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UNITED STOES FIDELITY AND GUAIRANO COMPANY <br /> BALTIMORE, MARYLAND <br /> - <br /> - RAILROAD PROTECTIVE LIABILITY POLICY <br /> µ (State or Federal Highway Projects) <br /> DECLARATIONS <br /> Branch Office and Agent or Broker <br /> ITEM 1. NAMEd INSURED <br /> SOUTHERN PACIFIC TRANSPORTATION CO. CORROON & BLACK OF OHIO,INC. <br /> Address (No. & Street, One Market Plaza, Room 1007 Columbus, Ohio 43202 <br /> City. County, State, Zip Code) San Francisco, CA 94105 <br /> Policy Humber <br /> ITEM 2. Policy Period Renews <br /> RPD is From Oct. 30, 1985 12:01 A.M. standard time at the RPB I� Ic`. .� .. To Jan. 01 , 1986 designated job site as stated herein fir D <br /> _ 1 <br /> ITEM 3 The insurance afforded is only with respect 10 such of the following coverages as are indicated by specific premium charge or charges.The limit of the Company's liability against <br /> such coverage or coverages shall be as stated herein,subject to all the terms of this policy having reference thereto. <br /> 1 COVERAGES (Subline 315) LIMITS OF LIABILITY <br /> Beldily Injury Liability, Property Damage $ 2,000 000 each occurrence <br /> Liability and Physical Damage to Property $ 6,000 . 000 aggregate <br /> I <br /> ITEM a. Name and Address of Contractor <br /> 0. H. Materials Co. , A Division of The K.B.I. Corp. <br /> P. 0. Box 551, Findlay, Ohio 45839-0551 <br /> ITEM 5. Name and Address of Governmental Authority for whom the work by the contractor is being performed. <br /> Rates Advance Premiums <br /> ITEM 6. Coverages <br /> Designation of the Job Site Premium Coverage�Ove Coverage 9 <br /> description of Work Bases A A B and C <br /> (a) Contract Cost (a) Per $100 of Cost <br /> (b) Rental Cost (b) Per $100 of Rental Cost <br /> State of California a) 9,000 a) 2.14 Incl. 278. MP Incl. <br /> Dept. of Transportation <br /> Contract #10A514. Removal of <br /> One Tank and Surrounding Concrete. <br /> Premiums $ 278, $ Incl. <br /> ll Poliry Period more than one year, premium is payable: <br /> on effective date of Policy 1st Anniversary 2nd Anniversary <br /> $ Total Premium $ 27$. MP <br /> $ $ <br /> CORROON & BLACK OF, OHIO, INC. <br /> 700 Ackerman Rd. , P.O. Box 02400 <br /> Columbus, Ohio 43202 <br /> mw n <br /> Countersigned by ;�-Authonzed•Representative <br /> These declarations and Railroad Protective Liability Policy (State or Federal Highway Projects) term comprise the policy. <br /> (rev. 2-17-65) <br /> Casually F39 (3-81) <br />