CERTIFICATE OF INSURANCE (3)
AUG-28-2003 15:13 AON 877 528 1656 26
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P.02/03
8128/2003
PRODUCER
Aon Risk Services, Inc, of S )uthern California
707 Wilshire Boulevard, Suie 6000
Los Angeles, California 900 17
(213) 630-3200
INSURED
Parsons Water and Infrast~Jcture Inc.
100 West Walnut Street
Pasadena, CA 91124
TI-IIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND cotlFERS NO RIGHTS
UPON TI-IE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EX TEND OR ALTER
THE COVERAGE AFFORDED BY THE POLICIES BELOW,
INSURERS AFFORDING COVERAGE
INSURER B:
National Union Fire Insurance Co. of Pittsburgh, PA
American Home Assurance Company
INSURER A.
INSURER c:
INSURER D:
INSURER E:
ATTACHMENTS (IF ANY) ON SECOND PAGE
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THE POLICIES OF INSURANCI; LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, No-rwITHSTANDNG
ANY REQUIREMENT. TERM 0 ~ CONDITION OF fIN( CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICI-I TI-IIS CERTIFICATE MAY BE ISSUED OR MAY
PERTAIN. THE INSURANCE 'FFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AlL THE TERMS. EXCLUSIONS, AND CONDITIONS OF SUCH
POLICIES, THE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
co TYPE OF INSURAN' ~E POLICY NUMBER POUC;Y EFFECTIVE
L TR DATE (MMIOCWYY)
POUCV EXPIRATION
DATE(MMOO/YY
LIMITS (IN THOUSI\NDS)
A
GENERAL LIABILITY
~ co....u;RCIAL GeNERAL WI. LJTY
o CIJ\.MS MADE ~ OC ::IJRRENCE
DOWNER'S & CONTRACTOR'S "ROT
GL9332371CC
1/1/2003
1/112004
GENERAL AGGREGATE $
PRODUCTS - COMPIOP AGG $
PERSONAL & ADV INJURY $
EACH OCCURRENCE $
ARE DAMAGE (Any One Fire) $
MED EXP (Any One Pelllon) $
COMBINED SINGLE LIMIT $
BODilY INJURY $
(Per person)
BODILY INJURY $
(Per accldenl)
500
soo
o
o
A
AUTOMOBILE LIABILITY
~ ANY AUTO
~ ALL OWN EO AUTOS
~ SCHEOULEDAUT09
~ HIRED AUTOS
~ NON.ovYNED AUTOS
o
o
CA8261264 - ADS & CA
CA8261266 - TX
1/1/2003
1/1/2004
sea
CAB261267 - MA
CA8261265 - VA
PROPERTY DAMAGE
$
o
o
AUTO ONlY-EAACCIDENT
OTHER THAN AUTO ONLY:
EACH ACCIDENT
AGGGREGATE
EACH OCCURRENCE
AGGREGATE
1000
1,000
1.000
GARAGE LIABILITY
o /AHY AUTO
B
EXCE5S LIABILITY
o UMBRBlA FORM
o OlliER THAN UMllREUA FOf M
WORKERS'COMPENSATION ~ND
EMPLOYERS' LIABILITY
THE PROPRIETOR! [61
PARTNERs/EXECUTIVE OCJ Included
OFACERS ARE: 0 Excluded
OTHER
PROFESSIONAL LlA6ILITY
WC70B5553 - ADS
WC7085552 - CA
1/1/2003
1/1/2004
~ :;".,cR~Tti,trs 0 OTllER
E.L. EACH ACCIDENT $
E.L. DISEASE - POLICY LIMIT $
E.L. DISEASE - EA EMPLOYEE $
A
GL933 2370P'vV1
1/112003
1/1/2004
1,000 EACH CLAIa,1
1,000 AGGREGATE
DESCRIPTION OF OPERATlONSIl OCATlONSNEHICLESIRESTRlCTIONSISPECIAL ITEMS
PV/I 531
9325
Re: Professional Engineering Se vices. See attached Additionallnsurlld end Notice of Cancellation Clauses.
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City of Clearwater ,;:},::,:,: SHOULD IWY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE
....: THEJIlEOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAil 30 DAYS WRrrEN NOTICE TO THE
Attn: Ms. Dina Katsc ugrakis }}},: CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO
P 0 7 .t:f} OBUGATlON OR LIABiliTY OF ANY KINO UPON THE COMPANY, ITS AGENTS OR RI,PRESENTATIVES.
I' ci":";, ~L 33mB-4746 I AlllHORIlEO REPREseNTATIVE :fi~.
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RUG-28-2003 15:16
RON
877 528 1656 26 P.03/03
. .
SPECIAL CLAUSES ATTACHING TO CERTIFICATE OF INSURANCE
(ACORD FORM 25-S)
Certificate Holder:
City of Clearwater
Attn: Ms. Dina Katsougrakis
P.O. Box 4748
Clearwater, FL 33758-4748
PII'II 531
9325
Additional Insured:
Except as respects V.' orkers' Compensation and solely as respects work performed by the named insured, the Certificate Holder is included as an additional
insured but only 10 lhll extent of the named insured's negligence.
Cancellation Notice:
It Is agreed that, in thll event of cancellation or material change In the aforementioned poIicy(ies), the Certlflcate Holder shall be given thirty (30) days prior
written notice.
TClTRL P.03