CERTIFICATE OF LIABILITY INSURANCE (963) eM'r AREHENG-41ABUYIENHUY
A�iQ►RL7�'�
CERTIFICATE L1ABILiTY INSURANCE
tMMIDOtYYYYI'RANCE 6/12/2019
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 rights to the certificate holder in lieu of such endorsements..
PRODUCER. % NTAE CT
N
Ames&Gouggh _ _.
8344 Greensboro Delve qAS ,, � 3 Q03)827 2277 (Arc-„N91;(743�827 2279
A D
Suite 984 - 13,admin@amesgough.com
McLean,VA 22142 ---
iNSURER(S)AFFORDING COVERAGE a_.._,_....._ ..-.-_r NA3C p .
INSURER A:RLI Insurance CompA Y At Xi 11-3-0115.6.-
INSURED
3056INSURED INSURER Phoenix Insurance C0111PARY A+,Xy 25623
Arehna Engineering,Inc. INSURER c Travelers Indemnity Co.Of America A++,-.XV 25666
5412 W.Lemon Street
Tampa,FL 33609
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 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,
EXCLUSION'S AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
.INS J. ADDL,SUBRi -POLICY EFF I POLICY EXP
LTR, _ 'r`t'PE t7F INSURANCE 1 ( Pf}LtCY NUNk'SER
LIMITS
A (. COMM€RCIAL GENERAL LIABILITY -. 'I,Q4Q,4Q4.
Ea.CH OOCURREh4�E,_ $
CLAIMS-MADE X..)OCCURj PSB0443479 512612019 512512424
DAMAGE TO RENTED 1,000,000
PREMISES(Ea Qc,urrenrel
Contractual Liab. 10,400
' _r _ I I MED EYP tA�v�i����nl._.�
i ERSONAL&,ADVINFIY Included
GEN L AGGREGATE LIMII:T..A,RPLIES..PER ( � I I _ GENERAL AGGRI PATE- 2,444,400
POLICY _ ;,PJEEGT 'c LOC PRO[?UCTS,-,C;?MF;fJ,P AGG r 2,400,444
OTHER — S
AUTOMOSILiz LIABILITY i - COMBINED SINGLE LIMIT 1 1'..,000,000
rX7ANY AUTO BA-4E982234 512612019 512512020 BODILY INJURY(ger rs -
I
OWNED SCHEDULED ...---...
J AUTOS ONLY II _;AUTOS l SOPILY JURY Per accident ;$
HIRED 'NON-OWNFII ' PROPERTY DAMAGE
AURS ONLY ...._I AUTO ONLY '.{Fera idem} ..... .: .......,. ._
iis
A X UMBRELLA LIABX OCCUR _. --- -
EACH OOCJFCREN E _ 5,000,000
r--
PSE0002011 512612019 15/26/2020 5,040 004
EXCE'SSLIAB' CERINS-MADE` i ,
� i AGGREGATE, �_
DEO X RETENTION$ 4i j I
C WORKERS COMPENSATION � �7�TI1:T.F 7_ I���..
AND EMPLOYERS'LIABILITY KIN N + ...._ ....
UB 1H227487 5126/2019 5126/2424 1 004 040
ANY PROPRIETORtPARTNERIFXECUTIVE 1 E EAGHA ..._
OEFICERIMEMBEREXCLUDE62 � N �iNIA 1,400,404
I IIt I.�ES �ZiP vibe un OPERATIONS below ,_._ ..:� � i ' E L plSEA51=:-PC�LEIGYtl�M1T�.._YEE $-- -1,000,000
A 'Professional Liab. RDP4416391 J 5/2612019 5126/2020 Per Claim/Aggregate ; 2,400,000
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 141,Additional Remarks Schedule,may be attached If more space is requlredl
Re.Engineering,RFQ 26-19
City of Clearwater is included as an additional insured with respects to General Liability,Auto Liability and Umbrelia Liability when required by written
contract.General Liability,Auto Liability and Umbrella Liability are primary and non-contributory over any existing insurance and limited to liability arising out
of the operations of the named insured and when required by written contract.General Liability,Auto Liability,Umbrella Liability and Worker's Compensation
policies Include a waiver of subrogation In favor of the additional insureds where permissible by state law and when required by written contract.30-day
Notice of Cancellation will be issued in accordance with policy terms and conditions.
CERTIFICATE HOLDER -- CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Ci of Clearwater THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Engineering RFQ#26-19
PO Box 4748
Clearwater,FL 33758-4748 AUTHORIZED REPRESENTATIVE
i
ACORD 25(2016/03) Q 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD