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CERTIFICATE OF LIABILITY INSURANCE (567)Ac.cww® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 2/29/2020 THIS CERTIFICATE IS ISSUED ASA 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 Aon Risk Services Northeast, Inc. Boston MA Office 53 State Street Suite 2201 Boston MA 02109 USA CONTACT NAME: aC No. Ext): (866) 283-7122 FAX 800-363-0105 ( C No ): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC 8 INSURED CDM Smith Inc. 75 State Street Suite 701 Boston MA 02109 USA INSURER A: Commerce & Industry Ins Co 19410 INSURER B: Liberty Mutual Fire Ins Co 23035 INSURER C: Liberty insurance Corporation 42404 INSURER D: LM Insurance Corporation 33600 INSURER E: Lloyd's Syndicate No. 2623 AA1128623 INSURER F: CLAIMS -MADE COVERAGES CERTIFICATE NUMBER: 570085453428 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. Limits shown are as requested INSR LTR TYPE OF INSURANCE ADDL INSD SUER WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY POLICY EXP (MDD/YYYY) LIMITS C X COMMERCIAL GENERAL LIABILITY TB7611B8T8Z6041 01/U1/2U2.NU 01/U1/2U22 EACH OCCURRENCE $2,000,000 CLAIMS -MADE X OCCUR DAMAGE 1ORENFED PREMISES (Ea occurrence) $1,000,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $2,000,000 GGEIEN'LAGGREGAATTE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 I x POLICY 1 PRO- I IJECT LOG PRODUCTS - COMP/OP AGG $4,000,000 OTHER: B AUTOMOBILE LIABILITY AS2-611-B8T8Z6-061 01/01/2021 01/01/2022 COMBINED SINGLE LIMIT (Ea accident) $2,000,000 X ANY AUTO BODILY INJURY ( Per person) OWNED — SCHEDULED AUTOS BODILY INJURY (Per accident) — AUTOS ONLY HIRED AUTOS — NON -OWNED AUTOS ONLY PROPERTY DAMAGE (Per accident) ONLY _ UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS -MADE AGGREGATE DED RETENTION D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY wA561DB8T8z6011 01/01/2021 01/01/2022 x PER STATUTE OTH- ER D ANY PROPRIETOR / PARTNER / EXECUTIVE Y / N N N/A AOS wC561188T8Z6021 01/01/202101/01/2022 E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED? (Mandatory in NH) WI E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 E Archit&Eng Prof PSDEF2100033 Professional/claims Made 01/01/2021 01/01/2022 Each Claim Aggregate $3,000,000 $3,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) Re: Project: City of Clear Water Reverse Osmosis Plant I Expansion. City PN 09 -0018 -UT. The City of Clear water is included as Additional Insured in accordance with the policy provisions of the General Liability and Auto Liability. General Liability evidenced herein is Primary and Non -Contributory to other insurance available to an Additional Insured, but only in accordance with the policy's provisions. A Waiver of subrogation is granted in favor of certificate Holder in accordance with the policy provisions of the General Liability, Automobile Liability policies. CERTIFICATE HOLDER CANCELLATION City of Clear water Attn: City clerk P.O. Box 4748 clearwater FL 33758-4748 USA 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 tS 4li i ;2 Yot.s,la 0 c//Ot.�1�Mrm6 ✓ s716t Holder Identifier : Certificate No : 570085453428 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 10518329 LOC #: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Services Northeast, Inc. NAMED INSURED CDM smith Inc. POLICY NUMBER See Certificate Number: 570085453428 CARRIER See Certificate Number: 570085453428 NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBERLIMITS POLICY EFFECTIVE DATE (MM/DD/YYYY) POLICY EXPIRATIONA DATF. (MM/DD/YYYY) WORKERS COMPENSATION C N/A WA761DB8T8Z6031 MA & PR 01/01/2021 01/01/2022 ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD ® 2008 ACORD CORPORATION. All rights reserved ACORO® AGENCY CUSTOMER ID: 10518329 LOC #: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Services Northeast, Inc. NAMED INSURED CDM Smith Inc. POLICY NUMBER See Certificate Number: 570085453428 CARRIER See Certificate Number: 570085453428 NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Professional Liab Policy # PSDEF2100033 Beazley (Syndicates 2623/0623) - 25% BRIT (Syndicate 2987) - 25% Ms Amlin (Syndicate 2001) - 12.5% Munitus (Syndicate 4242) - 12.5% Re/Rn (Syndicate 1458) - 10% National Fire & Marine Insurance Company (Policy # 42CNP31339701, Term: 01/01/2021 - 01/01/2022) - 15% ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD ® 2008 ACORD CORPORATION. All rights reserved. 03 03 003358 007205 P