The URL can be used to link to this page

CERTIFICATE OF LIABILITY INSURANCE (554)i Client#: 1048507 INGENENT ACORDT, CERTIFICATE OF LIABILITY INSURANCE DATE 5/27/2027/2020 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 CONTACT NAME: PHONE FAX (A/C, No, Ext): 813 321-7500 (A/C, No): 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 B : Travelers Property Cas. Co. of America 25674 INSURERC: Berkley Insurance Company 32603 INSURER D : Travelers Property Cas. Co. of America 25674 INSURER E : INSURER F : X 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. INSR LTR TYPE OF INSURANCE ADDLSUBR INSR WVD POLICY NUM POLICY EFF POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY X X 6803H433322 CL. JUN ' JUN(' OFFICIAL RECORDS LEGISLATIVE S / 19 LI AND_ 2YCS r ' -- r. 10/14/2019 10/14/2020 T 10/14/2020 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE X OCCUR PREMISES (ERENTED occu ence) $1,000,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE POLICY OTHER: x LIMIT APPLIES PRO - JECT PER: LOC GENERAL AGGREGATE $4,000,000 PRODUCTS - COMP/OP AGG $4,000,000 (Ee aociI SINGLE LIMIT $ $1,000,000 D AUTOMOBILE X X LIABILITY ANY AUTO OWNED AUTOS ONLY AUTOS ONLY XNON-OAUTOS _ SCHEDULED AUTOS WNEONLY D X X BA220M6366 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 AGGREGATE $5,000,000 $ DED X RETENTION $10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ C Professional Liability AEC903689001 05/29/2020 05/29/2021 $2,000,000 per claim $2,000,000 annl aggr. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Professional Liability coverage is written on a claims -made basis. RE: Engineer of Record RFQ34-15. The City of Clearwater is an Additional Insured as respects the Commercial General Liability policy where required by a written contract prior to a loss per policy terms and conditions. CERTIFICATE HOLDER CANCELLATION City of Clearwater Attn: City Clerk PO Box 4748 Clearwater, FL 33758-4748 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 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S28848870/M28848781 SECZP