CERTIFICATE OF LIABILITY INSURANCE (7)
LOCKTON COMPANIES
444 W. 47TH STREET, SUITE 900
(816) 960-9000
KANSAS CITY MO 64112-1906
DATE (MMIDDIYY)
06/01/2003 OS/24/2002
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
F P IC B
ACORDTM CERTIFICATE OF LIABILITY INSURANCE
PRODUCER
INSURERS AFFORDING COVERAGE
INSURED HDR ENGINEERING, INC.
13130 ATTN: LOUIS J. PACHMAN
8404 INDIAN HILLS DRIVE
OMAHA, NE 68114-4049
COVERAGES ~R
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
'~~~ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
~NERAL LIABILITY EACH OCCURRENCE 't 1 ,~~ ~,,~
A X COMMERCIAL GENERAL LIABILITY GL03504583 06/01/2002 06/01/2003 FIRE DAMAGE (Anyone firel 't 1 ,~ ~
i CLAIMS MADE W OCCUR MED EXP (Anyone person) $ <; 000
PERSONAL & ADV INJURY 't 1
-
- GENERAL AGGREGATE $ 1
~'L AGGRE~ LIMIT AP~ PER: PRODUCTS - COMP/OP AGG 't 1
POLICY X ~bW,: X LOC
-A!LTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
B JL ANY AUTO BAP3504584 06/01/2002 06/01/2003 (Ea accident)
ALL OWNED AUTOS BAP3504585 BODILY INJURY
- $ XXXXXXX
SCHEDULED AUTOS TAP3504586 (Per person)
-
JL HIRED AUTOS BODILY INJURY
$ XXXXXXX
JL NON-OWNED AUTOS (Per accident)
- PROPERTY DAMAGE $ XXXXXXX
(Per accident)
~RAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO NOT APPLICABLE OTHER THAN EAACC $ X XXXXX
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $ 1 000 000
E ~' OCCUR D CLAIMS MADE BX052852174 06/01/2002 06/01/2003 AGGREGATE $ 1 000 000
R [X] UMBRELLA (EXCLUDES PROF. LIAB) 'I; XXX xxx
DEDUCTIBLE X FORM 't
RETENTION $ $ XXXXXXX
C WORKERS COMPENSATION AND , 90-14910-01 06/01/2002 06/01/2003 v l~rf,,~TATU- ! InH-
v , '..'T.'
EMPLOYERS' LIABILITY EL. EACH ACCIDENT $ 1 (){){) (){){)
E.L. DISEASE - EA EMPLOYEE $ 1 (){){) (){){)
E L. DISEASE - POLICY LIMIT $ 1 (1(1(1 (1(1(1
D OTHER PLNI13978408 06/01/2002 06/01/2003 PER CLAIM: $1,000,000, AGG: $1,000,000.
ARCHS & ENGS PROFESSIONAL
LIABILITY
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CITY OF CLEARWATER, FLORIDA IS ADDITIONAL INSURED AS RESPECTS GENERAL LIABILITY AND AUTOMOBILE LIABILITY,
RECEIVED
JUN 03 2002
CI=RT HOLDER I I ADDITIONAL INSURED- INSURER LETTER: CANCELLATION rlflflfl RISK MANAGEMENT
310118 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
CITY OF CLEARWATER DATE THEREOF, THE ISSUING INSURER WILL IiNDIi^"OR TO MAIL --3-0- DAYS WRITTEN
RISK MANAGEMENT DEPARTMENT
ATTN:ETHELRAYBURN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,IlUT F^ILURIi TO DO SO SIl^LL
PO BOX 4748 IMPOSIi NO OIlLIG^TION OR LI^IlIUTY OF ^NY KIND UPON TIlIi INSURIiR, ITS ^GIiNTS OR
CLEARWATER FL 34618 RIiPRIiSIiNT^TllJIiS.
o i2-L0 [ 1\.lA; L ~ L T'-\ C- ceR. {( AUTHORIZED REPRESENTATIVE (;7. oJ /?? .ai7~ >
-
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P-l '5 f--
@ ACORD CORPORATION 1988
ACORD 25-S (7/97)
IMPORTANT
.JUN 0 4 2002
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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 lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.