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Certificates of InsuranceACOR" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 9/13/2012 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 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 endorsements . PRODUCER STA, a Division of Oswald Companies 3401 Enterprise Parkway, Suite 101 Beachwood OH 44122 NANTA T ME: PHONE C. No. Ext)*216-839-2807 "C No E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A:HartfOrd Casualty Ins, Co. 29424 INSURED M B I K2-1 INSURER B:HUdSOn Specialty Insurance Co. 25054 INSURER C : mbi-k2-m Architecture, Inc. INSURER D: Spectrum Design Services Inc. 1001 Whitehead St., Suite 101 Key West FL 33040-7522 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 341457792 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. INSR LTR TYpE OF INSURANCE ADDL INSR UBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY Y Y 45SBA107008 /14/2012 /14/2013 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO REN PREMISES Ea occurrence $1,000,000 MED EXP (Any one person) $10,000 CLAIMS -MADE li-I OCCUR 0 X AI Primary 8 OYM7 'Y DA PERSONAL & ADV INJURY $1,000,000 X Non -Contributory GENERAL AGGREGATE $2,000,000 WAIV�1 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 $ POLICY %( PRO- X LOC A AUTOMOBILE LIABILITY Y Y 45SBA107008 /14/2012 /14/2013 Ea accident $1,000,000_ BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS NON OWNED X HIRED AUTOS AUTOS X AUTOS PROPERTY DAMAGE Per accident $ X Al Primary A X UMBRELLA LIAB X OCCUR Y 45SBA107008 /14/2012 /14/2013 EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 EXCESS LIAB CLAIMS -MADE DED X I RETENTION$10,000 Excludes Professional $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/ N OFFICERIMEMBER EXCLUDED? N❑ (Mandatory in NH) N / A Y 45SBA107008 /14/2012 /14/2013 vvC STATU- X OTH- OH -STOP GAP E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYE $1,000,000 E.L. DISEASE -POLICY LIMIT J $1,000,000 H es, describe under DESCRIPTION OF OPERATIONS beiow B Professional Liability Claims Made N Y AEE7204505 /13/2012 /13/2013 Each Claim $3,000,000 Aggregate $3.000,000 Retro Date: 9/1 /2001 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Rem49s Schedule, If more space Is required) Additional Insured and Waiver of Subrogation as designated abovev In required of the Named Insured by written contract or agreement. Re:Marathon Courthouse Project 5EP 18 RECENED BY: CFRTIFICOTF HOLDFR CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County BOCC ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Ann M. Riger, Contracts Administrator 1100 Simonton Street Room 2-216 Key West FL 33040 G C_ AUTHORIZED REPRESENTATIVE 9)1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD a CERTIFICATE OF LIA THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONL' CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITU REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT; If the Certificate holder is an ADDITIONAL INSURED, the p the terms and conditions of the policy, certain policies may require an e Certificate holder In lieu of such endorsements . PRODUCER . Suite 101 OH 44122 INSURED MBIK2-1 mbi-k2m Architecture, Inc. Spectrum Design Services Inc, 1001 Whitehead St., Suite 101 Key West FL 33040-7522 COVERAGES CERTIFICATE NUMBER: 202721215 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSION$ AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. OATE(NIMIDDIYYYYI BILITY INSURANCEF411212013 ' AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES rE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED Acy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to ,idorsement. A statement on this certificate does not confer rights to the N A Patricia PHONE _ FAX MAJL INSURER 9 AFFORDING COVERAGE NAIC d INSURER A :Dartford Canua4 tt - Z INSURERe:LiUdson Spedalty insurance Co. INSURER C : INSURER D : INSURER E ; INSURER F ; 9 REVISION NUMBER: GENERAL LIABILITY Y Y 5SBA107D08 ' /14/2012 ( COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Q OCCUR A V AGEAW ( All Primay & DA ( Non-Contritx,tory W - GEN'L AGGREGATE LIMIT APPLIES PER: AVYOMOBILELIABILITY Y 45SBA107003 9/14/2012 /14/2013 ANY AUTO ALL OVMIED SCHEDULED AUTOS AUTOS K HIRED AUTOS X AUT AUTOS K a Primary K UMORELLA UAe X OCCUR Y 45SBA107008 811V2012 /14/2013 EXCESS UAe CLAIMS.MADF DED X RETENTION 10,000 WORRLRI COMPENSATION AND EMPLOYERS' uA81LnY Y 5SBAJO7008 /14/2012 /14/2013 Y I N ANY PROPRIETORIPARTNERIEXEC;UTIVE OFFICERIMEMDER EXCLVDED9 M N / A (Mandatory In NN) N Yes, rescSlbe older DESCRIPTION OF OPERATIONS below Professional Liability N Y E7204506 /13/2013 /1312014 Claims Merle P109 Date; 911/2001 PERSONAL a ADV INJURY 1 $1.000.000 1 f BODILY INJURY (Per person) 9 BODILY INJURY (Per aocident) $ PROPERTY DAMAGE(Per NIM) s a EACH OCCURRENCL $1,000,000 E.L. EACH ACCIDENT S1 000'Ooo E.L. DISEASE -EA EMPLOYE 11 000 000 E.L. DISEASE -POLICY LIMIT S1 000 000 Each Claim $3.000,000 Aggregate $3,000,000 GAP DESCRIPTION OF OPERATIONS I LOCAYIONS / VEHICLES (Attach ACORD 101, Additlonal RemarM 30odWe, If more space Is regulrodl Nddidonal Insured and Waiver of Subrogation as designated above is provided when required of the Named Insured by written contract or ■nrne.rne.,► Courthouse Project SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe Counter SOCC ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Ann M. Riger, Contracts Administrator 1100 Simonton Street Room 2-21 B AUTNORUMD REPRESENTATIVE Key West FL 33040 C 1998-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD G G ' //�,c�wG(,, ACORa® CERTIFICATE OF LIABILITY INSURANCE DM/DD/YYYY) FZOm11 THISCERTIFICATE 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 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 endorsements . PRODUCER Oswald Companies C 3401 Enterprise Parkway, Suite 101 o#A Beachwood OH 44122 G° .° a� N Q't �°�J N A T NAME: Patricia Cholewa PHONE - AA/C No : - - E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A:Hartford CasualtyIns, Co. 29424 INSURED M_1 mbi-k2m Architecture, Inc. `� Spectrum Design Services Inc. \ 1001 Whitehead St., Suite 101 Key West FL 33040-7522 INSURERB: INSURER C : INSURERD: INSURER E : Qom, INSURER F : COVERAGES CERTIFIM'MNUMBER:2027212159 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. INSR LTR TYPE OF INSURANCE ADDL IN SR UBR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY Y Y 45SBA107008 /14/2012 /14/2013 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY A T RENTED PREMISES Ea occurrence $1,000,000 MED EXP (Any one person) $10,000 CLAIMS-MADE1�1 OCCUR PFROU GE NT PERSONAL & ADV INJURY $1,000,000 X Al Primary & D X Non -Contributory GENERAL AGGREGATE $2,000,000 W �J[� GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $2,000,000 1 $ POLICY X PRO- X LOC JECT A AUTOMOBILE LIABILITY Y Y 45SBA107008 /14/2012 /14/2013 Ea accident) $1,000,000 BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS PROPERTY DAMAGE Per accident $ NON-OWNED HIRED AUTOS X AUTOS X $ Al Primary A X UMBRELLA LIAB X OCCUR Y 45SBA107008 /14/2012 /14/2013 EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 EXCESS L1AB CLAIMS -MADE DED X I RETENTION$10,000 Excludes Professional $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED9 N❑ N / A Y 5SBA107008 /14/2012 /14/2013 WC OR SI IMIT X O FIR OH -STOP GAP E.L. EACH ACCIDENT $1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 B Professional Liability Claims Made N EE7204506 / i 3/2013 /13/2014 Each Claim $3,000,000 Aggregate $3,000,000 Retro Date: 9/1/2001 E DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Additional Insured and Waiver of Subrogation as designated above is provided when required of the Named Insured by written contract or agreement. Re:Marathon Courthouse Project ltla:�II�L•lt\I�:NI�•l�: sr• • ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Monroe County BOCC ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Ann M. Riger, Contracts Administrator 1100 Simonton Street Room 2-216 AUTHORIZED REPRESENTATIVE Key We FL 33040 C-C- ",Of az"' ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010/06) The ACORD name and logo are registered marks of ACORD 41111111111 tHUMA Care Payroll Nemm Rasarses Rick itlerte Worn Benefits 9501 UNION CEMETERY ROAD LOVELAND, OH 45140 PHONE (513) 605-3522 FAX (513) 605-3523 MBI/K2M ARCHITECTURAL and HUMACare, Inc.- Consolidated Employee Management have entered into a co -employer / PEO relationship in which HUMACare Inc. assumes workers' compensation liability under the certificate attached. Questions regarding the certificate and/or the liability relationship should be directed to the Risk Management Department, 513-605-3522. Bureau of Workers' ng �io Compensation ColumObus,OH 43215 Certificate of Premium Payment This certifies the employer listed below has paid into the Ohio State Insurance Fund as required by law. Therefore, the employer is entitled to the rights and benefits of the fund for the period specified. For more information, cap 1-800-OHIOBWC. This certificate must be conspicuously posted. Policy No. and Employer Period Specified Below 1349248 ohiobwc.com HUMACARE 9501 UNION LOVELAND, Thru 8/31R013 MGT INC You can reproduce this certificate as needed. Ohio Bureau of Workers' Compensation Required Posting rr"",." _ •..+�r..brceo Effective Oct. 13, 2004, Section 4123.54 of the Ohio Revised Code requires notice of rebuttable presumption. Rebuttable presumption means an employee may dispute or prove untrue the presumption (or belief) that alcohol or a controlled substance not prescribed by the employee's physician is the proximate cause (main reason) of the work -related injury. The burden of proof is on the employee to prove the presence of alcohol or a controlled substance was not the proximate cause of the work -related injury. An employee who tests positive or refuses to submit to chemical testing may be disqualified for compensation and benefits under the Workers' Compensation Act. Ohio! Bureau of Workers' `.JJ .Compensation You muW post his lanquapa with Me oertilfrate W premium payment cod CERTIFICATE OF LIABILITY INSURANCE DAN W0°"""" 17/2013 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 caAMloate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns and oonditlons of the policy, certain policies may require an endorsement. A statement on this cartillcets does not confer rights to the certificate holder In lieu of such andorsama s . tROO110Ert he James B. Oswald Company 1100 Superior Avenue, Suite 1500 Cleveland OH 44114 Ron F M IQ me ma2164MM807 Wdoompaniffixorn LVIRIPM AFFORDING COVERAGE e Neu= M13IK2-1 mbl4k2m Architecture, Inc. 1001 Whitehead St., Suite 101 Key West FL 33040-7522 w@Lw&R s +ludaw Apida4 Insurance Co. WVJPM 0. INsuReR . OwWR e•. INSURER I e.r•vmwnCa r`CRTICIr_ATC Id11aIRCR-9C49A7n77 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. WBR LTR TYPE OF INSURANCE ARM Bit�-- POLICY NUMM PO U Y LIMITS GENERAL LIABILITY Y Y 48SOOM07008 W114013 W14IM14 EACH OCCURRENCE $1.000.000 DAMAGE TO WMU $1000 000 X__I I COMMERCIAL GEHEAAL LIASILnY MEDEXP An one arson $10000 � OCCUR PERSONAL a AOV INJURY 3 000 000Contributory rimary A rCWMSAAAM GENERAL AGGREGATE $2 000 000 GREGATE LIMIT APPLIES PER' PRODUCTS-COMPIOP AGO S2 000 000 S ICY X PC]LOC AUTOMOBILE LIABILITY Y y 45SBA07008 U1412013 IM412014 91,0001000 BODILY INAW (Per person) S ANY AUTO BODILY (Per ecdderd) INJURY S OWNEDSCHEDULED � ACC ALL X X NAUTOS NEO RTY D— PON—AW S HIRED AUTOS X AI Primary = A X uusRELLA uAe OCCUR Y 14121113 1412014 EACH OCCURRENCE 51.000,000 N AGGREGATE 611.1100.0DO EXCESS LIAS CLAIMS -MADE 141SRA10101111 DED X I RETENTION 10 000 Excludes 13mlessionai S A WORKERSCOMPENSATION Y BA10700e 11412013 1149014 ASTA T ' ER OHSTOPGAP EL EACH ACCIDENT s1 000000 AND EMPLOYERS' LIABILITY YIN ANYPROPRIETORIPARTNERIEXECUTNE NIA El DISEASE • EA EMPLOYE 51000 OOD ME OR.CENMSEREXCLUDED? (MendmM in NH) E.L. DISEASE • POLICY LIMIT 1 $1.000 000 k ya daaibe under 7 N8h B Professional Liability N Y EE1204IN 312013 V1312D14 Each Claim $3,000,000 Aggregate $3.000,000 Claims Made r Reko Date: W112001 DESCRIPTION OF OPERATIONS I LOCATIONS t VEHICLES (Anach ACORD 101. Ad"Onal RemsrM BoheduN. N more epees N "Wed) diUonal Insured and Waiver of Subrogation as designated above is provided when To a Named insurAd by written contract or agreement. Re:Marathon Courthouse Project B Vr OA WA o Monroe County SOCC Attn:Ann M. Riger. Contracts Administrator 1100 Simonton Street Room 2-21e Key West FL 33040 O SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANED MORE THE EXPIRATION DATE THEREOF, NOT" =JMLL BE QjLfVE88D IN ACCORDANCE WITH THE POLICY PROVISION&.& AUTHORIZED REPReSENTATIVE / •• v d5 129&2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010f05) The ACORD name and logo are registered marks of ACORD