CERTIFICATE OF INSURANCE (2)
ACORDN
CERTIFICATE OF LIABiliTY INSURANCE
OPID
CONSCRE 01 11 05
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
PRODUCER
Hatcher Insurance, Inc.
P.O. Box 540689
Orlando FL 32854-0689
Phone: 407-841.:.2686 J Fax: 407-841-2688
IN-SUR~~;:J () /J Y -
CCCS of Central Florida &
The Florida Gulf Coast, Inc
P. O. Box 4963
Orlando FL 32802-4963
INSURERS AFFORDING COVERAGE
NAIC#
INSURER A:
INSURER B:
INSURER C:
INSURER D:
INSURER E:
U.s. Fidelit & Guarant Co.
Llo Underwriters
United National Insurance C
North River Ins. Co.
American Home Assurance Co.
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 THE 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.
L TR iNSRa--'--~~;E~~~N;U-;'~CE POLICY NUMBER ~<i,;!iiJ'~~JlXE P8k~~Y(~~gg;~~~N
! ~':.NERAL LIABILITY
A' I Xi<:;.~MERCIAL GENERAL LIABILITY BK01907204
~uol--j CLAIMS MADE ~ OCCUR
I i
i "j ...--
~-~
~~~N'L AGGREGATE LIMIT APPLIES PER'
i"l POLICY i-l r;~& n LOC
~UtOMOBILE LIABILITY
! l ANY AUTO
~"-'-1
i I ALL OWNED AUTOS
:--1 SCHEDULED AUTOS
[~-1 HIRED AUTOS
f..J(: -: NON-OWNED AUTOS I
1--1-~-_n._____------_._--- !
I
I
,
LIMITS
A
BK01907204
EACH OCCURRENCE $ 1000000
PRE~iS~s (Ea occurence) .-
09/25/04 09/25/05 $ 300000
MED EXP (Anyone person) $ 10000
PERSONAL & ADV INJURY $ 1000000
GENERAL AGGREGATE $ 2000000
PRODUCTS. COM PlOP AGG $ 2000000
Emp Ben. 1000000
COMBINED SINGLE LIMIT $ 1000000
09/25/04 09/25/05 (Ea accident)
BODILY INJURY $
(Per person)
BODILY INJURY I $
~Ident)__---t-______
PROPERTY DAMAGE $
(Per accident)
t '. GARAGE LIABILITY
-1 ANY AUTO
---1
!
AUTO ONLY. EA ACCIDENT
$
OTHER THAN
AUTO ONLY:
EA ACC $
--
AGG $
C
: EXCESS/UMBRELLA LIABILITY
IXi OCCUR r.n) CLAIMS MADE FSU0010352
t----.-J ' L__-l
09/25/04
EACH OCCURRENCE
09/25/05 AGGREGATE
$ 1000000__
$ 1000000
$
$
$
f..,
I DEDUCTIBLE
I rxl RETENTION $10,000
I WORKERS COMPENSATION AND
i EMPLOYERS' LIABILITY
E II ANY PRClPRIETORIPARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
OTHER
WC7483150
01/01/05
X I TORY LIMITS I IOJ~-
01/01/06 E.L. EACH ACCIDENT $ 100000
E.L. DISEASE- EA EMPLOYEE $ 100000
E.L. DISEASE - POLICY LIMIT $ 500000
B Prof Liability 100500059343B 10/01/04 10/01/05
D I Directors & Off 5560014222 10/28/04 10/28/05
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Prof Liab
Dir & Off
1000000
2000000
J(15 .JFjr~; 13 A~fIO:5(
CERTIFICATE HOLDER
CANCELLATION
CITYCLE
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
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
City of Clearwater
Economic Dev/Housinq Dept
Attn: Marie Orsello
P.O. Box 4748
Clearwater FL 33758-4748
@ ACORD CORPORATION 1
ACORD 25 (2001/08)