CERTIFICATE OF INSURANCE (254)
AON
Client Service Center
To All Certificate Holders
"In accordance with ARCADIS G&M, Inc.'s upcoming Property & Casualty
renewal effective January 1, 2005 to January 1, 2006, please find enclosed
renewal certificate of insurance to your organization developed from our acquired
certificate records supplied by the previous insurance broker. Please take a
moment to review, and advise should this certificate of insurance no longer be
required, to the following AON representative."
Ms. Lola Morace
Aon Client Services - National
Phone: (832) 476-5769
Fax: (832) 476-6019
lola_morace@ars.aon.com
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Aon Risk Services of Texas, Inc.
15.,0 Posr Oak Blvd. . Suite 900. Houston, Texas n05!)
td: ~n2A76J;O()o. t:IX: H66...l30,] 0.,0. crn t:,x - H66,.iW.1 OYi . \\'\\'\\'"lOn.com
ACORDTM
DATE (MM/DD/YY)
12/27/04
THIS CERTIFICATE IS ISSUED AS A MA ITER OF INFORMATION ONLY
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTlFlCA TE DOES NOT AMEND, EXTEND OR ALTER THE
COVER.-\GE AFFORDED BY THE POLICIES BELOW.
PRODUCER
Aon Risk Services, Inc. of Tennessee
720 cool springs Blvd
Suite 680
Franklin TN 37067 USA
PHONE-(866) 283-7124 FAX-(866) 430-1035
INSURERS AFFORDING COVERAGE
INSURED
ARCADIS G&M, Inc.
Attn: Tim Myers
630 Plaza Drive, Suite 200
Highlands Ranch co 80129-2377 USA
INSURER A:
INSURER B:
Greenwich Insurance Company
XL specialty Insurance Co
INSURER C:
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INSURER 0:
INSURER E:
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THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA TED, NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY
PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IN'SR
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTI' POLICY EXPIRA nON
DA TE(Ml\1IDDlYY) DA TE(MMIDDWY)
LIMITS
A
GENERAL LlABILITY
GEC001076103
General Liability
01/01/05
01/01/06
EACH OCCURRENCE
$1,000,000
$1,000,000
$10,000
$1,000,000
$2,000,000
$2,000,000
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U'I
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 0 OCCUR
FIRE DAMAGEiAnv one fire:
A
MED EXP (Anv one person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
GEN'L AGGREGATE LIMIT APPLIES PER:
O PRO- 0
POLICY JECT LOC
PRODUCTS - COMP/OP AGG
Q
Z
A
AUTO~10BILE LLABILlTY
ANY AUTO
ALL OWNED AUTOS
AEC001075803
Auto (AOS)
AECOOll04703
Auto (TeXaS)
01/01/05
01/01/05
01/01/06
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
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01/01/06
SCHEDULED AUTOS
HIRED AUTOS
BODIL Y INJURY
( Per person)
NON OWNED AUTOS
BODIL Y INJLlR Y
(Per accident)
PROPERTY DAMAGE
(Per accident)
GARAGE LIABILITY
AUTO ONL Y - EA ACCIDENT
A
OTHER TI-l~1\f
AUTO ON'L Y .
EA ACC
ANY AUTO
AGG
EXCESS LIABILITY
OCCUR 0 CLAIMS 1\LWE
UEC001 759 3
umbrella
01/01/05
01 1 06
EACH OCCURRENCE
$5,000,000
$5,000,000
AGGREGATE
DEDUCTIBLE
RETENTION
$10, 000
B
WORKERS COMPENSATION AND
E~IPLO\'ERS' LIABILITY
WEc001076003
workers compensation
01/01/05
01/01/06
OTH-
ER
EL DISEASE-POLICY LIMIT
$1,000,000 _
$1,000,000 :I
$1,000,000 ~
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and Employers' Liability as
contract, and always subject ~
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EL DISEASE-EA EMPLOYEE
OTHER
DESCRlPTION OF OPERATIONSILOCA TIONSNEHlCLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Re: phase I, 1498 S. Greenwood Ave.
Certificate Holder is added as an Additional Insured excluding workers' Compensation
required by written contract but limited to the operations of the Insured under said
City of Clearwater
Attn: City Clerk
POBox 4748
Clearwater FL 33758-4748
USA
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSlJING COMPANY WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON 1HE COMPANY, ITS AGENTS OR REPRESENT A T1VES.
AlJfHORIZED REPRESENTATIVE
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Attachment to ACORD Certificate for ARCADIS G&M, Inc.
The terms, conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the
coverage afforded by the insurer(s). This attachment does not contain all terms, conditions, coverages or exclusions contained in the
policy,
INSURED
ARCADIS G&M, Inc.
Attn: Tim Myers
630 Plaza Drive, Suite 200
Highlands Ranch CO 80129-2377 USA
INSURER
INSURER
INSURER
INSURER
ADDITIONAL POLICIES
INSURER
If a policy below does not include limit information, refer to the corresponding policy on the ACORD
certificate form for policy limits,
POLICY POLICY
INSR TYPE OF INSUR-\NCE POLICY NUMBER EFFECTIVE EXPIRATION LIMITS
LTR POLICY DESCRIPTION DATE DATE
DESCRIPTION OF OPERA TIONSILOCATlONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMEI\'TISPEClAL PRO\lSI0NS
to the policy terms, conditions and exclusions. waiver of Subrogation is granted in favor of
Certificate Holder as required by written contract but limited to the operations of the Insured under
said contract, and always subject to the policy terms, conditions and exclusions. Coverage is
considered primary and is limlted to the operations of the Insured.cancellation provision shown herein
issubject;-to shorter or longer time periods dependi.ng on the jurisdiction of, and rea50n for, th~
cancellation.
Certificate No :
570012062399