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ACORD ---,--------TM CERTIFICATE OF LIABILITY INSURANCE PRODUCER Serial # 487 DATE (MMIDDIYY) 11/01/2004 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HDLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFDRDED BY THE PDLlCIES BELOW, COMPANIES AFFORDING COVERAGE Aon Risk Services, Inc. of New York 55 East 52nd Street New York, NY 10055 PHONE: 866-266.7475 FAX: 866-467.7847 COMPANY A AMERICAN CASUAL TV CO. OF READING PA INSURED PARSONS BRINCKERHOFF QUADE & DOUGLAS,INC, ONE PENN PLAZA NEW YORK, NY 10119 COMPANY B COM~ANY TRANSPORTATION INSURANCE COMPANY , COMPANY CONTINENTAL CASUALTY COMPANY D THIS IS TO CERTIFY THAT 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 B Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS ~T~ I ,. TYPEOF!NSU~ANCE -------~--- POLICY NUMBER -- - --T~~~~~gil~)E I pg;~i~~~~~~~-l- ------~I~~;;------- -------"---- A : GENERAL LIABILITY 'GL257246885 r- 11/01/2004 11/01/2005 ¡GENERAL AGGREGATE2.-__5,000,(jog, ~ X COM~:I~:LM:::ERA~.'.A~~::R g~~~~~~ii~BILlTY (AlS) I : ::~~::_--: ~ ~~~.~~~:::G_-~.:.-. ..--~:Ó%Ó:~Ó~ L^! GENERAL LIABILITY-STOP GAP , 1$ , OWNER'S & CONTRACTOR'S PROT : EACH OC_C_URR~~_~~_- ! $ ------.1 ,000,000 FIRE DAMAGE (Anyormlire) : $ 300,000 --------------- . ----- MED EXP (Anyone person) 5,000 " A AUTOMOBILE LIABILITY [KJ ANY AUTO 0 : ¡ ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS SUA 2057246899 COMMERCIAL AUTO SUA 2057245736 PD AUTO PHYSICAL DAMAGE 11/01/2004 11/01/2005 COMBINED SINGLE LIMIT 2,000,000 ---- ------ ---~ NON-OWNED AUTOS $500 OED COMP $1,000 OED COll I BODILY INJURY (Per person) C'-'--- , BODILY INJURY (Per accident) ---------- -- ----- i PROPERTY DAMAGE s GARAGE LIABILITY r~ ANY AUTQ ; - AUTO ONLY -- EA ACCIDENT 1$ ---- ---I- -------- OTHER THAN AUTO ONLY ------ ------ . EXCESS LIABILITY I UMBRELLA FORM : I OTHER THAN UMBRELLA FORM A I WORKER'S COMPENSATION AND A EMPLOYERS' LIABILITY C :THEPROPRIETORi ! PARTNERS/EXECUTIVE OFFICERS ARE EACH ACCIDENT $ AGGREGATE $ I-EACH ~~C~~~~ - $ ! AGGREGATE ----------- ---- ------ XIINCL , EXCL WC 257246854 AOS WC 257246868 CA QNL Y i we 25724b761 RETR0 (OR,VA,WI) WORKERS CQMPENSA TION 11/01/2004 11/01/2004 11/01/2004 11/01/2005 11/01/2005 11/01/2005 -------- - EL DISEASE - POLICY LIMIT $ ------ EL DISEASE - EA EMPLOYEE $ 1,000,000 __1 ~ooo ,goo 1,000,000 OTHER DESCRIPTION OF OPERATION$ILOCATIONSNEHICLESISPECIAL ITEMS (pB #11822) ON GENERAL LIABILITY INSURANCE, THE CITY OF SANTA ANA AND ITS OFFICERS AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSURED. BUT ONLY WITH RESPECT TO LIABILITY ARISING OUT OF PB'S NEGLIGENCE ALTON OVERCROSSING AT STATE ROUTE 55. PROJECT #1706, ACCOUNT #32-551-6631, WO #48493, . '£RTlF!CAÌîe fI\Il!1i!g . E QANq¡:~!ltA11IØN'¡Z~ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ~MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, CITY OF SANTA ANA ATTN: DAVE BIONODOLlLLO PUBLIC WORKS 20 CIVIC CENTER PLAZA ,M-93 SANTA ANA. CA 92702 ~ ~"""""'" """JOII)\' """", . I. ~<;ORb2~@!l5p PARSON ;?OOO 7S'S FP:1PARSON .?OOO 2S'S FP:1 AUTHOR~EPRESENTAT~ 7 )rJA.¿1. () I ~ . 10242936 , @ACORD éO.RPORATION 19ÐÐ