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CERTIFICATE OF LIABILITY INSURANCE (536)104 INGENENT ACORD„" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)10/14/2019 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(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 USI Insurance Services, LLC 2502 N Rocky Point Drive Suite 400 Tampa, FL 33607 =par : PHONEFAX (A/C, No, Ext): 813 321-7500 (A/C, No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Phoenix Insurance Company 25623 INSURED Ingenium Enterprises, Inc. 14499 N. Dale Mabry Hwy. Suite 250 Tampa, FL 33618 INSURER : Travelers Properly Ceo, Co. of Amedca B 25674 INSURER C :Berkley Insurance Company 10/14/2020 INSURER D : Travelers Properly Cas. Co. of America 25674 INSURER E : $1,000,000 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTRINSR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY X X 6803H433322 10/14/2019 10/14/2020 EACH OCCURRENCE $2,000,000 DAMAGET ENTED PREMISES a occurrence) $1,000,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $2,000,000 GENERAL AGGREGATE $4,000,000 GE 'L AGGREGATE POLICY OTHER: X LIMIT APPLIES PR T JECO- PER: LOC PRODUCTS - COMP/OP AGG $4,000,000 D AUTOMOBILE X X LIABILITY ANY AUTO OWNED AUTOS ONLY AUTOS ONLY X SCHEDULED AUTOS NON -OWNED AUTOS ONLY X X BA220M6366 10/14/2019 10/14/2020 (EaaoiNLIgINGLE LIMIT $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE X X CUP5K869570 10/14/2019 10/14/2020 EACH OCCURRENCE $5,000,000 $5,000,000 AGGREGATE $ DED X RETENTION $10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITYER ANY IME CLPROPRIETOR/PARTNER/EXECUTIVE (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A STATUTEPER OTH E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ C Professional Liability AEC903136800 05/29/2019 05/29/2020 $2,000,000 per claim $2,000,000 annl aggr. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD Professional Liability coverage is written on RE: Engineer of Record RFQ34-15. The City General Liability policy where required by a conditions. 101, Additional Remarks Schedule, may be attached if more space Is required) a claims -made basis. of Clearwater is an Additional Insured as respects the Commercial written contract prior to a loss per policy terms and ,ps sT;\. 7'71 CERTIFICATE HOLDER CANCELLATION City of Clearwater Attn: City Clerk PO Box 4748 OFFICLAt ECO RE S AHL} Clearwater, FL 33758-4748 IEGISUAT€VE Sly'/cDEP 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 'of—D=0 ,,t. ACORD 25 (2016/03) 1 of 1 #826885319/M26884414 © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SYWZP