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CERTIFICATE OF LIABILITY INSURANCE (309) ACORO® DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 10/22/2019 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 w � p y, policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT 'a NAME: Aon Risk services South, Inc. PHONE FAX N Franklin TN Office (A/C.No.Ext): (866) 283-7122 (A/C.No.): 800-363-0105 v 501 Corporate Centre Drive E-MAIL 2 Suite 300 ADDRESS: Franklin TN 37067 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Greenwich Insurance Company 22322 Arcadis U.S., Inc. INSURER B: XL Specialty Insurance Co 37885 630 Plaza Drive Suite 200 INSURER C: XL Insurance America Inc 24554 Highlands Ranch CO 80129 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570078919230 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 LTR TYPE OF INSURANCE AINSD SWVD POLICY NUMBERPOLICY EFF POLICY EXP LIMITS (MIWDD/YYYY) (MIWDD/YYYY) A X COMMERCIAL GENERAL LIABILITY GECO01076118 10/01/2019 10 01 2020 EACHOCCURRENCE $1,000,000 SIR applies per policy terris & condi ions CLAIMS-MADE X❑OCCUR PREMISES(Ea occurrence) $1,000,000 X Contractual Liability MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 P'L AGGREGATE LlIMITAPPLIESLP�EERGENERAL AGGREGATE $2,000,000 COMP/OPAGG63POLICY IJECT SX LOC PRODUCTS- , , o OTHERuD : o uD B AUTOMOBILE LIABILITY AECO01075818 10/01/2019 10/01/2020 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X ANYAUTO BODILY INJURY(Per person) O OWNEDAUTOS SCHEDULED BODILYINJURY(Peraccident) Z ONLY AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE U ONLY AUTOS ONLY (Per accident) ;U X Property Damage to Ot y U UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE DED I RETENTION C WORKERS COMPENSATION AND RWD943516314 10/01/2019 10/01/2020X STATUTE EORH EMPLOYERS'LIABILITY Y/N All Other States B ANY PROPRIETOR/PARTNER/EXECUTIVE N/A RWR943516714 10/01/2019 10/01/2020 N E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) AK, WI Only E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) i RE: Pursuit Number 60005817.0014, RFQ #26-19. City of Clearwater is included as Additional Insured in accordance with the �— policy provisions of the General Liability and Automobile Liability policies. Z �J �J KJ Ys CERTIFICATE HOLDER CANCELLATION_ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 0 a- City Of Clearwater AUTHORIZED REPRESENTATIVE Attn: Jillian Prieto PO Box 4748 Clearwater FL 33758-4748 USA v p ©1988-2015 ACORD CORPORATION.All rights reserved ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ACORO® DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 10/22/2019 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 w � p y, policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT 'a NAME: Aon Risk services South, Inc. PHONE FAX Franklin TN Office (A/C.No.Ext): (866) 283-7122 (p/C.No.): (800) 363-0105 'a 501 Corporate Centre Drive E-MAIL 2 Suite 300 ADDRESS: Franklin TN 37067 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Indian Harbor Insurance Company 36940 Arcadis U.S., Inc. INSURER B: Lexington Insurance Company 19437 630 Plaza Drive Suite 200 INSURER C: Highlands Ranch CO 80129 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570078919236 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 LTR TYPE OF INSURANCE AINSD SWVD POLICY NUMBERPOLICY EFF POLICY EXP LIMITS (MM/DD/YYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 10 KIN 1113 CLAIMS-MADE F_�OCCUR PREMISES(Ea occurrence) MED EXP(Any one person) PERSONAL&ADV INJURY m N P'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE rn E]PRO- I� POLICY JECT I I LOC PRODUCTS-COMP/OP AGG IL�� o OTHERuD : o uD AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANYAUTO BODILY INJURY(Per person) O OWNED AUTOS SCHEDULED BODILYINJURY(Per accident) Z ONLY AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE U ONLY AUTOS ONLY (Per accident) ;U d U UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE DED I RETENTION WORKERS COMPENSATION AND STATUTE EORH EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE tE.LDISEASE-EA CH ACCIDENT OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) EMPLOYEE If yes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT A Env Contr Poll US00090310EO19A 06/01/2019 06/01/2020 Each Claim $1,000,000 -- Professional & Pollution Annual Aggregate $1,000,000 SIR applies per policy terris & condi ions DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) i For Professional Liability and Pollution Liability coverage, the Aggregate Limit is the total insurance available for claims presented within the policy period for all operations of the insured. The Limit will be reduced by payments of indemnity and iJ expense. RE: Pursuit Number 60005817.0014, RFQ #26-19. �- 2J �J CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION rr.i DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Clearwater AUTHORIZED REPRESENTATIVE Attn: Jillian Prieto PO Box 4748 Clearwater FL 33758-4748 USA (� e>GR. ©1988-2015 ACORD CORPORATION.All rights reserved ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 570000005571 LOC#: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY NAMED INSURED Aon Risk services south, Inc. Arcadis U.S. , Inc. POLICY NUMBER See Certificate Number: 570078919236 CARRIER NAIC CODE See Certificate Number: 570078919236 EFFECTIVE DATE: 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# INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information,refer to the corresponding policy on the ACORD certificate form for policy limits. POLICY POLICY INSR ADDL SUBR EFFECTIVE DATE EXPIRATION LTR TYPE OFINSURANCE INSD WVD POLICY NUMBER LIMITS (MM/DD/YYYY) DATE OTHER X claims-Made X Professional Liabil X I and contractors X Pollution Liability ACORD 101(2008/01) ©2008 ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD