The URL can be used to link to this page

CERTIFICATE OF LIABILITY INSURANCE (971)AC ORO® �-- CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/27/2021 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 Aon Risk Services Northeast, Inc. Boston MA office 53 State Street Suite 2201 Boston MA 02109 USA CONTACT PHONE FAX (A/C. No. Ext): (866) 283-7122 (A/C. No.): 800-363-0105 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED CDM Smith Inc. 75 State Street Suite 701 Boston MA 02109 USA INSURERA: LM Insurance Corporation 33600 INSURERB: Liberty Insurance Corporation 42404 INSURER C: Liberty Mutual Fire Ins Co 23035 INSURER D: Lloyd's Syndicate NO. 2623 AA1128623 INSURER E: Commerce & Industry Ins Co 19410 INSURER F: CLAIMS -MADE I --- x I OCCUR 1 I COVERAGES CERTIFICATE NUMBER: 570090842800 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 !NSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS B X COMMERCIAL GENERAL LIABILITY TB7611B8T8Zb042 01/01/2022 01/01/2023 EACH OCCURRENCE $2,000,000 CLAIMS -MADE I --- x I OCCUR 1 I PREMISES (Ea occurrence) $500,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY 1 7( ATI PRO- n LOC i IJECT I- I PRODUCTS - COMP/OP AGG $4,000,000 OTHER: C AUTOMOBILE LIABILITY AS2-611-B8T8Z6-062 01/01/202201/01/2023 COMBINED SINGLE LIMIT (Ea accident) $2,000,000 X ANY AUTO BODILY INJURY ( Per person) OWNED — SCHEDULED BODILY INJURY (Per accident) — AUTOS ONLY HIRED AUTOS ONLY _AUTOS NON -OWNED AUTOS ONLY PROPERTY DAMAGE (Per accident) _ UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS -MADE AGGREGATE DED RETENTION A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WA561oB8T8Z6012 01/01/2022 01/01/2023 X PER STATUTE OTH- ER A ANY PROPRIETOR / PARTNER / EXECUTIVE y / N N N!A AOS WC561168T8Z6022 01/01/2022 01 01/2023 / E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (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 D Archit&Eng Prof PSDEF2200033 Professional/claims Made 01/01/2022 01/01/2023 Each Claim Aggregate $3,000,000 $3,000,000 PESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if 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 wi gEcriv EDsions of the General Liability, Automobile Liability policies. CERTIFICATE HOLDER JAN 0 7 2022 CANCELLATION OFFICIAL RECORDS AND City of Clear Water LEGISLATIVE SRVCS DEPT. 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 Holder Identifier : Certificate No : 570090842800 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AC RU O® 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: 570090842800 CARRIER See Certificate Number: 570090842800 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 DATE (MM/DD/YYYY) WORKERS COMPENSATION B N/A WA761DB8T8Z6032 MA & PR 01/01/2022 01/01/2023 ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD C 2008 ACORD CORPORATION. All rights reserved. 4WRL 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: 570090842800 CARRIER See certificate Number: 570090842800 NAC 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 Li ab Policy # PSDEF2200033 Beazley (Syndicates 2623/0623) - 25% BRIT (Syndicate 2987) - 25% Munitus (Syndicate 4242) - 12.5% Re/Rn (Syndicate 1458) - 10% castelmga (syndicate 2525) - 5% Convex (Syndicate 1984) - 7.50% Berkshire - 15% ACORD 101 (2008/01) The ACORD name and logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. kiait W