COI Expires 07/01/2017 �..N GHD0000 -01 PHILLIPAS
A�RL CERTIFICATE OF LIABILITY INSURANCE °ATE(O.MIDD/YYYY)
11/30/2016
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 POUCIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: H the certificate holder is an ADDITIONAL INSURED, the policy(les) 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 CONTACT Willis Towers Watson Certificate Center
Willis of Massachusetts, Inc. PHONE FAX
do 26 Century Blvd (A�, No, E at): (877) 945 -7 _ (p/D, 467 -2378
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P.O. Box 305191 Va certificates@willis.com
Nashville, TN 37230 -5191
INSURERS AFFORDING COVERAGE NAIL 0
INSURER A: Allied World Assurance Company (U.S.) Inc. 19489
INSURED INSURER B: Zurich American Insurance Company -. 16535
GHD Services Inc. INSURER C :
2055 Niagara Falls Blvd., Suite 3 INSURER D :
Niagara Falls, NY 14304
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 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 O F SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE ADDL SUBR POUCY NUMBER ......-- -- -- POLICY EFF POUCY EXP
LTR INSO NIVD fMMIDO/YYYYI (MNYDD/YYYYI LIMITS
A X COMMERCIAL GENERAL LIAeIUTY EACH OCCURRENCE $ 1,000,000
CLAIMS -MADE X OCCUR X 0310497 12/01/2016 12/01/2017 a°REMISESOLFaEoaxiDena31 1,000,000
MED EXPIAnLone person) $ 25,000
PERSONAL & ADV INJURY $ 1,000,000
GEM. AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000
POUCY X J ECT LOC PRODUCTS - COMP/OP AG $ 2,000,000
OTHER:
B AuTOMOeILE LIABILITY Me accident) $ 1,000,000
COMBINED SINGLE LIMIT
X ANY AUTO BAP 3757423 -01 07/01/2016 07/01/2017 BODILY INJURY,Lperperson) E ' .
_
AUTOS ONLY AUTOS �LEEDp BODILY INJURY (Per accident} $ '
X AUTOS ONLY X AUt03 ONLY (Pe. aao ld t)AMAGE _ --- - - -- ._...----
X Cal Ded: $500 X Comp Dad- $250 Hired Phys Dmge - $ 100,000
UMBRELLA UAB OCCUR EACH OCCURRENCE $
EXCESS UAB CLAIMS -MADE AGGREGATE $
DED RETENTION $ $
B AANNDEMPPLLOYERSL! COMPENSATION YIN X ITATUTE ER _ _
ANY PROPRIETOR/PARTNER/EXECUTIVE WC 0380936 01 07/01/2016 07/01/2017 1,000,000 .
oFFlCERIMEMBEREXCLUDED? N NIA E_LEACHACCIDENT $
(Ma�Watory In NH) E.L. DISEASE - EA EMPLOYEES 1'000
If yes describe under - - --
-
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000
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DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORO 101, Additional Remarks Schedule, may be attached W more space is required)
GHD Project no.: 11122167, Access Agreement, 151 Marine Avenue, Tavemier, Florida -
Board of County Commissioners of Monroe County is included as an Additional Insured as respects to General Liability where required by contract or
agreement.
- PRIOEL) .t .4041Y7.:. • _ EN} .
WAI N /�� S
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Board of County Commissioners of Monroe County AUTHORIZED REPRESENTATIVE
Monroe County Engineering V
1100 Simonton on Street, , 2 -- 216 (/Lt1C-t�—
Key West FL 33040
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