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CERTIFICATE OF LIABILITY INSURANCE (308) DATE(IMMADD/YYYY) 0 U23120 19 CERTIFICATE OF LIABILITY INSURANCE I 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 fieu of such endorsement(s). PRODUCER CONTACT ADD Risk Services South, Inc. -NAME:-- PHONE3-71,22 FAX 900-305 Franklin IN office _{�ILNo. EAI): t8 6) 28 (AJC No.} 63 01 � 10 501 Corporate Centre Drive E-MAIL 0 suite 300 ADDRESS: Franklin TN 37067 USA INSURER(S)AFFORDING COVERAGE NAIL# INSURED INSURERA: XL insurance America Inc 24554 Arcadis u.S,, Inc, INSURER 8: XL Specialty Insurance Co 37885 630 Plaza Drive suite 200 INSURER C: Greenwich Insurance Company 22322 Highlands Ranch co 80129 USA IN SURER D� INS URFR E: INSURER F: COVERAGES CIERTIFICATE NUMBER: 570077591419 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 fNSR I A SUBR POLICY EFF POLICY EXP LTR - TYPE OF INSURANCE I N')SDD9 WVD POLICY NUMBER (MMIDDIYYYYi IMWD—yy)l LIMITS C � X COMMERCIAL GENERAL LIABILITY GECO01076117 01/01/2019 1 O/U'/ZU=L9 EACH OCCURRENCE $1,000,000 CL-Mms st"Er [7X OCCUR SIR applies per policy terns & conditions -AMAGE TO RPWTTU S1,000,000 PREMISES!,E. X Commulua[L,abo,iy MED EXP(Any are ppmo,,) $10,000 PCR FONAL&ADV'NJURY $1,000,000 -GEN'LAGGREGATE LIMITAPPLIES PER GENERAL AGGREGATE $2,0(50,000 POLICY F—"IRO'J'-'C I FX LOC PRODUCTS-GOMP�OP AGG• S2,000,000 r- OTHER BAUTOMOBILE LIABILITY ALCO01075817 0110112019 1U101 2019 COMBINED SINCLE UWT s1,,000,000 L X ANY AUTO II Lf IN.R�IRY'Pepe,s,o,) 0 z OWNED SCHEDULED BODILY INJURY iper acc,aent) — AUTOS ONLY AUTOS PROPERTY DAMAGE EIRED�',1,TQS NON-O'ANED IPer acidenl) —ONLY AUTOS ONLY Ix pmpe,ty pa,,aRR,Ic t UMBRELLA LIAR OCCUR EACH OCCURRENCE CUR EXCESS LIAS IL-AIMS41ADEM AGGREGATE DEDI IRETENTION A WORKERS COMPENSATION AND RWD943516313 01.10112019 10,201,12019 PER OTHL EMPLOYERS'LIABILITY i X I STATUTE LES YIN All other states ANY PROPRIETOR,PARTNER I EXECUI IVEEACH B OFF)CERT MFNMER EXCUUDEE," [-N-] NIA RINIR94351.6713 ()11011201 911c,,01 1 12019 1-L- ACCIDENI S-1,000,0()o (Marldalo,y in NH) AK, WI Only E L DISEASE-EAEMPLOYEE SI,000,00() If yps describe under ........--- DEGORIPT;0N OF OPLRrUONE�miow E L DISEASE-FOLLC;Y L,m.i r $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) RE: Pursuit Number 60005817.0014, RFC) #26-19. city of Clearwater is included as Additional insured in accordance, with the policy provisions of the General Liability and Automobile Liability policies, M;-® CERTIFICATE HOLDER CANCELLATION A7 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. city of Clearwater AUTHORIZED REPRESENTATIVE Attn: )illian Prieto PO Box 4748 Clearwater FL 33758-4748 USA @1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD P% es, DATL(MMIDD(YYYY) CERTIFICATE OF LIABILITY INSURANCE077231077231X19� 19 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)rnust 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 enclorsementis). PRODUCER CONTACT NAME: Aon Risk. Services South, Inc, -FFH-0NE -- --- Franklin TN Office (AIC,N.,Ett; (866) 283-7122 PVC,No,1: 363-0105 501 Corporate Centre Drive E-MAIL 0 Suite 300 ADDRESS: Franklin IN 37067 USA INSURER(S)AFFORDING COVERAGE MAIC# INSURED INSURER A; indian Uarbor inSUrance Company 36940 Arcadis U.S.. Inc. !NSURER B. Lexington Insurance Company 19437 630 Plaza Drive suite ZOINSURER C. O Highlands Ranch co 801.29 LISA INSURER D. INSURER E: ...tL N!URER F� CfOVERAFaES CERTIFICATE NUMBER: 570077591642 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 -ADDT P! W� D=F --POLTCY EXPIJ INSRJ ICY NUMBER DNYYY LIMITS LTR TYPE OF INSURANCE INSD7777777Z- (M jimmloo)yyyy 171 COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS,'^MADE. OCCUR F11ED EXP{Any are(er�—j JPERSONAL&ADV INJURY................. . ..... GENAL AGGREGArE I-JIVIrAPPUES PER GENERALAGGREGATE. ' -ROY- U-) POLICY [—] E LC C, PRODUCTS COMPjOPAGG, OTHER AUTOMOBILE LIABILITY COMMNED SINGLE LIMIT ANY AUTO BODILY INJURY(Pe,mrso") z OA'NEDSCHEDULED l BODILY INJURY(Prccrden!] laD AUTOS ONLY AUTOS — -F� -PWOPEPTY DXMA M WRT,f)AUTOS NON-01AINED u ONLY AUTO$QNLY (Per accident) UMBRELLA LIAR OCCUR j EACH OCCURRENCE L) EXCESS LIAR f CLAIMS-MADE I I AGGREGATE WORKERS COMPENSATION AND IPER EMPLOYERSLIABILITY YJN j S rAL)t E Ac p7 EL FAC'HACCIDENT NIA� (Mandato in NH) (Mandatary EL DlSrASE-K.AEMPLII'YyEf, If yes,describe under .... .. ...... DESCRIPTION OF OPERATIONS belaw E L DISEAS15-POLICY LIMI r I A Env Contr Poll u500090310EO19A 06/01/201910 15/01/2020 Each Claire $1,000,000 Professional & Pollution Annual Aggregate $L,000,000 SIR applies per policy terns & condiF 1, - -- i ....................... DESCRIPTION OF OPERATIONS I LOCATIONS IVEHICLES(ACORD 101,Additional Remarks Schedule,may be attached timers space is required) For Professional I.i abi I i ty and Pol I U t!on Li abi I i ty coverage, the Aggregate Limit is the total insurance avaiiIable for claims presented within the policyPeriod for all operations of the insured. rhe Limit will be reduced by payrnents of indemnity and expense. RE: Pursuit NUM60005817.0014, RFQ #26-19. CERTIFICATE HOLDER CANCELLATION SHOULD ANY Of THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Tor EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Clearwater AUTHORIZED REPRESENTATIVE Attn: 3illian Prieto PO Box 4748 C,learwater F1, 33758-4718 USA l— am @1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000005571 LOC 4: ADDITIONAL REMARKS SCHEDULE Page c of AGFNCY NAMED iNSURED Aorl Risk Services South, Inc. Arcadis u,S., inc. PC\'NUM OLI, BFR see certificate, Number: 570077591642 NA I C C CARRIEP ODE see certificate Nurnhcr, 570077591642 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S,) AFFORDING, COVERAGE NAIC# INSI'RFR 1NSU!Rl-R INSI:Rl R ADDITIONAL POLICIES lfapolic% below doe,;nt)t hiciride hniit inforinalion, refer io tl.rr coryesp(ni(l Ill,, policy 13n ffieACORD cerlifleate 161-111 161-policy limits. ,%$)1 1 Sr BPOLICI J( -, ' JAR I I'V Or INSI RAN(V INS,!, %441) riEGI INT FXPIRAFION LS ti411'5 DA I E DAIF- 'ht x7,rtLT"k'14 1-r of%I I)NA,I I FxC 1 a i pi s-m a d e L_ FXT_110__sional Liahil [X—jand contractors I_ T PollutJon tJability ACORD 101(2008101$ 2008 ACORD CORPORATION,All rights reserved. The ACORD name and logo are registered niarks of ACORD