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CERTIFICATE OF LIABILITY INSURANCE (258)Client#: 1048486 ADVANENG4 ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATDIYYYY) 1111 112 1120 0 21 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER USI Insurance Services, LLC 2502 N Rocky Point Drive Suite 400 CONTACT NAME: PHONE g13 321-7500 FAX ac No, E# : A/c Ne : E-MAIL ADDRESS: X COMMERCIAL GENERAL LIABILITY Tampa, FL 33607 INSURER(S) AFFORDING COVERAGE NAIC 11 INSURERA: Old Dominion Insurance Co 40231 INSURED Advanced Engineering &Design, Inc. 3931 68th Avenue North INSURER B: Travelers Casualty and Surety Company 19038 Liberty Insurance writers, Inc. 19917 INSURER C : Y Under Pinellas Park, FL 33781 INSURER D: INSURER E: INSURER F: 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 CONTRACTOR 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 ADDL INSR SUBR MO POLICY NUMBER POLICY EFF MM/DD[YYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY X X BPG2647A 2/16/2021 02/1612022 EACC�H OCCURRENCE $1,000,000 CLAIMS-MADEF7OCCUR PREMISES caaoavrrDance $500000 MED EXP (Any one person) $10,000 PERSONAL B ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY [7] JET LOC PRODUCTS - COMPIOP AGG $2,000,000 $ OTHER: A AUTOMOBILE LIABILITY X X BPG2647A 2/1612021 02/16/202 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Peraaitlent) $ X HIRED ONLY X NON -OWNED AUT08 ONLY _ PROPERTY DAMAGE $ Per accitlenl UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEO I I RETENTION$ $ B AND EMPLOYERS' LIABILITY WORKERS COMPENSATION ANY PROPRIETOWPARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? N/A X U134,10817119/01/2020 09/01/2021 OTH- X STATUTE I Eg E.L. EACH ACCIDENT $1,000000 E.L. DISEASE - EA EMPLOYEE $1,000,000 IMandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 C Professional AEXNYAA9RTDO03 2115/2021 02/15/202 $2,000,000 per claim Liability $2,000,000 annl aggr. DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, AddMonal Remarks Schedule, may be attached if more space is required) Professional Liability coverage is written on a claims -made basis. The City of Clearwater is named as an additional insured on all policies listed above except the workers compensation and professional liability as required by written contract including completed and ongoing operations on per project basis, coverage is primary and non contributory. Waiver of subrogation in favor of the additional insured applies to all policies listed above as required by written contract. Thirty (30) (See Attached Descriptions) City of Clearwater Engineering FQ#26-19 P.O. Box 4748 Clearwater, FL 33758-4748 ACORD 25 (2016103) 1 of 2 #S309293311M30929174 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 OLS Bt O&W.e Aa,. ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BTRZP