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Kimley-Horn, COI 4/1/2022-4/1/2024
�®AC DATE(MM/DDIYYYY) �� CERTIFICATE OF LIABILITY INSURANCE 8/3/2023 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 14atpibp 'n lieu of such endorsement(s). CONTACT PRODUCER �O ` 44 NAME: Jerry Noyola Edgewood Partners Ins. Center/Greyli PHONE FAX 3780 Mansell Rd. Suite 370 • INC.No.EMI: 7702207699 INC,No):7702207699 412 Alpharetta GA 30022 �I E-MAIL• DSS: greylingcerts@greyling.com S# INSURER(S)AFFORDING COVERAGE NAIL# CO in a'�O } ;3 2J23 a INSURER A: National Union Fire Ins Co of Pittsburg 19445 INSURED ,� 0 K •S INSURER B:Allied World Assurance Co(U.S.)Inc. 19489 Kimley-Horn and Associates, Inc. r 421 Fayetteville Street, Suite 600 INSURER C:New Hampshire Insurance Company 23841 Raleigh, NC 27601 to INSURER D:Lloyd's of London �w��I �f ON` INSURER E: -4d W�r 4``` INSURER F: COVERAGES CERTIFICATE NUMBER:1844804655 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. INSRL TYPE OF INSURANCE INSD 1 SUBR D POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MM/DDIWW /Y) (MMIDDYYY) A X COMMERCIAL GENERAL LIABILITY GL5268169 4/1/2023 4/1/2024 EACH OCCURRENCE $2,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED PREMISES(Ea occurrence) $1,000,000 X Contractual Liab MED EXP(Any one person) $25,000 PERSONAL&ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 POLICY r X JERCOT X LOC PRODUCTS-COMP/OP AGG $4,000,000 OTHER: $ A AUTOMOBILE LIABILITY CA4489663 4/1/2023 4/1/2024 COMBINED SINGLE LIMIT $2,000,000 A CA2970071 4/1/2023 4/1/2024 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY _AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ B X UMBRELLA LIAB X OCCUR 03127930 4/1/2023 4/1/2024 EACH OCCURRENCE $5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED X RETENTION$1 n,nnn $ C WORKERS COMPENSATION WC015893685(AOS) 4/1/2023 4/1/2024 X PER OTH- C AND EMPLOYERS'LIABILITY Y/N WC015893686(CA) 4/1/2023 4/1/2024 STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED? N N/A (Mandatory in NH) 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 Professional Liab B0146LDUSA2304949 4/1/2023 4/1/2024 Per Claim $2,000,000 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Re: SE 8th Avenue Drainage;Lauren Smith.The City of Okeechobee is named as an Additional Insured with respects to General Liability where required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Okeechobee ACCORDANCE WITH THE POLICY PROVISIONS. Public Works Director 55 SE 3rd Avenue AUTHORIZED REPRESENTATIVE Okeechobee FL 34974 g ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Client#: 25320 KIMLHORN ACORD,CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 4/15/2022 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 b -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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Jerry Noyola Greyling Ins. Brokerage/EPIC PHONE FAx A/c Ex No, t : 770-220-7699 A/C, No: 3780 Mansell Road, Suite370 E-MAIDDRL jerry.noyola@greyling.com Alpharetta, GA 30022 INSURER(S) AFFORDING COVERAGE NAIC tt INSURER A: National Union Fire Ins. Co. 19445 INSURED y and Associates, Inc. INSURER B : Allied World Assurance Company (U.S.) 19489 INSURER c : New Hampshire Ins. Co. 23841 421 F Fayetteville Fayetteville Street, Suite 600 INSURER D : Lloyds of London 085202 Raleigh, NC 27601 Raleigh, INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 22-23 REVISION Nl1MRFR- 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 CONTRACTOR 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 SUBR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FXI OCCUR GL5268169 4/01/2022 04/01/2023 EACH OCCURRENCE $1,000,000 PREMISES OEa occur ence $500000 X MED EXP (Any one person) $25 000 Contractual Liab PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREf�GATE LIMIT APPLIES PER: PRO - POLICY I "I ECT 7X LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AAUTOMOBILE LIABILITY CA44S9663 4/01/2022 04/01/202 COMBINED SINGLE LIMIT Ea accident $2,000,000 BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY X NON-OWNEDPROPERTY AUTOS ONLY IX BODILY INJURY (F'er accident) $ DAMAGE Per accident $ B X UMBRELLA LIAB X OCCUR 03127930 4/01/2022 04/01/2023 EACH OCCURRENCE s5,000,000 X EXCESS LIAB CLAIMS -MADE AGGREGATE s5,000,000 DED I X RETENTION $10 000 $ C C. WORKANDEMPS EMPLOYERTIONS' AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEY/N OFFICER/MEMBER EXCLUDED? ® N / A WC015893685 AOS ( ) WC01 5893686 (CA) 4/01/2022 4/01/2022 04/01/202 04/01/202 X PTRT OTH- E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1 000 000 (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS below D Professional Liab B0146LDUSA2204949 4/0112022104/01/202 Per Claim $2,000,000 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: General Engineering Services; Denise Palmatier. The City is named as an Additional Insured with respects to General Liability where required by written contract. Should any of the above described policies be cancelled by the issuing insurer before the expiration date thereof, 30 days' written notice (except 10 days for nonpayment of premium) will be provided to the Certificate Holder. Umbrella Follows Form with respects to General, Automobile & Employers Liability Policies. 17 V LIJGrY City of Okeechobee City Administrator 55 SE Third Avenue Okeechobee, FL 34974 SHOULD ANY OF THE ABOVE DESCRIBED POLICL=S BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ldc?�(V- ACORD 25 (2016/03) 1 of 1 #S3236797/M3180887 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD JNOY1 RoWn Brock Fromm: Palmatier, Denise <Denise.Palmatier@!<imley-horn.com> Semi: Friday, April 15, 2022 10:51 AM To: Robin Brock Cc: Smith, Lauren Subject: FW: I(imley-Horn - City of Okeechobee (REVISED) A•'l••'tc)d mnents: JNOY1_12845968_21460.pdf 'J�in, le��_ See helo` ; re;� rd::r1s our i(la; liTl!I;:1 1ii7111s. From: Jerry Noyola <'ep rry.noyoia@areyiingcom> Sent: Friday, April 15, 2022 10:00 AM To: Hill, Lisa <, .F i�66a:icir:eiEy-horn com> Cc: Jerry Noyola < =rt;.ro=rota ?reyfine_cc : > Subject: Kimley-Horn - City of Okeechobee (REVISED) Lisa, The General Liability limits evidenced on the certificate are the maximum limits as per KHA's policy, however the Umbrella Policy evidenced Follows Form meaning it wilt cover the difference for the higher limits the city is requesting. Point them out to the last sentence in the description section that Umbrella Follows Form. If the city has any additional questions or -further clarification please have them contact Greyling. Thanks. Jerry