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TR9302-CS 920205 (2)Alexander & Alexander of Califomla Inc. 3550 Wilshire Boulevard Los Angeles, California 90010 Telephone 213-385-5211 TWX 910-321-2907 February 5, 1992 Ms. JanicMcPhail Barton-AschmanAssociates, Inc. 5485 Belt Line Road Suite 199 Dallas, TX 75240 RE: Insurance Certificate State of Texas D.O.T. We are pleased to enclose the following insurance documents: [] Insurance Policy No. [] Endorsement No. for Policy No. I~ Certificate of Insurance. One or±gina~. i-I Loss Payable Form. [] Audit. [] Binder. I'-t Document for your records. [] Insurance Company document to be completed and returned. [] Invoice No. Credit Memorandum No. If you have any questions regarding the enclosed, please advise. Yours very truly, Alexander & Alexander of California Inc. ~ Liccarc~ TxOOT Farm No. 20.102 (Rev. 12-gl) prev,~s editions of this form may not be used. NO · Copies of the endorsements fisted below are not requlred as attach. TEXAS ~ ments to this ¢e~ificate. DEP~TMENT OF T~NSPORTATION CERTIFICATE OF INSURANCE The ~ contra~or ~all not commence wor~ until he/she has obtained the minimum Insulate speclfl~ in SecUon II, below, a~ oblained t~ follo~ng endorte~nts: the Texas Oepa~ment of Tranxene/ion as an Additional Insur~ for coverages ] and 4, and a Waiver ol $~rogatlon In favoe of the ~me depa~ment under coverages 2, 3 and ~. Only certificates of Insura~e publlsh~ by this department are a~eptabte as p~oof of insurance. Commercial <~,le~s' ce~flcates a~e u~cceptable. ~E~ION I-IDeNTIFICaTION ~TR ....... 1.1 Insured ContractOr'S Name 1.2 Street/Mailing Add~es$ Evanston, IL 60204-1381 CRy ] 1.4 State I1.$ Zip Evanston TL 60204-1381 1.6 Phone Number AreaCode( 708] 491-1000 "~ECTION II - TY'~>E OF INSURANCE Type ' Policy ' ' Effective Expiration Limits of Liability Number: Date: Date: Not Less 'Than: 2. WORKERS' COMPENSATION 2.1 t, aC12320P. 1 2.2 6/19/91 2.3 6/3.9/92 Statutory- Texas COMMERCIAL GENE RAL LIABILITY Bodily InlurylProperty 3.1_.~ Damage 3.3,..~,~.~ $325,000 combined single limit each occurrence and In the aggregate Endorsed with the Texas Department of Transportation as an Additional Insured and endorsed with a Waiver of Subrogation In favor of the Texas Department of Transportation. TEXAS BUSINESS AUTOMOBILE POLICY A. Bodily lnjury 4.1 ]~,~427G28 4.2 6/19/91 4.3 6/19/92 8. Property Damage 4.4 " 4.S " 4.6 " S I00.000 ea. person $300,000 ea. occurrence S25.000 ea. occurrence Endorsed with the Texas Department of Transportation as an Additional Insured and endorsed with a Waiver of Subrogation In favor of the Texas Department of Transportation, UMBRELLA POLICY (If Applicable) 5.1 5.2 5.3 S 'SECTION iil- CERTIFICATION P~:: Traffic ~ight s~:~oniza~on 'Z'T Grant program for' all -~ Certificate of~mu,ance .elsie, affi,matively o, negatively amends, exter. Js: m ,Ite,, the cove,age a.o,eed ~ ~he at. ye I~;~,a~c~'~fl~~ i~ued by the Insurance compaq), named below. CencellaUon of the Insurance polities shall not be made until THIRTY DAYS AFTER the unde~gned agent or h~slhe¢ company has sent written notkes by certified mall to the contrac~o~ and the Texas Department of TranspOrtation. THI~ 15 TO CERTIFY to the Texas Department of Transportation, acting on behalf of the State of Texas, that the imarance policies above meet all the requkements stipulated above and such policies are in full force and eflen. Name of Insurance Company NATIONAL UNIC~I FIRE ]/;SURANCE COMPA:~T Company Add~es$ 3699 Wil .s~ire Blvd. I 6.4 State L.A. '! CA Authorized Agent's Phone A,eaC~._l 213].. 385-5211 63 Zip 90010 7.1' ' Name of A~thorlzed Aoent ' ' TxDO! t~o~m No. 20.102 {Rev. 12-91) Prev,~s editions of this form may not be used. below are not required as a~tach. TEXAS ~ ments to this ce~iflcate. DEP~TMENT OF T~NSPORTATION CERTIFICATE OF INSURANCE The ~ contra~o~ ~all not commence wor~ unlil he/she has oblained the minimum Insu,a~e s~clfl~ in Section II. below, a~ obtained ~ folio~ endot~e~nts: ~e Tesas Oepa~ment of Trans~atlon as an Additional Insur~ for coverages S~r~atlon I, favo~ of the ~me department under coverages 2, 3 and 4. Only certificates of lnsura~e publlsh~ by a~eptable as proof of inlutance. Commercial ~r~lers' ce~flcntes a~e u~cceptable. ~E~ION I- IDENTIFICATION DATA ,, 1.1 insured Con~racto~'s Name 1.~ ltreetlMailingAdclres~ 820 Davis St. Evanston, IL 60204-1381 !I-4 at'to !"$ Z'P 60204_1381 1.3 Cl~/ Evanston IZ, 1.6 PhoneNumbe, Areafode( 708) 491-1000 _ _ SECTION II - TYPE OF INSURANCE _ _ , Type Policy Effective Expiration Limits of Liability Number: Date: Date: Not Less 1'hah: 2. WORKERS' COMPENSATION 2.1 ~C12320~1 2.2 6/19/91 2.3 6/19/92 Statutory-Texas COMMERCIAL GENERAL LIABILITY Bodily lnlury/Property Damage 3.2._~z~_~_~ 3.3...~ S325.000 combined single limit each occurrence and In the aggregate Endorsed with the Texas Department of Transportation as a'n Additional Insured and endorsed with a Waiver of Subrogation in favor of the Texas Department of Transportation. TEXAS BUSINESS AUTOMOBILE POLICY A. Bodilylnjury 4.1 ~----~42'7623 4.2 6/19/gl 4.3 6/19/g2 S 100.000 ea. person $300°000 ea. occurrence Name of Insu, ance Company NATIONAL UNIC~q FIRE Company AddlesS 3699 Wils~. ire Blvd. ¢~ 6.4 State , 90010 L.A. o C~ I Authorized Agent't Phone No. 7.1 Nameof AuthOrized Aaent 8. Property Damage 4.4 " 4.S " 4.6 " S2S.000 ea. occurrence Endorsed with the Texas Department of Transportation as an Additional Insured and endorsed with a Waiver of Subrogation In favor of the Texas Department of-Transportation. $. UMBRELLA POLICY (If Applicable) 5.1 S.2 S.3 $ SECTION Ill- CERTIFICATION P~: Traffic Light syndLronization II Grant program for all ~Thls Cer:ificate of Insurance neltl~e~ affi, matlvely o, negativel), amends, e~tend~. M alters the coverage ariD,ClOd by %h, above Insu,anc~"~:~ncT~ Isiued by the Int~,tance company r. amed below. Cancellation of the Insurance pollclet shall not be made until THIRTY DAYS AFTER the undet~gnecl agent or h,slher company has sent wr;tten notices by certified mall to the cont~actGr and the Texas Department of TranspOctation. THIS IS TO CERTIFY tO the Texas Department Qf Transportatk)n. acting on behalf of the State of Texas. that the insurance polkles ab<)ve meet the ~equirements stipulated above and such polkles are in full ~o~ce and effect.