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CERTIFICATE OF LIABILITY INSURANCE - RFQ 34-15 (35) a DA,re:(MMOWYYYY) ACCM0 CERTIFICATE OF LIABILITY INSURANCE L 11M12,020 THIS CERTIFICATE, IS ISSUED AS A MATTER OF IWF_6AMAT16N ONLY AND CONFERS NO RIGHTS UPON THE. CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AM' N' EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING IN AUTHORIZED RE-PRESENTATIVE OR PRODUCER,,AND THE CERTIFICATE HOLDER, IMPORTANT: It the cerfificato holder Is an ADDI'TIONAL INSURED,the policy(les)must Ihave ADDITIONAL IN provisions or be endorsed, If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, cerlain policies may require an endorsernent. Astateme"t on this cartificatedoes not eonfer rN hta to Cha aartlNticata holder In lieu of A ch andarsomenta i. PAODUCERUVAITACT-Z NAM e Team 11-111--1----__ Arthur J1, Ga0agher Ri�isk Management Ser0ces, inc, PHONE PAW" ............. 250, Park AvenUe, 5th Floor JpVq,.q -9947047 gj�_212 New'(ork NY 10177 Atp.TAR r GGB WSPLIS, e r1auRE (§11A ......... J­­ NAK 0 INSURE R A AIG SqL�SijvqInsu 00 Cornp, y 26883 INSURES (NSURER 8 VVSP USA �mc. ............. One Penn Plaza C . ..... New York, NY 1G119 JOAPLIFIER E COVIEFIAGES CERTIFICATE NUMBER:,39401576 REVISION NUMBER; "IT s u--6 E POLICY PERi THIS GTO CERTIFY THAT THE PCIIIJOES OF INSURANCE LISTED BEI HAVE BEEN E TO TRE INSURED NIA FOR TH­' Ril D INDICATED, NOTWITHSTANIMNG ANY REQUIREMENT, TERM UR CONDITION IOF ANY CONTRACT 08 OTHER DOCII,IMEINT WITH RESPECT TOWH�CH T°ICIIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCF AFFORDED BY THE POUCIES DESCRMED HEREIN IS SUBJECT TO At.k. THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,UMITS SHOWN MAY HAVE BEEN REDUCED BY PAI10 CLAlMS, POLIVY of TYPE OF INSURANCE P(A.Icy UNTS CO MMERCIAL GENERAL LIABILITY EAGHOCCURRENCE S CLAIMS-MADE 0CXAJR ............................................... J LE,oE�XP��t �1 �Y�n2pw�n __J.s PER­E14NIA, L,,&AD.ViN,II X.V_I-S CakwRLAOGREQATEUWT APPUESF4'fl� GF ERALAGGPIEGATE tnT0 RXICY LCK, PRODUCTS (,QMPil(.,)PA(3G S ..................................... 6........... IT V NER: ...... ........... 77A 91 N F 0 S i ING,�F I�M I r A k)TOMOBILF UABIUTY NES WA,NNMAPkkN S XV AU'ro K)DH Y INJURY 0,., OWNED J SCHEDULED f AUT OG ONLY AUTO$ 110-DILY"I,NJ R,Y..,(,P.w,acrid,aM HIRED N0 4 OWN15r) Mie,:)P E R1,Y 0A MAG E AU705,04LY AUTOS 04LY rA Rai), A ......... ............--------------- ..................... ....... aJTMNERELLALIAR C)CCLI K NI(X CUA A E NC�E 6 CIAWIS MADE AQ'GHEQATE rJED nETEW iON 6 _7- 1 W KE AT '�;03 ON RSCOMPENSA110N ,AND EM6L0Y0RS'UA5ILrrV Y)Nw. N A (Mandolory in N14) El DiSFASE,EA FMPb)yFE,1 s 41 w dascroe undw 10 CRIPTI'N E,L,DISFASE-PO'L'!fly A P'u19a.T>uao+Colada 91& CIP028238,456 11IM12020 '-71172n'21 Pet ClslrrUftpegate $5,000,000, ......... OPSCRIII OF OPERATIONS LOCATIONS I VEHI D,10 (ACOR1,Addiflonal Morwo0ke Schedule,nway'be at1whed it onarle,9 ce Is I 1 7 THIRTY (30)DAYS,NOTICE OFCANCELA-KrION KV 0 9 2020 MY Of earter rin ghlee., CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CI�of Clearwater, Erionng eetiFCS @34-15 ACCORDANCE WITH THE POLICY PROWSIONS, P, Box 4,748 CLEARWATER FL 33758-4748 AUTHORIZED REPRIWERTAnVE USA W....... 0 1988-21015 ACORD CORPORATION', Ali rights resierved. ACORD 25(2016103) The ACORD nairie and logo are registered marks of ACORD 2'04 9A of 4 3954 AC V CERTIFICATE OF LIABILITY INSURANCE DATE,MMI°°NYYY, ' �� 11r1rza2a THIS_CERTIFICATE IS ISSUED 'C AS A MATTER OF INFORMATION'ONLY ANDONFERS NO RIGHTS UPON THE,CERTIFICATE HOLDER. THIS CERTIFICATE DpES NOT AFFIRMATIVELY OR,NEGA71VELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE.POLICIES BELOW. THIS:CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(% AUTHORIZED REPRESENTATIVE OR PRODUCER,ANOTHE CERTIFICATE HOLDER. IMPORTANT: If the certificate hold.01s•an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provlslons 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 certlflcate.does not confer rights to the certificate holder in heu.of.such-endorsemeni(s), PRODUCER .CONTACT .NAME; AJG Berates Team Arthur J.GallagherRisk Manageni ent SeNices, Inc. PHONE 2129612485 -994-7047250 ParkAv.enue 5th:FIDor Noll:2I2 E-MAIL'YotcNY 10177 ADESS' GGB:WSPUS.CertRe uest s a' ;cam .INSURER(S)AFFORDING COVERAGE NAIC# INSUREFIA.A*Spectalty Insurance Company 26883 INSURED WSPGLOB-01 .INSURER B W5P USA Inc, One Penn Piaza INSURERC: New York, NY 10119 INSURER D INSURER E,. INSURER F: COVERAGES CERTIFICATE NUMBER:958262773 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 I5 SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH:POLICIES.LIMITS SHOWN MAY-HAVE BEEN REDUCED BY PAID CLAIMS. .LTR TYPEOFINSURANCE A >}LBUeR POLICY EFF, POLICY EXP - LIMITSINSD wva POLICVNUMBER •MMlD01YYY MWDDNYY COMMERCIAL GENERAL LIABILITY EAdHOCCURRENCE $ DAMAGETCLAIMS-MAE)E ❑OCCUR PREMISES Eaocdrnence TEU $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER-.. GFNERALAGGREGATE $ POLICY D PRO- ❑ JECT LOG PRObUCTS-CDMP,`OP AGG $ O'rFiER;- $ AUTOM061LE LIABILITY ED SINGLE LIMIT $ KINen ANYAUTO BODILY INJURY(Per person) $' OWNEDSCHEDULED 'AUTOS ON LY AUTOS BODILY INJURY(Peraocdenl) $. HIRED N014-OWNED PROPERTY DAMAGE AUTOS ONLYr AUTOS ONLY Por aeoidont $ 4DUMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ ED - RETENTIONS $ WORKERS COMPENSATION; PE OTW AND EMPLOYERS'.LIABILITY YIN STATl1TE ER ANYPROPRIETCR/PARTNERIEXECUTIVE N A E.L.EACH ACCIDENT $ OFFICE RrMEM B E R EXC LI J D E D? (Mendalory In NH) E L.DISEASE-EA EMPLOYEE S It yyes,describe under. 0 SORIPTION OF OPERATIONS behw E.L.DISEASE-POLICY LIMIT $ A PelutionLialillitY &028238455 11/1/2020 11/112021 PercfafiniAggregate $5,000;000 °ESCRIPTION OFOPERATIONS I LOCATIONS VEHICLES (ACID RD 101.Add]tianal Remarks Sohedute,may,pe atlsehed'if more space Is requl ed) THIRTY(30)DAYS NOTICE OF CANCELLATION CERTIFICATE HOLDER CANCELLATION SHOULD ANV OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Clearwater; Engineering,FQ @34-15 ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 4748 CLEARWATER FL 33758-4748 'AUTHORIZED .USA ©'1888-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016]03) The ACORD name and logo are registered marks of ACORD 3"or4 3954 81 DATE�MMMMYY) A C,C>R YYCERTIFICATE OF LIABILITY INSURANCE I M 12020 H.!S�lC�EFRIIT�l�F�lC�A�T�E.16�,l�SStU�E,ID�A�S��AZMAtT7TER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDEA, TPNS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTERTHE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSnTUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, tMPORTANT;! If the cer ficate holder Is an ADDITIONAL INSURED,Ahe policy(ies) must have ADDITIONAL INSURED provislons or be endorsed, It SUBROGATION IS WAIVED, subject Jo the terms and coinditIons of the policy, cerialn policies may require an!endorsement. A statement on this certificate does not,co ter to'he ce"Ifico �Nolder In�Ileu o1suchendo' A S rel s ��nc PRUOUCIER �ce ce-Tea"rn, Arthur J, (770agher Msk.Mrage rent E a 250 Park AvenUe, 5th Floo 1-2489, 12-994-7074 mrtRe eSts New,York NY 10177 PUS,Ce a QW, NAIC# MUREA A QBE �p INSUREUSA D, WSP Inc, ............... One Penn Plaza 'Nsy!!EFc New York, NY 10 11�g #060 ANSVIRIE9E'� ..... .......... COVERAGES CERTIFICATE NIntl MBER:1 952066877 REVISION NUMBER,, THIS M TO CERTIFY THAT THE N>OIJC�ES OF GNSURANCE LASTED BELOW HA�E BEEN lSSUEDTO THE: ONSURED NAMED AM'.)VE FOR THE POLICY PEMOD 71�ICI '�l PSS W04CATED. NOTWITHSTANDING ANY REQLAREVENT, TERM OR CONMTpON OF ANY CONTRACT OR OTHER D0CUMLNT'vvrrH RESPECT To WHI0.4 THM CESTWICATE MAY BE $SUED OR MAY PERTAKTHE NNSLIRANCE AFFORDED I rHE POLICIES DESCRIBED Hr-REIN US SUBJECT TO ALI, THF TEAMS, EXCLUSION'i ANCONDI rIONS OSHI 1`10LICIE&LIMITS,SHOWN MAY HAVE BEEN REDUCED HYPAW CLAUS, L WOW fflij� TYPE OF INSURANCE POLICYNUMOER UOTS ,n------------ COMMERCIAL GENERAL LIAW71M EACH 00C URRENCE CLAMAS-MADE OCCUR .......... ........... � fd EX qfu ft AG04EOArE,UIM IT APP UES FIER CIENEN.RAGGREGATE F , POL Ic Y JAW�FT q-OC PRoDo,,.,'rs COMP�OPAGG AUTOMOBILE UASILMY 'INGLE $ ANY A(YTO WANLYINJUPY(Por romm) OWNED E0, E01A.ED ROM UTOS ONLY [ ;HY INJURY Tov accdepifl" t I_ AUTOS HPROPERI Y rMMAGE WFO N IAL I S AU1(0*;014L y NO ................ 74WEA LIAR MCUR EXCESS UAS U.APASVADaz ................ 41 RKERSCOMPENSAnON AND I EMN.Oerrs'LlAWLITY YIN OFFICEIIVMEMSEHEXCLUDEI NfA I(Mamdaloq in N14) E'M NX)YEEJ s �1 vs,dagoidbe vnijvv — " ''. CIMPT ERAt' E L D15FAS E POU,ry t i4 toat op A CIPL0022630 11P112020 10/31r2,021 Per CisirnAggregale f $5,000,000 C,i,AWSMAiiE .......... DESrAIPTKNOfOPERATWNSFLOCAYMSfVSHtCLES is TI+RTY(30)DAYS NOTICE OF CANCIELLATION. NOV 0 "J" 2020' City_gq ()fdeanvater, rin piee 9,.Dqp', rtment I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THOVE DESCPJBED POUCIESS BE CANCFILL D BEFORE THE, EXPIRATION DATE THEREOF, NOTICE WILL BE DIELIVERED IN %M Cit of Cleaiwater, EngInelering Ftp -15 ACCOADANIC15 TH THE POLICY PROVISIONS, P.�, Box 4748 CLEARWATER FL 33758-4748 AUTHOgInq'I�VPRESENTAPVE USA 0 1980-2015 ACORD CORPORATION, A1111 rights rosorved., A (2016/03) The ACORD narrio and logo are registered marks of ACORD 4*of 4 �3054 Arthur J.Gallagher Risk Management Services, Inc. 250:Park Avenue, 5th Floor New York, NY 10177 3955 1 MB 0.436 3955 hIII„iill��l�'I��'I�'�Il�ll��l���ill'lllf Illuln[IIIIIr�I�,�� CITY OF'CLEARWATER ENGINEERING DEPARTMENT, PO BOX 4748 CLEARWATER, FL 33758-4748 We are providing you with a Certificate of Insurance confirming our client's coverage. Want to get.certificates of,insurance faster? "Go Green with Gallagher" by receiving digital,c'opies of certificates via e-mail in the future.Or, do you no longer require&certificate of insurance for our client?Please contact us at COLD dateM Email@AJG.com and provide the following information for processing: 1. Confirmation that a certificate of insurance is no,longer required;or 2. E-mail address to send future certificates of,insurance in'lieu of U.S. Mail delivery _ .3. Insured.Code found in the Insured section on the enclosed certificate.An-example of this codeiis XXXXXX-01 4. This Certificate Number: 457326859 To learn more about the Insurance and Risk Management Services offered by Gallagher, please visit us at www.ajg.cQm/us!about-uslhow-we-worklcore-3fi0. Gallagher.does not share your e-mail'as detailed in our privacy policy found at bttps://www.Qig.qoMIustprivacy--polic t'of 3 3%5 ACX>R& CERTIFICATE OF' LIABILITY INSURANCE 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 TK POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT` CONISTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMP,ORTANTW If the certificals holder Is an ADDITION-ALN—NSUA—E-0,t-he policy(les)niust have ADDITIONAL,IN provisions or be enclotsed. If SUSIROGATIONI IS WAIVED:, subject to the terms and!conditions of the policy, certain policies may require an endorsement. A staloment on this certificate does 2 !!tLrN Riah tho certificate holder In III Lw of such endor PRODUCER CONTArT NAMi_7 AJG,$er'vica'Tewr Arftr,), Gaflagher Risk Management SerOces,, Inc MONE 2510 Park Avenue, 5th Floor 21 994.70,47 New York NY 10177 _Q A L GGB WSPUS,CertRe .......... MURER A, AIG:: p2f�l�jft a 26883 ............. ........ —I'll, 11 1 6 . INSURED VVISPULN3 011 INSURES 8:: ............... WSP USA Inc. One Penn Plaza Niew York, NY 10 119 . .................... F: ,COVERAGES CERTIFICATE NUMBER.457326859 REVISION NUMBER: THIS &S To CERTIFY THAT THE POLwCWS Or INSURANCE LISIED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PEP�00 NDICATED NOTWrTFISTANDING ANY REQUIREMENT, TERM OR CONDTkON OF ANY CONTRACT OR OTHER DOCUMENT wrm RESPECT TO WHR,,H T'HM CERTIRCATE MAY BE p�,',SUED OR MAY PERTAIN, THE iNSURANGE AFFORDED BY THE P(WOES OESCRIBED HERMN IS SUBJECT TO ALLTHE TEms, EXCLUSONS AND CONDI'HONS OF SLCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, NSA MIR PID 'wysxpi�"' Lwww. Aq!', NyYyJ' im UWTS TYPE OF INSURANCE 2M V mm L _Mg H —WAL ZUT C EROAL GE EArH OCCURRE CLAIM&MAVE 0CMIR 6 AQA dw-va-mckin ADV INJUnY $ AGGREGATE LWT AFIFILH.'.8 PEk GENERA,,AGGREGATE NILICY 'C'T LOC PAGG 770kA 8 1—NE D S I qu[E_0 M AUTOMOSILELIAMUTY t. 0 M) ANY Aura 80MLY MURY Par pe"un�' SC+iEDULED AU10S(Y&Y AU,TOS lWiMLY M�)PY�Pov acodanfl S Y DAMAGE WK-0 NON45WNED AUTOS ONLY (Au ros 0%ry UMBAFLLA LIAO jC-C;k'jjj EACM0 CUMENCE, f EXCESS LMB (,",LNM8 MAD,EAGGREGATE .......... ——------------- ...... WORKERS COMPENSATION AND MPLOYERS'LIABILITY YiN AN YPEnOPIRETOR'PAR'TNerr"q,fEXECU'w'IVE NrA! (Mandataty hi MR) BI SuRmwiSursar ............ A 6liblkp6on Uabt 11 LT CF1028236455 111111202 r1111IRI 2t Pw 0auwdAgoogate $5,C100,0,00 .......... VEHIOLVS IACOKI 101,Additional Rentarks Schodulle,may beatlached 10nore space karoquhlod) THIR Y.- . .BIW E- 'ATaII I L '07 C.el, I V el NOV 09 2020 e2lear- CERT IF artawt- CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED PO CIES BE CANCELLED BEFORE THE EXPIRA7`10N DATE THEREOF, NUrICE WILL BE DELIVERED IN City of Clearwater ACCORDANCE WITH THE POLJCY PROVISIONS, Enganeenng Department, PO Box 4748 AVTHOIRIZED REPRESENTATIVE CIllearwater FL, 33758-4748 ............... —---------- 0 198115 ACORD CORPORATION, AM rights reserved. ACORD 25(2016/03) The ACORD name and logo are regI marks of ACORD 2'03 3955 CERTIFICATE OF LIABILITY INSURANCE DATE(MW00NYVV) I Wr2020 THIS CLER71FICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NO'T AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTWICATE OF INSURANCE DOES NOT CONSTITUTE: A CONTRACT BETWEEN, THE ISSU1114G INSUIRER(S, AUTHORIZED REPRESENTATIVE OR PRODUCER,AND,THE CERTIFICATE HOLDER, IMPORTANT, If the certtficate holder to an ADDITIONAL INSURED,the poficy(les)must have ADDITIONAL INSURED provisions or,be;7nd—orsed. Rt SUBROGATION IS WAIVED, subject to The termsand conidltions of the policy, certain policies maiy require an endorsement. A slatement on thIs cortificate does not confer rights to the cerfificate holder in lieu of such enclorsoment a 7W PRODUCER AVLA EEkI A1C r#TCN�Pn rtliur J. Gallagher Risk ces, n Managemekit SerOIir PHONE 'PAS 2:50 ParkAvenue, 5th Floor981 2485 New'York NY 10177 A,PpRift GGS.WSPUS, 4 ...................... A!?!9RViNG C WFAAGE NAIC MSURER A QB J±j!�Lr 11515 INSORED WEP,11,08-01 I WSP .............USA Inc One Penn Plaza New York, NY 10119 ql un COVERAGES CERTIFICATE NUMBER:2127328261rz�VISION NUMSER TW15 IE TCS CEn'rIFY THATTHE P01.01ES OF IN LISTED BELOW HAVE BEEN IS&JED 'IK)"THE WSLARED NIAMIED ABOVE FOR THE POLICY PERK)D INOIGATED, NOTWITHSTANDING ANY REQUIREMEN7, TERM OR CONI'NT�ON OF ANY CONTrRA(j OR OTHER DOCUMENT WMH RESPECT TO WI-11CH TIqfS CERTIFICATE MAY BE iSstIED f)R MAY PERTAIN, THE NNSUPANGE AFFORDED BY THE POLICJES, DESCRIBED HEREIN NS SUB,L'ECTTO »LL.TR412TERMS, EXCLU$ONS AND CONUfflONS OF SUCH POLICIES,UMIrS SHOWN MAY H,A,VE BEEN REDUCED BY PNO CLAIMS, *06-9, "0, 10,111,111,11,11110-011 --V I Lj UR vo,- ... ........ .......... W rylyj aa,,-LM, I ILI TYPEOFINSURANCE UNTS ............. wdw COMMERMAL OFNERAL LAAWLMY EACHOCCLOWLINCE .......... CNL TRS ITL CLAIMS,WNDE OCCUR PERSONAL ADV TRtlNFP 9F,114 1.*KAREGATE LiMff AFIN,&ES,PE-13 IF4CJ ... .. ....... K)OCY 'PRIIOID,�,J�,��l',S,�,,,CO.MP.�.'q�,AGO_ [,� ............ . ...... $ AUTOMOBILE LIABILITY ANY A UTO OWNED AUT(M8 CM,Y SCIHEDULED 8001Y INJURY(PoN acxdeM HMED RrvRvq OWNED A1U1'()S C04LY &J70SIDNIN PROPE R1 VDAMAGE f �7- 5 UMBSELLA LIRE Emem UAS AC40 REG ATE DN f 6 7­ ------ ATION '11.E PL Lee LIA 'ACH ACQUF.N1 —tA 1 111, E L, WA� .. ........... ............... j F,,L DISEASE EA EMPLO E Y.. 'grW PfK)N C 't A amm,& amasa A Puafessm0a Llgb[Aly QN-NIZ2630 1 111r2,020 1013tlrz'021 PWCIG-iAgg-900E 0010,000 CLAJMSMAC* oa$cmpr� Of Remark%ftluidulle,ffv,v Ue 01whed if fluve SEs raqukodiN 'rHIRT Y(3,0)D Y, NOV 0 !) 2020 eity of (Yearwater jj j?ertnq,j)epartment j CERTIFICATE HOLDER CELLATION SHOULD ANY'OFTHE ABOVE DESCRIBED POILICIMS BECANCELLED BEFORE THE EXPIRATION DATE THEREOF,, NOTICE WILL BE DELIVERED IN 0ty of 0earwater ACCORDANCE VAT14HE POLICY PROVISIONS, EngIneering Department, PO Box 4748 ALMHOWED REPRESENTATIVE Clearwater FL 337584,748 .......... ............. T 1968-20115 ACORD CORPORATION. All riights reserved. ACCIRD 25(20161013) TRT e ACORD norne and logo aro registered marks of ACORD 3'of 3 3065 Arthur J.Gallagher Risk Management Services, Inc. 250 Park Avenue,5th Floor New York, NY 10177 39541 MB 0.436 3954 Illllhhrrllllllnrlllnl�,rlll lllrrllll[[ I[I�[I�II[!r CITY OF CLEARWATER; ENGINEERING FQ @34-15 PO BOX 4748 CLEARWATER, FL 33758-4748 We are providing you with a Certificate of Insurance confirming our client's coverage. Want to get certificates of insurance faster? "Go Green with Gallagher" by receiving digital copies of certificates via e-mail in the future. Or, do you no longer require a certificate of insurance for our client? Please contact us at COI.UpdateMyEmail@AJG.com and provide the following information for processing: 1. Confirmation that a certificate of insurance is no longer required;or 2. E-mail address to send future certificates of insurance in lieu of U.S. Mail delivery 3. Insured Code found in the Insured section on the enclosed certificate.An example of this code is XXXXXX-01 4. This Certificate Number:39401576 To learn more about the Insurance and Risk Management Services offered by Gallagher, please visit us at www.a-ig.comfustabout-us/how-we-work/core-360. Gallagher does not share your e-mail as detailed in our privacy policy found at https:Hwwwaig-,comlus privac - oWicvl. 7'014 3954