CERTIFICATE OF INSURANCE (3)
CERTIFICATE NUMBER
SEA-000503997 -10
PRODUCER
MARSH RISK & INSURANCE SERVICES
P. O. BOX 193880
SAN FRANCISCO, CA 94119-3880
CALIFORNIA LICENSE NO. 0437153
THIS CERTlACATIE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTlFICATIE HOLDER OTHER THAN THOSE PROVIDED IN THE
POLICY. THIS CERTlACATE DOES NOT AMEND, EXTlEND OR ALTER THE COVERAGE
AFFORDED BY THE POLICIES DESCRIBED HEREIN.
COMPANIES AFFORDING COVERAGE
URSA-F-ALL-W/PRO- FL TAM URS
INSURED
URS CORPORATION
600 MONTGOMERY STREET
25TH FLOOR
SAN FRANCISCO, CA 94111
COMPANY
A NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA.
COMPANY
B N/A
COMPANY
C LEXINGTON INSURANCE COMPANY
COMPANY
D INSURANCE CO. OF THE STATE OF PA
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAYBE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES.
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DA TIE (MMIDDlYY) DATE (MMIDDIYY)
A GENERAL LIABILITY 706-1033 04101105 04101106 GENERAL AGGREGRATE $ 2,000,000
X COMMERCIAL GENERAL LIABILITY PRODUCTS-COM PlOP AGG $ 2,000,000
CLAIMS MADE 0 OCCUR PERSONAL & ADV INJURY $ 1,000,000
OWNER'S & CONTRACTOR'S ",ROT EACH OCCURRENCE $ 1,000,000
FIRE DAMAGE (Anyone fire) $ 1,000,000
MED EXP (Anyone person) $ 5,000
A AUTOMOBILE LIABILITY 826.2024 (AOS) 04/01105 04101 /06
COMBINED SINGLE LIMIT $ 1,000,000
X ANY AUTO
ALL OWNED AUTOS BODIL Y INJURY
SCHEDULED AUTOS (Per person) $
X HIRED AUTOS BODIL Y INJURY
X NON-OWNED AUTOS (per acciden~ $
PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONL Y- EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT
AGGREGATE
EXCESS LIABILITY EACH OCCURRENCE
UMBRELLA FORM AGGREGATE
OTHER THAN UMBRELLA FORM
A WORKERS COMPENSATION AND 7155121 (CA) 01/01 /05 01101 /06
D EMPLOYERS' LIABILITY 7155122 (AOS) 01/01105 01/01/06
1,000,000
D THE PROPRIETORl X INCL 7155118 EXCLUD.CA,AOS,GA 01101105 01101106 EL DISEASE-POLICY LIMIT 1,000,000
PARTNERs/EXECUTIVE
E OFFICERS ARE: EXCl- 7155119 (GA) 01101/0S. 01/01106 EL DISEASE-EAq-1 ~MPL.9YE,E 1 000 000
OTHER
C PROF(E&O)L1ABILlTY 11 55287 04101105 04101106 EACH CLAIM $1,000,000
CLAIMS MADE FORM AGGREGATE $1,000,000
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/SPECIAL ITlEMS
CLEARWATER CITY PROPERTY - BROWNFIELD REHABILITATION 901-927 CLEVELAND ST.
PROJECT NO.: 12002390
STATE OF FLORIDA IS AN ADDITIONAL INSURED AS RESPECTS GENERAL & AUTO LIABILITY.
CITY OF CLEARWATER
112 SOUTH OSCEOLA AVENUE
CLEARWATER, FL 33766
SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL 30 DAYS
WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH
NOTICE SHAlL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER
AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES, OR THE ISSUER OF THIS
CERTIFICATE.
MARSH USA INC
BY: Mlchlo Nakota
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P~DUCER -
MARSH RISK & INSURANCE SERVICES
P. O. BOX 193880
SAN FRANCISCO, CA 94119-3880
CALIFORNIA LICENSE NO. 0437153
DATE (MM/[)[)/YYjii':.
03131/05 :':"..
COMPANIES AFFORDING COVERAGE
COMPANY
E AMERICAN INTERNATIONAL SOUTH INSURANCE CO,
URSA-F-ALL-W/PRO- FL TAM URS
COMPANY
F
INSURED
URS CORPORATION
600 MONTGOMERY STREET
25TH FLOOR
SAN FRANCISCO, CA 94111
COMPANY
G
COMPANY
H
CITY OF CLEARWATER
112 SOUTH OSCEOLA AVENUE
CLEARWATER, FL 33766