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CERTIFICATE OF LIABILITY INSURANCE (560) DATE(MM/DD/YYYY) ACORN® CERTIFICATE OF LIABILITY INSURANCEF 9/24/2020 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Wallace Welch &Willingham, Inc. PHONEFAX 300 1 st Ave. So., 5th Floor A/c No Ext): 727-522-7777 A/c,No):727-521-2902 Saint Petersburg FL 33701 ADDRESS: certificates@w3ins.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Architects&Engineers Ins Co 44148 INSURED DRIGENG-01 INSURER B: Travelers Property Casualty Co of Amer. 25674 Driggers Engineering Services, Inc. PC Box 17839 INSURER C: Old Dominion Ins.Co. 40231 Clearwater FL 33762 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:424495871 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 INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY B X COMMERCIAL GENERAL LIABILITY Y X6601C729473PHX19 8/10/2020 8/10/2021 EACH OCCURRENCE $2,000,000 CLAIMS-MADE ® OCCUR DAMAGETORENTED PREMISES Ea occurrence $1,000,000 MED EXP(Any one person) $5,000 X XCU PERSONAL&ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY ® ECT ® LOC PRODUCTS-COMP/OP AGG $4,000,000 OTHER: $ C AUTOMOBILE LIABILITY Y B1T6102X 8/10/2020 8/10/2021 COMBINEDSINGLELIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIREDX NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ B X UMBRELLA LAB X OCCUR CUPOL2570501947 8/10/2020 8/10/2021 EACH OCCURRENCE $5,000,000 EXCESS LABCLAIMS-MADE AGGREGATE $5,000,000 DED X RETENTION$1 C non $ B WORKERS COMPENSATION UBOL712553 8/10/2020 8/10/2021 X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $1,000,000 OFFICER/M EMBER EXCLUDED? ❑ N/A (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 A Professional/Pollution Liab AEICPG18 9/24/2020 9/24/2021 Per Claim $2,000,000 Claims Made Aggregate $5,000,000 Retro Date 9/24/1986 Deductible $25,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Clearwater is additional insured with respect to General Liability if required by written contract subject to terms,conditions,and exclusions of the policy. City of Clearwater is additional insured on a primary basis with respect to Auto Liability if required by written contract subject to the terms and conditions and exclusions of the policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Clearwater ACCORDANCE WITH THE POLICY PROVISIONS. Engineering, RFQ#26-19 PC Bax 4748 AUTHORIZED REPRESENTATIVE Clearwater FL 33758-4748 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD