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Certificates of Insurance
7 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/13/2013 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 certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION 1S 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 One Federal Street 0a Boston MA 02110 USA e�OCg�V CONTACT NAME: PHONE 800-363-0105 (A/C. No. Ext): (866) 283-7122 FAX (AIC E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED i D� INSURER A: Zurich American Ins CO 16535 INSURERS: Lloyd's syndicate No. 2623 AA1128623 CDM Smith Inc. BQ`,, ONE CAMBRIDGE PLACE D t' 50 HAMPSHIRE STREET VON- INSURERC: ACE Property &Casualty insurance Co. 20699 CAMBRIDGE MA 021390000 USA INSURER D: INSURER E: INSURER F: I�UVCKYI�C� l:FK11Fll=YIF 1Y111MKFK' •1/1111.'1//ll//'1 FIFvl VlflY W1111e MI-W. 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 LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMI MMIDO/YYYY LIMITS GENERAL LIABILITY GLO EACH OCCURRENCE S2 , 000, 000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X❑ OCCUR SIR applies per policy terns & condi ions PREMISES Ea occurrence S300, 000 MED EXP (Any one person) S10, 000 PERSONAL &ADV INJURY S2,000,000 GENERAL AGGREGATE $4,000,600 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $4 , 000, 000 POLICY X PRO- XJECT LOC A AUTOMOBILE LIABILITY BAP 8376631-18 01 01 2014 Ol Ol 2015 COMBINED SINGLE LIMIT a accident) $2, 000, 000 BODILY INJURY ( Per person) ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED Ix AUTOS BODILY INJURY (Per accident) PROPERTY DAMAGE Per accident C X UMBRELLA I" OCCUR XOOG27373720 01/01/2014 01/01/2015 EACH OCCURRENCE $5,000,000 EXCESS LU1B N CLAIMS -MADE AGGREGATE S5,000,000 DED I X IRETENTION S25, 000 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR / PARTNER / XE ECUTIVE OFFICER/MEMBER EXCLUDED? N I A wc837663319 01 Ol 2014 01/01/2015 X I WC STATu- oTH- TORY LIMITS ER E.L. EACH ACCIDENT $1, 000, 000 E.L. DISEASE -EA EMPLOYEE Sl, 000, 000 (Mandatory in NH) U yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT S1,000,000 B Archit&Eng Prof QC1401367 O1/ /2014 01/01/2015 each claim $3700,000, SIR applies per policy ter s conditions aggregate $3,000,000' DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedu , U more space is required) Monroe County Board of County Commissioners is included as Additi al Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. PP tY M ENT I WAIVER N/A YES_ CERTIFICATE HOLDER CANCELLATION n1nTHE uI1UJ yU n �itpIRRATIO DATE THER OF, NOTICE WALL BE DELIVERED IN ULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED CCORDANCE BEFORE THE •• POLICY PROVISIONS. Monroe County Board of County AUTHORIZED REPRESENTATIVE Commissioners 1100 Simonton Street h .6 NV E _ 33 NJ ���� Key West FL 33400 USA ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD `m 0 N N N u) 0 in CERTIFICATE OF LIABILITY INSURANCE °A'�`°` 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 certificats 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 AOn Risk Services Northeast, Inc. Boston MA Office CONTACT FH13ft (866) 283-7122 FAX(800) 363-0105 (Ale. Ne. E ANC. No. E-eIAM ADDRESS' one federal street Boston mA 02110 USA INSURERI31 AFFORDING COVERAGE NAIC I MURED INSURER A: NEW Hampshire Ins co 23841 CDM Smith Inc. 75 state Street, suite 701 Boston MA 02109 USA INSURER 0: American Home Assurance Co. 19380 NSURERC: Illinois National Insurance Co 23817 INSURER 0: National Union Fire Ins co of Pittsburgh 19445 INSURERS: Lloyd's syndicate NO. 2623 AA1129623 INSURER F. CDVICRACFS CERTIFICATE NUMBER' 570064MB551 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 INSR TR TYPE OF INSURANCE POLICY NUMBER LXP LIMITS X COMMERCIAL GENERAL LIABILITY GL EACH OCCURRENCE $2 , 000 , 000 CLAIMS -MADE rX OCCUR DAMAGE TO RENTED PREMISES Esgmanrice) 5300,000 MED EXP (Any one person) S10,000 PERSONAL &ADV INJURY $2,000,000 GENL AGGREGATE LIMIT APPLES PER I GENERAL AGGREGATE 14 , 000 , 000 POLICY X� JE`� �X Loc PRODUCTS - COMP/OP AGG $4 , 000.000 OTHER D AwOMOBLEWNury CA 1921822 AOS 01/01/2017 01/01/2018 COMBINED SINGLE LIMIT 52,000,000 BODILY INJURY ( Per peon) _._.._ D X ANY AUTO CA 1921821 01/01/2017 01/01/2018 BODILY INJURY (Per scodent) OWNED SCHEDULED NA AUTOS ONLY AUTOS X HWEDAUTOS X NON -OWNED ONLY AUTOS ONLY PROPERTY DAMAGE Psr acodent UMBRELLA LIAR OCCUR EACH OCCURRENCE excess UAa CLAIMS -MADE AGGREGATE DED I 1RETENTioN A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR I PARTNER I EXECUTIVE Y i N OFFICERIMEMBER-CLUDED7 N❑ (MandatwyInNK M yy_ss 0OSCribe urMer DESdRIPTIONOFOPERATIONSbelow NIA WC 14 4 AOS WC014649626 AK,AZ,VA / 1 1 01/01/2017 1/ 1/ 01 01/01/2018 X PTATUTF 07 E. L. EACH ACCIDENT _ $l , 000 , 000 E.L.DISEASE-FA EMPLOYEE S11000,000 E.LOISEASE-POLICYLBAR $1,000.000 E Archit&Eng ProfPSOEFl 01/01/2017 01/01/2 18 each 770 S1,000,000 Professional/claims made aggregate $2,000.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, AddkbMt Remarks schedule, may he smahed 0 mom spece is rpuired) Re: on call Professional Engineering services. Monroe County Board of county Commissioners is included as Additional Insured in accordance With the policy provisions of the General Liability and automobile Liability policies. tV&CBY CERTIFICATE HOLDER CANCELLATION ( M SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DED.IVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe county Board of AUTHORIZED REPRESENTATIVE County Commissioners Simonton street Key �� ��.JL Key West. FL 33040 USA 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 20518329 LOC #: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY Aon Risk Services Northeast, Inc. NAMED INSURED CDM Smith Inc. POLICY NUMBER See Certificate Number: 570064855551 CARRIER NAIC CODE see certificate Number: 5700648SSSS1 EFFECTIVE DATE ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of LlabllRy 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. I.NSR LTR TYPE OFINSURAICE ADDL INSD SUBR WVD POWCYNUMBER POLICY EFFECTIVE DATE fMMA1D/YYYY POLICY E.CI'DRATOY ATE MMIDDA'YYY LIMITS WORKERS COMPENSATION B N/A I JWC014649627 CA 01/01/2017 01/01/2018 C N/A WC014649628 FL 01/01/2017 01/01/2018 A N/A WC014649629 It, KY, NC, NH, LIT 01/01/2017 01/01/2018 A N/A WC014649630 MA, ND, OH, WA, WI, WY 1 1 1 01/01/2018 A N/A WC014649631 N3, PA 01/01/2017 01/01 2018 ACORD 101(200110t) ® 20aB ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD