCCUR EACH OCCURRENCE i EXCESS LIAB I CLAIMS-MADE AGGREGATE S �OED RETENTION$ ....... ...................a...... 13 WORKERS COMPENSATIONR OT - X UB4J08171117 0910112018109/0112019_X H AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNEWEXE CUTIVE E L,EACH ACCIDENT $100'000------............. NIA IOFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $100'000 If yes.describe Under —--—-------- DESCRIPTION OF OPERATIONS below E LL DISEASE-POLICY LIMIT i s5OO,OOO C Professional AEENYAA9RTDO02 0211512019102/1512020 $2,000,000 per claim Liability $2,000,000 anni aggr. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Professional Liability coverage is written on a claims-made basis. RE: R1FQ#26-19 The City of Clearwater is named as an additional insured on all policies listed above except the workers compensation and professional liability as required by written contract including completed and ongoing operations on per project basis, coverage is primary and non contributory.Waiver of subrogation in favor of the additional insured applies to all policies listed above as required by written contract.Thirty(30) (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Clearwater THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Engineering FQ#26-19 ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 4748 Clearwater,FL 33758-4748 AUTHORIZED REPRESENTATIVE 'Ift 06—Gi-.A06--1 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S258901651M24882996 MRLEW DESCRIPTIONS (Continued from Page 1) days prior written notice of cancellation except 10 clays for nary payment of premium will be given on all policies listed above. SAGITTA 25,3(2016/03) 2 of 2 #S25890165/M24882996 Client#: 1048486 ADVANENG4 ACORD. CERTIFICATE OF LIABILITY INSU RANCEDATE(MMIDONYYY) 210412019 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER - CONTACT -. _.. NAME., USI Insurance Services,LLC a DNEa Ext:813 321-7500 2502 N Rocky Point Drive EAUML AIc N Suite 400 ( . ADDRESS. Tampa,FL 33607 VISURER(s)AFFORDING COVERAGE NAIC Ir INSURER.A:QId Demrnipn&nu,anc,C ,40231 INSURED INSURER a.Tra"Im CaauNb{mid 8ursty Ca or Am 31194 Advanced Engineering&Design,Inc. INSURER C:i Int.-ai Undwwrli i19917 3931 68th Avenue North Pinellas Park,FL 33781 INSURER D INSURER E INSURER F, COVERAGES CERTIFICATE NUMBER: 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 REDUCER BY PAID CLAIMS. INSR ADDL sus LTR TYPE OF INSURANCE r"sWoPOLICY NUIaIBER. l+,0,L.18 EFF I.IPOLICY P-- LIMITS A `X COMMERCIAL GENERAL LIABILITY X BPG2647A 211612019102116/202 gEACH CCCURRENCE $1 p(1( 000 OLAIMS-MADE. EXOCCURF'RMGE TO aEaNTE , DV $500 flfltl i MED EXP(Any one person) $10000 — PERSONAL 8 ADV INJURY $1,000,000 GEN°L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,0001000 PRO- PRODUCTS-COMPIOPAGG $2 000,000 POLICY[:1JECT LOC OTwER $ }` AUTOMOSILE LIABILITY X BPG2647A 02JI612019`021161202 COMBINED SINGLE LIMIT Eaecpidtear$ 1,000,000 ANY AUTO BODILY INJURY(Par person) $ AUTOS OWNER ° AUTOSLILEr1 (Paracc ort) $ AUTOS ONLY TBODILY INJURY HIRED NON-OWNED AUTOS ONLY AUTOS ONLY I'ROPERi Y I3AI7AGE Pee a,xedee,t is UMBRELLA LIAR OCCUR _.- _. EACH OCCURRENCE 5 EXCESS LIAB CLAIMS-MADE. AGGREGATE $ _ a DED RETENTION$ S B WORKERS COMPENSATION _ ]( U 84J08171117 910112018 091011201 X PER L]TH AND EMPLOYERS"LIABELrrY LU ANY PROPRIETOR/PARTNER/EXECUTIVE Y IN E.L.EACH ACCIDENT- $100,000 OFFICER/ME EXCLUDED? NIA Mandatory rnNEfl E.L DISEASE-EAEMPLOYEE s100000 - I!yye�sa,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT ,500,000 C Professional AEENYAA91RTD002 0211512019 0211512020 2,000,000 per claim Liability $2,000,000 annl aggr. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 191,Additional Remarks Schedule,may be attached If more space Is required) -. Professional Liability coverage Is written on a claims-made basis. The City of Clearwater is listed as an Additional Insured as respects the Commercial General Liability policy where rewired by a written contract prior to a loss per policy terms and conditions. CERTIFICATE HOLDER CANCELLATION City Of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL, BE DELIVERED IN Attn:Engineering Dept. ACCORDANCE WITH THE POLICY PROVISIONS. P.O.Box 4748 Clearwater,FL 33758-4748 AUTHORIZED REPRESENTATIVE CD 1988-2015 ACOREA CORPORATION.All rights reserved. ACORD 2 (2416103) 1 of 1 The ACORD name and logo are registered marks of ACORD #S24883180/M24882996 1lSCZP