CERTIFICATE OF LIABILITY INSURANCE - RFQ 26-19 (16) �1
,acorzo• CERTIFICATE OF LIABILITY INSURANCEDATE(MMJDDrrfM
`� 5/1/2021 4/10/2020
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 polley(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 ondorsement(s).
CONTACT
PRODUCER Locklon Companies NAME:
444 W.47th Street,Suite 900 Arc,No Ext): FAX
Arc No):
Kansas Ci MO 64112-1906 E-MAIL
(816)960000 ADDRESS:
INSURER(SI AFFORDING COVERAGE NAIC#
INSURER A: Berkshire Hathaxay Specialty Insurance Company 22276
INSURED STANTEC CONSULTING SERVICES,INC. INSURERS: Travelers Property Casualty CoofArnerica 25674
1415077 3701NTERLOCKEN BOULEVARD,SUITE 300 INSURER C:
BROOMFIELD CO 80021-8012
INSURER D,.
INSURER E
-- -- - 4 - INSURER F: -
COVERAGES CERTIFICATE NUMBER: 1614 292 REVISION NUMBER: XXXXXXX
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.
LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP
INSD WVD MM1D0 MM/Db LIMITS
A X COMMERCIAL GENERAL LIABILITY y y 47-GLO-307584 5/1/2020 5/1/2021 EACH OCCURRENCE S 2,000,000
CLAIMS MADE OCCUR PREMISES ERENTED
ocau ante S 1 000 000
X CONTRACTUALICROSS MED EXP(Any onePerson) 25,000
X XCU COVERED PERSONAL&ADV INJURY I S 21000,000
GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s 4.000,000
POLICY PRO-
FX LOC PRODUCTS-COMPIOPAGG S 2,000,000
OTHER: S
B AUTOMOBILE LIABILITY y y TC2J-CAP-8E086819(AOS) 5/1/2020 5/1/2021 Ea BINE0 SINGLE LIMIT S 1,000,000
ae
B TJ-BAP-8E086820 5/1/2020 5/1/2021
B JX ANY AUTO TC2J-CAP-8E087017(NJ) 5/1/2020 5/1/2021 BODILYINJURY(Perperson) $ �
AUUTOS ONLY SCHEDULED BODILY INJURY(Per accident $ YY,)C) �X
HIRED NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY Peraccdent S �X
5 )Cxxx X
A X UMBRELLA LIAB X JOCCUR N N 47-UMO-307585 5/1/2020 5/1/2021 EACH OCCURRENCE S 51000,000
X EXCESS LIAB ICLAIMS-MADE AGGREGATE S 5,000.000
DED RETENTION S S )DC XXXX
B WORKERS COMPENSATION PER H.
ANbEMPLOYERS'LIABILITY Y UB-3P635310 A05) 5/1/2020 51I/2021 X STATllTE ER
B ANYPROPRiETORIPARTNEWEXECUTWE ❑ NIA UB-3P5330( VVI) 5/1/2020 5/1/2021 E.L.EACH ACCIDENT $ 1,000,000
B OFFICERIMEMBER EXCLUDED? N EXCEPT FOR OH YVD A WY
(Manaateryln NH) E.L DISEASE-EA EMPLOYEE S 1,000,000
If y .aeseritfe under _
—-1) RIPTION CF OPERATIONS WOW —-- - - -- `- - E L pAS
ISEELf-POLICY MIT �1-000 OOO J'
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
RE:RFQT26-I9/ENGINEER OF RECORD CONSULTING SERVICES: PLANNING,STUDIES AND DESIGN SERVICES.CITY OF CLEARWATER
IS ADDITIONAL INSUREDS AS RESPECTS GENERAL LIABILITY AND AUTO LIABILITY,AND THESE COVERAGES ARE PRIMARY AND
NON-CONTRIBUTORY,IF REQUIRED BY WRITTEN CONTRACT.WAIVER OF SUBROGATION APPLIES TO GENERAL LIABILITY,AUTO
LIABILITY AND WORKERS COMPENSATION/EMPLOYER'S LIABILITY WHERE ALLOWED BY STATE LAW AND IF REQUIRED BY WRITTEN
CONTRACT.
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.
16147292 AUTHORIZED REPRESENTATIVE
CITY OF CLEARWATER
ENGINEERING,RFQ#26-19
P.O.BOX 4748
CLEARWATER FL 33758.4748
ACORD 25(2016103) 19188-2015 ACORD CORPORATION.All rights reserved
The ACORD name and logo are registered marks of ACORD
ACC>R"' CERTIFICATE OF LIABILITY INSURANCEDATE(MMIDDIYYYY)
16-.� 10/11112020 1 9/13/2019
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(les)must have ADDITIONAL INSURED provisions or be endorsed.
If SUIBROGATION 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).
CONTACT--
PRODUCER Lockton Com@nies NAME:
444 W.47th Street,Suite 900 PHONE
&
0�No,Est:
Kansas CIt MO 64112-1906 L
(816)9607000 ADDRESS:
INS' nRISIAFFORDING COVERAgE... NAI C#
t ' 76
INSURER A: I3,Awure I Srcvalt:,I nsurance 0.,m1pully 222
INSURED STANTEC CONSULTING SERVICES,INC. INSURERS: AIG Sc?ahInsurance Company 2688'
1414100 370 iNTERLOCKEN BOULEVARD,SUITE 300 INSURER C:
BROOMFIELD CO 80021-8012
INSURER D
JNSURE k E;
INSURER F;
COVERAGES CERTIFICATE NVMBER: REVISION NUMBER: XXXXXX
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 A
LTR TYPE OF INSURANCE :011L SUBR POLICY EFF POLICY EXP
WIT POLICY NUMBER (MMIDDtyyyy (MMIDD LIMITS
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ xxxxxxx
CLAIMS-MAUE OCCUR NOTAPPLICABLE DAMAGE� RENTED
SL
Ea or
'r
,u""."el XXXXXXX
PREWS
MED EXP(Any one person) S xxxxxxx
PERSONAL&ADV INJURY s XxXxxxx
GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ XXXXXXX
JECT: ❑LOC
POLICYE PRO- F PRODUCTS-COMPICP AGO S XXXXXXX
OTHER: S
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
fEa acadeft S XxXxxxx
ANY AUTO NOTAPPI.-ICABLF BODILY INJURY(Per person) $ xxxxxx.x
OWNED qSCHEDULED
AUTOS ONLY AUTOS BODILY INJURY(Per accident $ XXX,XXXX
HIRED NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY (per accident) S xxxxxxx
UMBRELLA LIAR OCCUR EACH OCCURRENCE $ Xxxxxxx
EXCESS LIAR CLAIMS-MADE NOTAIIIII ICABLE AGGREGATE $ xxxxxxx
DED I I RETENTION $
WORKERS,COMPENSATION ER 11TI1-
STAT,�, ER
AND EMPLOYERS'LIABILITY YIN NO[ A11I1[_ICABIJ'-' [P
OFFICEP,IMEMBER EXCLUDED? NiA E L EACIA Ar-CIOVEN
ANY PROPRIETORIPARTNERIEXECUrIVE F s xxxxxxx
(MaYWA*ry In NH) L—i F L MaEASE•EA EMPLUYEE XxXxxxx
11r,
sr,
D SCMPTtONQFOPERAMNSwk— I L MSELASE,POLICY UN11 T _xxxxxxx
A Profe sional Liab N N 47-1`11P-308810 10"1"2019 101112020 S3,1000,000 PER CLAIM;AGG
A NO 1>ETROACTI V F'DATE INCLUSIVE OF t'Iosl S
SI,000
Conmacwrs Pollution Li' CP08085428 101;120 19 1 10/112021 00(1 PIR I_0SSACG
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If mors;pace is required)
RE, RF Q#26-19M FNGINEFR OF RECORD CONSULTING SERVICES: PLANNIN(ri. S_FUDIFS AND DESIGN S1_RVICFS.
P
CERTIFICATE HOLDER CANCELL-ATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
16147296 AUTHOR2EO REPRESENTATIVE
CITY OF CLEARWATER
ENGINEERING,RFQ#26-19
P,Oi BOX 4748
CLEARWATER FL 33758-4748
ACORD 25(201 103) Oc 108-2015 ACORD CORPORATION,Ali rights reserved
The ACORD name and logo are registered marks of ACORD
AC"R"o CERTIFICATE OF LIABILITY INSURANCE DATE(MM1DDNYYY)
10/P2020 9/1.320 19
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(fes)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).
CONTACT
PRODUCER Lockton Companies NAME:
444 W.4781 Street,Suite 900 P14ONE --------FTIA7
fN2t No,_Ext. INC -
Kansas Ci MO 64112-1906 E-MAIL I ,N�
(816)9602000 ADDRESS;
INSURER S'AFFORD NG COVERAGE NAJC N
INSURER A: II t€h"rts SPe�J-If`lnsulmlc�Cw-nf-1011Y 22276
INSURED STANTEC CONSULTING SERVICES,INC. INSURER e: AIG SpecialLv Insurance Company 26883
1414100 370 iNTERLOCKEN BOULEVARD,SUITE 300 INSURER C:
BROOMFIELD CO 80021-8012
INSURER D-
INSURER E-
INSURER F i
COVERAGES ........... CERTIFICATE NUMBER: 15163628 REVISION NUMBER; XXXXXXX
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,
INSA ADDL S
LTR TYPE OF INSURANCE , UBRI PO ICY EFF PO
WVD POLICY NUMBER ,ICY EXP
_I _P=y)(Mw DIYYYY) LIMITS
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE r x .xxxxx
CLAIMS-MADEOCCUROCCUR NOT APPLICABLE DAMAGE TO RENTED
I -A PRFMISES,(.L2,ar_,currence) X.xxxxxx
MED EXP,IAny one persun) xxxxxxx
PERSONAL&AOV INJURY S . XXXXXX
75N'L AGGREGATE LUT APPLIES PER, GENERAL AGGREGATE $ xxxxxxx
POLI Yid
PRO- L®1 LOC I
JECT PRODUCTS-COMP/OP AGG S xxxxxxx
OTHER:
I $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
— fEa accident) $ xxxxxxx
— ANY AUTO N OT All IIIA CAB 1. BODILY tNJURY(Per person) s XXXXXXX
OWNED GI-IE
S
— AUTOS ONLY AUTOS BODILY INJURY(Per accident $ XXXXXXX
HIRED NOWOWNED PROPER rY DAM—AGE -
- AUTOS ONLY AUTOS ONLY Sxxxxxxx
— UMBRELLA UAB IOCCUR EACH OCCURRENCE xxxxxxx
EXCESS LIAB CLAIMS-MADE NO FAPPIJCABIA:-MADE AGGREGATE S xxxxxxx
DED I I RETENTION$ $
WORKERS COMPENSATION R
AND EMPLOYERS'LIABILITY Y-1 N NOI'APPLICABLE TATUTI OH-
ETR
ANY PROPSIETORPARTNER/FXECUTIVE ❑ NIA r.L EACH AC; DENT Xxxxxxx
OFF
VXCLUDE� F-1
(Mandatory In NH)uldF.L MSEASr-CA EMPLOYEE xxxxxxx
rfvcs descloo -r
CESCRMI ION'OF OPERATIONS E L VISEASE-POLICY LJOT X-X 11C--\, X x X
Profess4mat Liab N 47-EPP-3088 10 LA
S.uJ00,000 PER CML'A(Al N NORiETBOAC;TIVE.DATE' INCLUSIVE OF COS I-S
Lt ConTructors P(fllwion Liab CP08085428 I t),;1 -io 19 101!1,,2()?1 $1,000,000 PER LOSS'. G(J
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IACORD 101,Additional Remarks Schedule,may be aftched if more space Is required)
Rs,rAN'I`EC PROJECTNCI. 21 i614 125. 17-003 1-F"N,C1 FY OF CLEAR11 A1 ER I,IVIAGINE,CLEARWATER MASTER PLAN-t)ESIGN AND
CONSTRUCTION SERVICES),
rI
0
CERTIFICATE HOLDER CANCELLATION See Atlachnierit
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
15163628 AUTHORIZED REPRESENTATIVE
CITY OF CLEARWATER
ENGINEERING DEPARTMENT
PO BOX 4748
CLEARWATER FL 33758-4748
ACORD 25(2016103) C 1988-2015 ACORD CORPORATION.All rights reserved
The ACORD name and logo are registered marks,of ACORD
y Attachment Code:D522052 Certificate ID: 15163628
Policy No: 47-EPP-308890 , NO RETROACTIVE DATE
Named Insured: See Attached Certificate
PROFESSIONAL LIABILITY
NOTICE OF CANCELLATION FOR THIRD PARTIES
This contract is amended as follows:
In consideration of the premium charged, it is hereby understood and agreed as follows:
(1) Underwriters authorize [Lockton Companies/BFI, Canada] the ("Certificate Issuer")
to issue Certificates of Insurance at the request or direction of the Insured. It is
expressly understood and agreed that, subject to Paragraph (2) below, any Certificate
of Insurance so issued shall not confer any rights upon the Certificate Holder, create
any obligation on.the part of the Underwriters, or purport to, or be construed to, alter,
extend, modify, amend, or otherwise change the terms or conditions of this Policy in any
manner whatsoever. In the case of any conflict between the description of the terms and
conditions of this Policy contained in any Certificate of Insurance on the one hand,
and the terms and conditions of this Policy as set forth herein on the other, the terms
and conditions of this Policy as set forth herein shall control.
(2) Notwithstanding Paragraph (1) above, such Certificates of Insurance as are
authorized under this endorsement may provide that in the event the Underwriters
cancel or non-renew this Policy or in the event of a Material Change to this Policy,
Underwriters shall mail written notice of such cancellation, non-renewal, or Material
Change to such Certificate Holder 30 days prior to the effective date of cancellation,
non-renewal, or a Material Change, but 10 days prior to the effective date of
cancellation in the event the Assured has failed to pay a premium when due. The
Insured shall provide written notice to the Underwriters of all such Certificate Holders, if
any, specified in each Certificate of Insurance (i) at inception of this Policy, (ii) 90 days
prior to expiration of this Policy, or (iii) within 10 days of receipt of a written request from
Underwriters. Underwriters' obligation to mail notice of cancellation, non-renewal, or a
Material Change as provided in this paragraph shall apply solely to those Certificate
Holders with respect to whom the Assured has provided the foregoing written notice to
the Underwriters. --
(3) It is further understood and agreed that Underwriters' authorization of the Certificate
Issuer under this endorsement is limited solely to the issuance of Certificates of
Insurance and does not authorize, empower, or appoint the Certificate Issuer to act as
an agent for the Underwriters or bind the Underwriters for any other purpose. The
Certificate Issuer shall be solely responsible for any errors or omissions in connection
with the issuance of any Certificate of Insurance pursuant to this endorsement.
(4) As used in this endorsement:
(1) Certificate of Insurance means a document issued for informational purposes only
as evidence of the existence and terms of this Policy in order to satisfy a contractual
obligation of the Assured.
(2) Material Change means an endorsement to or amendment of this Policy after
issuance of this Policy by the Underwriters that restricts the coverage afforded to the
Assured.
All other terms and conditions remain unchanged.