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CERTIFICATE OF LIABILITY INSURANCE - RFQ 26-19 (2) Risk Strategies Company 2040 Main Street,Suite 450 Irvine,CA 92614 MAIL DOCUMENT Certificate of Insurance Delivery by ecertsonlineTM City of Clearwater Sender: Sandi Moreno Engineering, RFQ#26-19 Phone: 949-242-9240 RO. Box 4748 Clearwater FL 33758-4748 Subj,eet: Cert No.53054943-Certificate of Liability:Carollo Engineers, Inc.-Renewal Date: 12/19/2019 No. of Pages 9 URL: www.risk-strategies.com If you have any questions, please contact Sherry Young at syoung@risk-strategies.com. Thank you! THIS MESSAGE IS INTENDED FOR THE USE OF THE INDIVIDUAL OR ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS PRIVILEGED,CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW.IF THE READER OF THE MESSAGE IS NOT THE INTENDED RECIPIENT,OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERING THE MESSAGE TO THE INTENDED RECIPIENT,YOU ARE HEREBY NOTIFIED THAT ANY DISSEMINATION,DISTRIBUTION OR COPYING OF THIS COMMUNICATION IS STRICTLY PROHIBITED.IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR,PLEASE NOTIFY US IMEDIATELY BYTELEPHONE,AND RETURN THE ORIGINAL MESSAGE TO US AT THE ABOVE ADDRESS VIA REGULAR POSTAL SERVICE Certificate of Insurance Delivered by ecertsonlineTM Insurance Visions, Inc.All rights reserved. DATE(MMIDDIYYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 12/19/2019 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 endorsement(s). PRODUCER Riskp y CONTACT Strategies Com an NAME: Risk Strategies Company 2040 Main Street, Suite 450 AI°NN Ext: 949-242-9240 AIX No: Irvine, CA 92614 E-MAIL ADDRESS: syoung@risk-strategies.com INSURER(S)AFFORDING COVERAGE NAIC# www.risk-strategies.com CA DOI License No.OF06675 INSURERA: Continental Insurance Company 35289 INSURED INSURER B: American Casualty Company of Reading, PA 20427 Carollo Engineers, Inc. INSURER C: Valley Forge Insurance Company 20508 2795 Mitchell Dr. Walnut Creek CA 94598-1601 INSURER D: Continental Casualty Company 20443 INSURER E: National Fire Insurance Co of Hartford 20478 INSURER F: COVERAGES CERTIFICATE NUMBER: 53054943 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMIDDIYYYY MMIDDIYYYY A `/ COMMERCIAL GENERAL LIABILITY ✓ 6050490317 12/31/2019 12/31/2020 EACH OCCURRENCE $$1,000,000 DA CLAIMS-MADE 1✓ OCCUR PREM SES Ea occurrDence $$1,000,000 ✓ Deductible$0 MED EXP(Any one person) $$25,000 PERSONAL&ADV INJURY $$1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $$2,000,000 PRO- POLICY ✓� ECT [::] LOC PRODUCTS-COMP/OP AGG $$2,000,000 OTHER: $ E AUTOMOBILE LIABILITY ✓ 6050490267 12/31/2019 12/31/2020 EOaaBINEDtSINGLELIMIT $$1'000'000 ✓ ANY AUTO BODILY INJURY(Per person) $ OWNEDSCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ ✓ AUTOS ONLY ✓ AUTOS ONLY Per accident Ded:Com /Collision $$1,000 UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION 6050490270 12/31/2019 12/31/2020 `/ STATUTE ✓ EERH Deductible:$0 AND EMPLOYERS'LIABILITY C Y/N 6050490298 12/31/2019 12/31/2020 OFFICER/MEMBER EXCLUDED? ❑N NIA E.L.EACH ACCIDENT $$1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $$1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $$1,000,000 D Professional Liability AEH288354410 7/4/2019 7/4/2020 Each Claim: $1,000,000 Unlimited Prior Acts Aggregate: $1,000,000 Deductible: $400,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Projects as on file with the insured including but not limited to:New Engineer of Record Agreement, RFQ#26-19. City of Clearwater is included as additional insured with respects to general&auto liability. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Clearwater THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Engineering RFQ#26-19 ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 4748 Clearwater FL 33758-4748 AUTHORIZED REPRESENTATIVE f 7-- Michael Christian ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 53054943 1 *19-20 GL-AL-UL-WC 19-20 PL ($1M/$1M) I Sandi Moreno 112/19/2019 2:35:05 PM (PST) I Page 1 of 8 CNA Blanket Additional Insured - Owners, Lessees or Contractors - with Products-Completed Operations Coverage Endorsement This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART It is understood and agreed as follows: I. The WHO IS AN INSURED section is amended to add as an Insured any person or organization whom the Named Insured is required by written contract to add as an additional insured on this coverage part, including any such person or organization, if any, specifically set forth on the Schedule attachment to this endorsement. However, such person or organization is an Insured only with respect to such person or organization's liability for: A. unless paragraph B. below applies, 1. bodily injury, property damage, or personal and advertising injury caused in whole or in part by the acts or omissions by or on behalf of the Named Insured and in the performance of such Named Insured's ongoing operations as specified in such written contract; or 2. bodily injury or property damage caused in whole or in part by your work and included in the products-completed operations hazard, and only if a. the written contract requires the Named Insured to provide the additional insured such coverage; and b. this coverage part provides such coverage. B. bodily injury, property damage, or personal and advertising injury arising out of your work described in such written contract, but only if: 1. this coverage part provides coverage for bodily injury or property damage included within the products completed operations hazard; and 2. the written contract specifically requires the Named Insured to provide additional insured coverage under the 11-85 or 10-01 edition of CG2010 or the 10-01 edition of CG2037. II. Subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with: A. coverage broader than required by the written contract; or B. a higher limit of insurance than required by the written contract. III. The insurance granted by this endorsement to the additional insured does not apply to bodily injury, property damage, or personal and advertising injury arising out of: A. the rendering of, or the failure to render, any professional architectural, engineering, or surveying services, including: 1. the preparing, approving, or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; and 2. supervisory, inspection, architectural or engineering activities; or B. any premises or work for which the additional insured is specifically listed as an additional insured on another endorsement attached to this coverage part. IV. Notwithstanding anything to the contrary in the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS, the Condition entitled Other Insurance, this insurance is excess of all other insurance available to the additional insured whether on a primary, excess, contingent or any other basis. However, if this insurance CNA75079XX (1-15) Policy No: 6050490317 Page 1 of 2 Endorsement No: Effective Date:12/31/2019 Insured Name: Carollo Engineers,Inc. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 53054943 1 *19-20 GL-AL-UL-WC 19-20 PL ($1M/$1M) I Sandi Moreno 112/19/2019 2:35:05 PM (PST) I Page 2 of 8 CNA Blanket Additional Insured - Owners, Lessees or Contractors - with Products-Completed Operations Coverage Endorsement is required by written contract to be primary and non-contributory, this insurance will be primary and non- contributory relative solely to insurance on which the additional insured is a named insured. V. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the addition of the following: Any additional insured pursuant to this endorsement will as soon as practicable: 1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim; 2. except as provided in Paragraph IV. of this endorsement, agree to make available any other insurance the additional insured has for any loss covered under this coverage part; 3. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation, defense, or settlement of the claim; and 4. tender the defense and indemnity of any claim to any other insurer or self insurer whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph (4) does not apply to insurance on which the additional insured is a named insured. The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured. VI. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to add the following definition: Written contract means a written contract or written agreement that requires the Named Insured to make a person or organization an additional insured on this coverage part, provided the contract or agreement: A. is currently in effect or becomes effective during the term of this policy; and B. was executed prior to: 1. the bodily injury or property damage; or 2. the offense that caused the personal and advertising injury for which the additional insured seeks coverage. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the designated Insurers, takes effect on the effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. CNA75079XX (1-15) Policy No:6050490317 Page 2 of 2 Endorsement No: Effective Date:12/31/2019 Insured Name: Carollo Engineers,Inc. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office,Inc.,with its permission. 53054943 1 *19-20 GL-AL-UL-WC 19-20 PL ($1M/$1M) I Sandi Moreno 112/19/2019 2:35:05 PM (PST) I Page 3 of 8 CNA NOTICE OF CANCELLATION TO CERTIFICATEHOLDERS It is understood and agreed that: If you have agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record has issued a Certificate of Insurance, and if we cancel a policy term described on that Certificate of Insurance for any reason other than nonpayment of premium, then notice of cancellation will be provided to such Certificateholders at least 30 days in advance of the date cancellation is effective. If notice is mailed, then proof of mailing to the last known mailing address of the Certificateholder on file with the Agent of Record will be sufficient to prove notice. Any failure by us to notify such persons or organizations will not extend or invalidate such cancellation, or impose any liability or obligation upon us or the Agent of Record. City of Clearwater Engineering RFQ#26-19 P.O. Box 4748 Clearwater FL 33758-4748 CNA68021 XX (2-13) Policy No: 6050490317 Page 1 Endorsement No: Effective Date: 12/31/2019 Insured Name: Carollo Engineers, Inc. ©CNA All Rights Reserved. 53054943 1 *19-20 GL-AL-UL-WC 19-20 PL ($1M/$1M) I Sandi Moreno 112/19/2019 2:35:05 PM (PST) Page 4 of 8 Named Insured:Cuollo Engineers,Inc. Policy Number: 6050490267 Effective Date: 12/31/2019 C7VA ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY It is understood and agreed that this endorsement amends the BUSINESS AUTO COVERAGE FORM as follows: SCHEDULE Name of Additional Insured Persons Or Organizations ANY PERSON OR ORGANIZATION ON WHOSE BEHALF YOU ARE REQUIRED UNDER A WRITTEN CONTRACT OR AGREEMENT. 1. In conformance with paragraph A.1.c. of Who Is An Insured of Section II — LIABILITY COVERAGE, the person or organization scheduled above is an insured under this policy. 2. The insurance afforded to the additional insured under this policy will apply on a primary and non- contributory basis if you have committed it to be so in a written contract or written agreement executed prior to the date of the "accident" for which the additional insured seeks coverage under this policy. All other terms and conditions of the Policy remain unchanged. CNA 71527XX(Ed.10/12) 53054943 *19-20 GL-AL-UL-WC 19-20 PL ($1M/$1M) I Sandi Moreno 112/19/2019 2:35:05 PM (PST) I Page 5 of 8 CNA NOTICE OF CANCELLATION TO CERTIFICATEHOLDERS It is understood and agreed that: If you have agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record has issued a Certificate of Insurance, and if we cancel a policy term described on that Certificate of Insurance for any reason other than nonpayment of premium, then notice of cancellation will be provided to such Certificateholders at least 30 days in advance of the date cancellation is effective. If notice is mailed, then proof of mailing to the last known mailing address of the Certificateholder on file with the Agent of Record will be sufficient to prove notice. Any failure by us to notify such persons or organizations will not extend or invalidate such cancellation, or impose any liability or obligation upon us or the Agent of Record. City of Clearwater Engineering RFQ#26-19 P.O. Box 4748 Clearwater FL 33758-4748 CNA68021 XX (2-13) Policy No: 6050490267 Page 1 Endorsement No: Effective Date: 12/31/2019 Insured Name: Carollo Engineers, Inc. ©CNA All Rights Reserved. 53054943 1 *19-20 GL-AL-UL-WC 19-20 PL ($1M/$1M) I Sandi Moreno 112/19/2019 2:36:05 PM (PST) Page 6 of 8 s Carollo Engineers, Inc. CMA It is understood and agreed that: If you have agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record has issued a Certificate of Insurance, and if we cancel a policy term described on that Certificate of Insurance for any reason other than nonpayment of premium, then notice of cancellation will be provided to such Certificateholders at least 30 days in advance of the date cancellation is effective. If notice is mailed, then proof of mailing to the last known mailing address of the Certificateholder on file with the Agent of Record will be sufficient to prove notice. Any failure by us to notify such persons or organizations will not extend or invalidate such cancellation, or impose any liability or obligation upon us or the Agent of Record. All other terms and conditions of the policy remain unchanged. This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below. Form No:CC68021A(02-2013) Policy No:6050490298 Endorsement Effective Date: 12/31/2019 Policy Effective Date: 12/31/2019 Endorsement No: Underwriting Company:• American Casualty Company of Reading, PA Valley Forge Insurance Company_ CNA All Rights Reserved. Workers Compensation 53054943 *19-20 GL-AL-UL-WC 19-20 PL ($1M/$1M) I Sandi Moreno 112/19/2019 2:35:05 PM (PST) I Page 7 of 8 CNA PROFESSIONAL LIABILITY AND POLLUTION For All the Commitments you Make INCIDENT LIABILITY INSURANCE POLICY INSURED: Carollo Engineers,Inc. Policy AEH288354410 Effective?/4/2019 Endorsement Number NOTICE ENDORSEMENT - CANCELLATION OR NON-RENEWAL We agree with you that your Policy is amended to include the following additional provisions. 1. Your Policy will not be: XX Cancelled by us until we provide at least: 10 days prior written notice if we cancel your Policy for Non-payment of Premium; 30 days prior written notice if we cancel your Policy for The following reasons : Any reason other than non-payment of premium. Non-renewed by us until at least days prior written notice is given to the person or entity named in 2. below. 2. Person or Entity: City of Clearwater Engineering,RFQ#26-19 P.O. Box 4748 Clearwater FL 33758-4748 All other terms and conditions of the Policy remain unchanged. This endorsement, which forms a part of and is for attachment to the Policy issued by the i designated Insurers, takes effect on the effective date of said Policy at the hour stated in said i i Policy and expires concurrently with said Policy unless another effective date is shown above. I I By Authorized Representative James F. Willging (No signature is required if issued with the Policy or if it is effective on the Policy Effective Date) ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- James F. Willging Countersigned by Authorized Representative 256423 (Ed. 10/05) 53054943 *19-20 GL-AL-UL-WC 19-20 PL ($1M/$1M) I Sandi Moreno 112/19/2019 2:35:05 PM (PST) I Page 8 of 8