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AG O/20tDATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 04/092014 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 pollcy(les)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 Ileu of such endorsement(s). PRODUCER CONTACT v Aon Risk Services South, Inc. PHONE NAA . (866) 283-7122 FAX B00-363.0105 Franklin TN Office M6.No.Ext): �•No.): 501 Corporate Centre Drive EAWL c Suite 300 ADDRESS: _ Franklin TN 37067 USA INSURER(S)AFFORDING COVERAGE NAIC N INSURED INSURER A: Greenwich Insurance Company 22322 Arcadis U.S. Inc. INSURER B: XL Specialty insurance CO 37885 630 Plaza Drive suite 200 INSURER C: Highlands Ranch co 80129 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:570053438074 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 LTR TYPE OF INSURANCE I D VND POLICY NUMBER POLICY EFF POLICY EXP us LIMITS X COMMERCIAL GENERAL LIABILITYUl/Ul/2014WOI/2015 EACH OCCURRENCE S1,000.000 CLAIMS-MADE F"OCCUR DA GETORENTED PREMISES Ee occurrence 51,000,000 X Contractual Liability MED EXP(Any one person) S10,000 PERSONAL a ADV INJURY 51,000,000 GENL AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S2,000,06-0 POLICY [E]IRI E ❑X LOC PRODUCTS-COMPIOP AGG S 2,OOO,000 Ln OTHER: 8 B AECO01075812 01/01/201401/01/2015 COMBINED SINGLE LIMB AUTOMOBILE LIABILITY $1.000,000 A05 Ea Pood.nt) e XANY AUTO AFC001719510 01/01/2014 01/01/2015 BODILY INJURY(Per person) Z ALL OWNED SCHEDULED MA BODILY INJURY(Par accklent) t9 AUTOS AUTOS X HIRED AUTOS X AUTOS Per aent NON-OWNED PROPERTY DAMAGE cdd X Property Damape b d A x UMeRELLALue x OCCUR UECO01075912 01/01/2014 01/01/2015 EACH OCCURRENCE 51,000,000 t) EXCESS LUIS CLAJMSMADE AGGREGATE 51,000,000 DED X ETENTION 510,000 B WORKERS COMPENSATION AND RWD 6 0 1 1 14 1 0 XJPER OTH- EMPLOYERS'LIABILITY STATUTE YIN All other States 10— ANY PROPRIETOR I PARTNER/EXECUTIVE E.L.EACH ACCIDENT S1,000,000 a OFFICERAMEMBEREXCLUDEDl NIA RWR943516708 01/01/2014 01/01/2015 (Mandatory In NH) wi E.L.DISEASE-EA EMPLOYEE S1,000,000 M e•daecrlba under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S1,000,000— DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,AddNlonal Remarks Schedule,may he attached N more apace Y required) RE: ARCADIS Project No. RV009840.0012.90003. Glenn Springs Holdings Inc. and Super Store Industries are included as Additional insured in accordance with the policy provisions Of the General Liahility policy. ._1 tds CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 7 EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WRH THE POLICY PROVISIONS. ARCADIS U.S., Inc. AUTHORIZED REPRESENTATIVE Attn: Scott Hackman 630 Plaza Drive, suite 100 Highlands Ranch CO 80129 USA Jv. 01988-2014 ACORD CORPORATION.All rights reserved. ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD