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CERTIFICATE OF LIABILITY INSURANCE - RFQ 36-16 Client#: 25320 KIMLHORN DATE(MM/DD/YYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 4/01/2019 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(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 Jerry Noyola 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 no ola re Iln ADDRESS:er ry• Y @g Y g•com Alpharetta, GA 30022 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:National Union Fire Ins.Co. 19445 INSURED INSURER B:Aspen American Insurance Company 43460 Kimley-Horn and Associates, Inc. INSURER C:New Hampshire Ins.Co. 23841 421 Fayetteville Street,Suite 600 INSURER D:Lloyds of London 085202 Raleigh, NC 27601 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 19-20 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 LIMITS (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY 5268169 04/01/2019 0410112020 EACH OCCURRENCE $1,000,000 CLAIMS-MADE L*OCCUR PREMISESOEa occur°nce $500,000 X Contractual Liab. MED EXP(Any one person) $25,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO- POLICY X JECTPRO- X LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY 4489663 04/01/2019 04/01/202 (CEO,acccS iden INGLE LIMIT $1'000'000 X ANY AUTO 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 $ B UMBRELLA LAB X OCCUR CX005FT19 04/01/2019 0410112020 EACH OCCURRENCE $5 000 000 X EXCESS LAB CLAIMS-MADE AGGREGATE s5,000,000 DED I X RETENTION$0 $ C WORKERS COMPENSATION 015893685(AOS) 04/01/2019 04/01/202 X STATUTE EERH AND EMPLOYERS'LIABILITY A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 015893686(CA) 04/01/2019 0410112020 E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 D Professional Liab B0146LDUSA1904949 04/01/2019 0410112020 Per Claim$2,000,000 Aggregate$2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re: RFQ#36-16-Agreement for Professional Services.The City of Clearwater is named as an Additional Insured with respects to General &Automobile Liability where required by written contract.The above referenced liability policies with the exception of workers compensation&professional liability are primary&non-contributory where required by written contract.Should any of the above described policies be cancelled by the issuing insurer before the expiration date thereof, 30 days'written notice(except 10 days for nonpayment of premium)will be provided to the Certificate Holder. CERTIFICATE HOLDER CANCELLATION Cit of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O. Box 4748 ACCORDANCE WITH THE POLICY PROVISIONS. Clearwater, FL 33758-4748 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S1546356/M 1513917 J N OY1 This page has been left blank intentionally.