CERTIFICATE OF INSURANCE (14)
A4I~4I~III.~
CERTIFICATE OF INSURANCE
PRODUCER
Aon Risk Services, Inc. of Southern California
707 Wilshire Boulevard, Suite 6000
Los Angeles, California 90017
(213) 630-3200
DATE (MM/DD/YY)
01/05/2004
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS
UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER
THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURER A:
INSURERS AFFORDING COVERAGE
INSURED
Parsons Engineering Science, Inc.
100 West Walnut Street
Pasadena,CA91124
National Union Fire Insurance Co. of Pittsburgh, PA
American Home Assurance Company
INSURER B:
INSURER C:
INSURER D:
..,
.
,
INSURERE: ATTACHMENTS (IF ANY) ON SECOND PAGE
C()VI:RACiIiS' .....,....: .'....:..........,.......... :.. ....,. :,'...... ......,..,..... ::' .. ...,. .... . ." ........ .:......:.. ':... : : ....Y.:,....~..:.. ...'.' ................"..,:.,....,:.
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. THE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
LTR
POLICY EFFECTIVE
DATE (MMlODIYY)
POLICY EXPIRATION
DATE (MM/DDIYY
TYPE OF INSURANCE
POLICY NUMBER
A
GENERAL LIABILITY
~ COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 1;,(1 OCCURRENCE
[J OWNER'S & CONTRACTOR'S PROT
[J
[J
01/01/2005
GL9332979
01/01/2004
A
AUTOMOBILE LIABILITY
1'(' ANY AUTO
r" ALL OWNED AUTOS
lil SCHEDULED AUTOS
~. HIRED AUTOS
I~ NON.OWNED AUTOS
CA8261605 - MA
CA8261606 - VA
01/01/2004
01/01/2005
CA8261603 - AOS
CA8261604 - TX
[
GARAGE LIABILITY
i ANY,AUTO
B
EXCESS LIABILITY
1-- UMBRELLA FORM
!:~ OTHER THAN UMBRELLA FORM
WORKERS' COMPENSA nON AND
EMPLOYERS' LIABILITY
THE PROPRIETOR! ,.-
PARTNERS/EXECUTIVE l>{ Included
OFFICERS ARE 1.1 Exclud.ed
OTHER
PROFESSIONAL LIABILITY
01/01/2005
WC6436138 - AOS
WC6436137 - CA
01/01/2004
01/01/2005
A
GL933 2979E
01/01/2004
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESlRESTRICTIONS/SPECIAL ITEMS
Re PES-Tamp~~L~~~~~~f'~."
See attached Additonal hisuied (ops), Contractual Liability (con), and Notice of Cancellation (30) clauses.
..:...... ..
LIMITS (IN THOUSANDS)
GENERAL AGGREGATE $
PRODUCTS - COMP/OP AGG $
PERSONAL & ADV INJURY $
EACH OCCURRENCE $
FIRE DAMAGE (Any One Fire) $
MED EXP (Any One Person) $
COMBINED SINGLE LIMIT $
BODILY INJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
AUTO ONLY - EA ACCIDENT $
OTHER THAN AUTO ONLY: .....'..V......:.........:.....
EACH ACCIDENT $
AGGGREGATE $
EACH OCCURRENCE $
AGGREGATE $
$
~J WC STATU. e J OTHER ."Y.
TORY LIMITS E.L. EACH ACCIDENT $
E.L. DISEASE - POLICY LIMIT $
E.L. DISEASE - EA EMPLOYEE $
500
500
500
"
1.000
1,000
1,000
1,000
1,000
EACH CLAIM
AGGREGATE
PES 220
2196
CERTIFICATE HOLDER
City of Clearwater
City Engineers, Attn: Alice Eckman
100 S. Myrtle Avenue, 2nd Floor
Clearwater, FL 33756-5520
CANOELLATION .... .....'.:'.:.: .:Y':'
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE
THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE
CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO
OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE ~~(
ACORD 25-S (1/95)
'.::.
..:.
:.
@AOORD OORAORATION 1988
SPECIAL CLAUSES ATTACHING TO CERTIFICATE OF INSURANCE
(ACORD FORM 25-S)
Certificate Holder:
City of Clearwater
City Engineers, Attn: Alice Eckman
100 S. Myrtle Avenue, 2nd Floor
Clearwater, FL 33756-5520
PES 220
2196
Addilionallnsured:
Except as respects Workers' Compensation and solely as respects work performed by the named insured, the Certificate Holder is included as an
additional insured but only to the extent of the named insured's negligence.
Cancellation Notice:
It is agreed that, in the event of cancellation or material change in the aforementioned policy(ies), the Certificate Holder shall be given thirty (30)
days prior written notice.
Contractual Liability:
General Liability includes Contractual Liability (insurance is available only to the extent provided by the policy).