CERTIFICATE OF LIABILITY INSURANCE (2)
From: Qndy John~n At: ~rlisle Fields & Company FaxID: 727-725-3663 To: Commerce
Date: 81312005 09:24 AM Page: 2 of 3
ACORD.. CERTIFICATE OF LIABILITY INSURANCE OP ID C~ DATE (MM/DDIYYYY)
GREA'l'-3 08/03/05
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONL Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Carlisle Fields & Company, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
I?O. Box 7910 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Clearwater FL 33758-7910
I?hone:727-797-0441 Fax:727-725-3663 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A 18988
Auto OWne,r.s Insurance CQmpany
INSURER B. FCC I Insurance Group 33472
Clearwater Regional Chamber of INSURER C
Commerce
I?O. Box 2457 INSURER 0
Clearwater FL 33757
INSURER E
,
COVERAGES
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 mE 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
I'LTR NSRC I TYPE OF INSURANCE POLICY NUMBER DATE (MMIDDIYY) 'Ok!fEY(MMlDDIYY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
- 08/01/05 08/01/06 ~~~~~~S lEa occurenee)
B X COMMERCIAL GENERAL LIABILITY BINDER $50,000
- =:=J CLAIMS MADE ~ OCCUR
- MED EXP (Anyone person) $ 5,000
PERSONAL & ADV INJURY $1,000,000
GENERAL AGGREGATE $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS. COMP/OP AGG $ 1,000,000
Xl n PRO. nLOC
X POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
r-- $1,000,000
B ANY AUTO BINDER 08/01/05 08/01/06 (Ea accident)
r--
ALL OWNED AUTOS BODIL Y INJURY
r- (Per person) $
I---'-- SCHEDULED AUTOS
X HIRED AUTOS BODIL Y INJURY
r-- $
X NON.OWNED AUTOS (Per aCCIdent)
-
- PROPERTY DAMAGE $
(Per aCCident)
GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $
=1 ANY AUTO OTHER THAN EAACC $
AUTO ONL Y: AGG $
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $2,000,000
A ~ OCCUR D CLAIMS MADE 4346391200 08/01/05 08/01/06 AGGREGATE $
$
~ DEDUCTIBLE $
X RETENTION $10,000 $
WORKERS COMPENSATION AND ITOR'yt:~iT~ I IUER
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? E.L. DISEASE. EA EMPLOYEE $
If yes, describe under
SPECIAL PROVISIONS below EL DISEASE. POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
CI'l'Y005
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30
DAYS WRITTEN
City of Clearwater
Anne Fogarty
100 S. Myrtle Ave.
Clearwater FL 33758
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRE
PO RATION 1988
ACORD 25(2001/08)