HomeMy WebLinkAboutOwners and ContractsU4I1t/LUU9 LV:Jo rasp
1
. -20 3 i'46 RIBS MINN
5"F 'A LZ one i owr�r Square, friar a #. "Co t*
OM
�'S
OWE ANO CONTRACTORS POLICY NUMBER; 0T -P 5-95499605-1i42-03
PROTECTiVE UpslLITY ISSUE CIA1E: 1O 25•••d5
COV€RA'GG PART OECL,A 4T1ON5
04SURINO COWPAN ':
flf TRAVELEitS IN,3E*ITY :kt4Y
Declarations Period: from t c-12-OS Ito 1 Q-12-O6 1Ns'G A M. StanTtrne *tt your malting address shown
in the Common Policy Oecla.rations.
The Owners and Contractors. Protective i ity Coverage Partconsleb3 at these Dedacat n$ and the Co:ferns
Fortrt shown below. The Oomzwn Policy Conditions do not .Rily1a this Coierage Pen.
1. ARO LIMIT'S OF INSURANCE:
OWNERS A NO CONTRACTORS 'PROTTaC flY2 LIABILITY
co RASE 1O1 M
Amptegate L11Ri t
Each 0Cou r"$nce L i ni t
E. AUDIT PERIOD: NONE
• 3. FORM OF BUSINESS: c ORPveaTION
i 4.
5.
•
DEsfG$ATeo CONTRACTOR:
Name ENv1ROWas E SEitVxCES to UP
MBi;itmp Addreu PO BOX 431.494 J
SOUTH MII AIM . f L 333243-1494
LOCATION OF COVERED OPERATIONS: PROJECT T11 ✓
CITYwiDE SIORM SEWER
LIMIT'S OF INSU# 4NOE
$ 1 , coo. coo
S 1 .00Q . oco of
INLET NORTH Z014
PART NUMBERS S
ARE LISTED BELOW DR ATTAGHEO �kSA SEPARATL U5i1Ni�. PART OFTHIS�'G��i�'�
•
COT0030395
PRODUCER: sago & ww-MU MI t: FOE: sP-fotsON
I
0100-0e-czar. thy• M FAx:3057406316 ID: CITY PUBLIC WORKS
PAGE : 9I4=95
WR-aB- 16' I i 16
VIM PAUL
law TRAVELERS
SPININ BRAIN
IP. 03
•
ICY NUMBER: DT- PRSa-8549S3Q5- I •O5
=f C1WE wkre: i0-12 -05
WEE WS 10-QS-O5
1111 ' VII 1111111 'NO
•
LI STING OF FORMS , B hDORSE MEM S MD SO€OUL€ WOOERS
THIS LISTING SNOWS THE ►,. ABER OF FMMS SCHEDULES AND VitaeS PCNTS
BY 4.10i Di SUST1'ESS
IL TO 02 11 88 COMMON POLICY OECLARA'1IDNS
IL T8 -01 10 93 Faits% E t+DORSE NEWTS AND SCHIEDuLE MASERS
OWNERS /GONTTRACTORS PROTECT!1E LIASELITY
OG TO 43 ,C33. 1�S OWNERS AND CoWIZLc Ton PROT LIAR DEC
00 TO 07 03 715 DECLARATI ON.5 PREAU UM SCt'EOLIL-E
CO To 06 .11 03 iv'E Y TO DECLARATION$ PRE MUM SCHEDULE
GO TO 78 11 07 TASLE OF ANT
OG 00 09 CO '01 OWNERS/CONTRACTORS PRO`iEC1 VE LIAart.I Y
00 O9 17 11 03 APEi4CHT OF =NC1t& -POLLUTION
CG 21 70 11 02 CAP ON LOS E6 CERTIF1E0 Aei'S 'T'E'Rf 0RiSM
c.G 03 53 03 05 EXCLUSION - SILICA
CO 00 63 12 02 WAR LIAR;LITY EXCLUSION
CG 31 91 04 -2 • TUNE/ OR BACTERIA E ZOLUSION
CO 00 76 06. 93 EXCLUSI3N-L£AD
00 T4 78 02 90 ESCLUSION-ASBESTOS►
Chi 28 6i 03 98 FL GFif.14088- N E L.ATlON AND NOWENEWAL
CMG 29 51 01 96 EMPLOYNMENT-REL.AMC p7AcrICE5 EXCLUSION
iNTERLYt* ENDORSE tENrs
I L T3 68 OS 04 FEDERAL TERRORISM RISK rP4URANZIE ACT
IL 03 21 07 02 MJCLEAQ EWNW LIA$ E) CL £NO-490A3 'FORM
#i. T'8 41 ,44343
ammo
PAGE : 1 OF i
APR- 26-2036 03: 35PM F AX: 305 r406316
ID:CITY PUBLIC WORKS FR E:335 R=95%
. r'iPR7218- WAG
: ul6
VSTPAUL . .
TRAVELERS
1011111111111MMININNEW
a
•
P .432
One Tower Vie, Hartford, Corwtectioix 06143
CONTRACTORS
COMMON POLICY DECLARATIONS
ISSUE DATE: i0/25/,t
POLICY N DT--PRS-95496800 45
3NSURZNG GOMPIINY/44E__TRAveues_airEjoaxt,..-ximp _Amy
: f
1. NAMED INSURED AND MAlLI J A SS:
CITY OF WI AMR f
444 SW 2ND AVENL*
MI AMI . *L 33430
POLICY PERIOD: from 10/112/0 !C 1Q/i2 12:Q1 A.M. Siemderld sins at
4
2 . M►OLI your mal l i ng address.
R . LQ Al -I ONE
Premises En dR .
Lae. No. No. Occupancy Address
ON FELE WI iH COWANY
4. covERAce PARi"5 FORMING PART OF Tioll S POLICY AND I SURINo c01rlPANI1:3
OWNER CONTRACTORS PROTECT; VI cOV PANT DECLARATIONS CO TO 03 03 95 IND
5. rJ.046ERS Of FORMS MD ENDORSEMENTS
FORMI NO A PART OF THIS -POLICY: SU II. Ts 01 1O 33
8 . SUPPLE r+ENTA! POLI CrES : Each of the f al i awi rva is a se4r&`.* pol Icy
r rtl:ai rs1 rag i is oompl at* pr ov4 si art :
Poi Icy Poi icy Na. In:ur#frig Comeny
7. PREMIUM SUMMARY:
Provi si orrsl f remi um $ 1,5007
Ova at Inception $ 1 ,SOO
D:Ig at Each S
NAIVE AND ADDRESS OF AGENT OR 8ROl R :
BROWN A DROWN-Ml AMI Oft 05 )
5000 GOVeRUORS SQUARE SLIM
SUX' T 400
t�i 11Mi LAMES, fL 330161.5138
IL TO 02 1 i PAGE 1 OF 1
OFF IDE s SP-EDISON
COUNTERSIGNED eY:
A4.thorsted Rs dive
DATE:
ROXYCHECKIED
et-v
�s�sr�:rrraA
APR-26-2036 23:35PM FAX: 305 T40631G
ID :CITY PUBL I C N0RKS PAGE : E06 R =95