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CERTIFICATE OF INSURANCE (4) 04/09/200'1 10: 44 8139525744 DKS SOUTHEAST PAGE 01 D/(S Associates TRANSPORTATION SOLUTIONS o URGENT Please rJeliver to address" IMMEDIATEL Y! fax transmittal TO: Dina Katsougrakis Senior Staff Assistant AFFILIATION: T: 727-562-4750 Ci of Clearwater FROM: Shay Angelo, Administrative Assistant PIA No: DA TE; April 9, 2004 PAGES (including cover): FAX NUMBER: 727--562-4755 3 Settings: o Superfine Q Fine o Normal RE: Request for Certificate of Insurance Ms_ Katsougrakis- Attached1 per your request, is an updated Certificate of Insurance. Please note that this certificate will be renewed, automatically on May 1, 2004, and will be valid through May 1, 2005. As soon as I receive an updated version, I will forward a copy to your office. . Please notify me if you are in need a specific "project related" certificate. Since no work has been authorized to date regarding the Engineer of Record, , have not requested a specific certificate and have attached our general certificate for your records. Thank you, ~ t..-..-'.-. ....-... r-~l re r~~'1 ......I.....I'.....i !.....[ ..,.I,'r 'I. I r~'-. r I! .. ;' U L_.'f4PR - 9 g.: I ' . Jl '. ..,' r! !~': 12000 Norlh Ca~ Mabry Highway Suite 1 ~2 Tamps, H 331)18 (813) 962-5959 (813) 962-574,~ fax WWW.dksassociales.com W as requested 0 for your use o document to follow nnder separate cover via: D For Review! Suhtnission D US Mail 0 FedEx 04/09/2004 10:44 8139625744 DKS SOUTHEAST PAGE 03 ...~ ACOJW.. CERTIFICATE OF LIABILITY INSURANCI;.&_~" ..:;,;~ THlSC lFICA~lSfSSU SAMATTEftOFINPORMA N . aNI. V AND CONFERS .NORlGJofTS UPON l1:Ie esRTI~A TS HULDER..THt$ CeRTIFlGATeOO1i$'NOT AMSlD,.EX'mNDOR .: ALTER-THE COVeRAGe AFFORDED BY THE!.POllCfE9 BEl..ow. INSUR~RSA~HG COVEFMGt'; I'RODUQ!R JQQk~/At.hen.s :Ins Saerament.o .t.icense No. 0545479 .~. Q.: B.o~. 13$4'7. S&c::amento CIl 95853 "1...:: 93. 6-g2!i-2S2S .~&x: S!:J;$-92S-3S9S' ...~ l~~i'~~t:ilijta:eet. 'JOO ~'ak~lUldC1\. . 9~ G12 COVEAAGes ~ERA; ~lI: ~c. INSUIll;R D: IISlJRER e a1 ~nsur&ne. Co o~ Amar~a .Na1:.1~l Onion ~~re tn~ Co PA .connecticnt IndElllln.i.~ Co. ~ur1~.Amor~can ~n~~~aace Co 'RtE.l"O(;lClU l;ll'.~ ~mED D~ HAVl! IlEEN ISSUEIl TO THi! ~Eo ~ ABaEI'OR ll1liPOtlCY Pl!RIOO ItlOQ1Bl. HO;n.1IIr}f8Tl-NOIN<l ANY ~II!!IiT, ~.OFIi.ClJIlDll1ONQf' NfrCONtMcT~.OTMell;l~TWlm~WWHlCHnIIS.CE/(llJ:ECA'tI:MAY.lle 1SStJaI~. WI., PE~ .Ilit; ~~ 1!N lHEPOtlClQ~HeflEIK I$lIUl!JGCTMAU. ntl!1HUoIS, IEXCl.l.IlIloN$ ANOCONQIIlOHS .Q!;:lRJCH . . .-.............................--........-. ". '. . ~ . 1M :t't~OFIH$lJlWIa!: POUCYllUNlU :IlATElli . u..ns . ~ L:A8lIJty . . ~ OCCI.IAAt:HCE '1 OOD.OOlJ A ~p~I:RCw.~l.IAlIlUrv,.. PTSV034403 lfS/Oi/O~ 05/01/04 .FlRIi~E(.......~..~rY) .300.000 ' ~. :tt~sw.ce ~OCC1JA. ~ liXP lI'<"I 'lflli p'*rs<>t>l "!10.0000 . . ~ ~~:. L.;i.abj,U~ . I'eRSOIW. "At1V INJURY .-1- OOO.O(lQ . [.j. Cl:a.\;;SG. A~lies, . .GENaW. AGGflEGATe a2,OOO.000 rt~ri;N'fii3P~ - PROCIlJCTs_ CONPlOp.AQQ .$2 000.,000 .. POlICY X l.OC ~~IIlU:UABltitv COIolIllHEl> SltlQ~ LIMIT lIi:1,000,000 .J\- --=- , . . ~ST'.3~.8a4e 05/01/.08 .05/01/04 lE--~ ~r>'IKT._1 U I- IU,l. ~aw Al11'Qs BODn.'r\l'l.lURY :Ii , .S~U;U AUtos., (P...~I ,....... ~ . H~ AI11'OlI llODllv IKJUR'r 8 ~N".ow~ P.l.rro$; ,p<<~ : -- .. '-- ~ , ,PROI'l!l'I:n~ ~ ..~~ . - WaMGeUAeltitv . AUTO oNLy -.e.o.ACC~T J - . t~l<'M'Aljm ~"'Aee ". Wift~ $ -AaG .$ ue"'l:lABlI1l"Y .f'ACtl"~ ....1.000 000 .~ [1~~etJR. 0 .Cl.Af.I~ flW:lE BIU205445 05/01/03 . 05/01/04- NiciREGATE ~ 1 , 0'0.0 . 000 $ -~ ,DI;pI)(m~Ul i X MttIil'lo~ INtI:. ~ ~ WOflI(aw.~IPI!NIu,1'JOI\l AHO 1W C ~~lJA$lutY .' ~W20004'103 05/01{O3 05/01./04 .E_L~A!=~ 81..000,000 . E.L. Olll~ -l!AEIAPto'(6\i "1,000,000 /!J.. V1GI;qE'fIIOUCYIJMfT $ 1 _ 000 .00.0 0JIiU .. ]) pro-fe$.i,on-..l,. 1!;OC(USB55709 05/01/03.. . 05101104. l'Cli..<Ua.:i.IIl .$1,000,000 L.1aMUtv An"';e~at.i $1 000.000 I.DO IIIp1l(lH OP 0I'E.1lA~ ~.I\OOl!!DlllY_OIllSBI~~:& 10 ~V n.Qi:ic~. o~ ~;,m,~~.tt.on. -Ul app:1y i~ ClUlcel1.ad fOr f,U);n-paymtant of prem.i'Wll.. C&R.11ACA ie: HO ~OER "TN 1 AOlll1ioHA1.lH.!illJU!t)~.N!SURl!!R\o~ .CA~TlON o[(s -1 SiiQlA.DAJlYQF THEAlJOveO~QllBSO POUal~ Slii~g ~lii TIIl<lOO'lIU.1iQi: DKs ~15Oc::iatGts Ot\~~IOQF. na; l$3UiHo ImlUIWl WII.t.I!No""VOR 7D AA,~ ~D"'YSWR:lT1'eN Dire'Qtor o~ Contracts ~ 1'0 lMe.~Te~ lIAIIl;O TO THE Len. 81J'l' I'AlI..UlU:'fO "os":&1L\l.L C<u:l Krauae IIll'()sa 10/0 08l..JaA..~ ~ ~(W At!'( KINo \lPON nu, 1N.w1lER.1fll AGe-tin O~ 19SEi WebllltlEl!r St. $uito 300 Oa~land CA .94612-:29,25 ftl!ffiUI!HTA~. . ~u=- ~,.rnv' /7 . 1 V' ~ ACORD :l5-S (7/97) ICACORD CORPORA nON. 1988