CERTIFICATE OF INSURANCE (229)
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CERTIFICATE OF LIABILITY INSURANC~LEf:1~ M DA~E~~~;D70)3
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
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
Bouchard- S'tarcres t
101 Starcrest Drive
POBox 6090
Clearwater FL 33758-6090
Phone:727-447-6481 Fax:727-449-1267
INSURED Clearwater Automot ve, Inc.
Pasco Auto Salvage Inc.
Hudson Auto & T+uck Parts, Inc
Salvage Properties
Joel Kehrer & Frank L McKinley
205 Greenwood Avenue South
Clearwater FL 33756
INSURERS AFFORDING COVERAGE
INSURER A:
INSURER B:
INSURER C:
INSURER 0:
INSURER E:
VALLEY FORGE INSURANCE CO
SCOTTSDALE INSURANCE COMPANY
AMERICAN STATES INSURANCE CO
BRIDGEFIELD EMPLOYERS INS 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 MAYBE 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,
INSR TYPE OF INSURANCE POLICY NUMBER ~<;1b'~r".~f'=."'lilIVE Prl'Al{i~~JW'~?N LIMITS
LTR DATE MMlDDJYYi'
GENERAl LIABILITY EACH OCCURRENCE $1,000,000
-
A X COMMERCIAL GENERAL LIABILITY C4000555817 05/01/03 05/01/04 FIRE DAMAGE (Anyone fire) $50,000
-._~_.- nO IlclA11Vfs"M,A.IlE;' [!J OCCUR r ...C= _....._.n._. - - n. -----"---- - -- - ---- - .. ,- ---.~-- .- ". ....-..--- $5; bO a
MED EXP (Anyone person)
PERSONAL & ADV INJURY $1,000,000
-
GENERAL AGGREGATE $2,000,000
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS. COMP/OP AGG $2,000,000
ih PRO. n
POLICY JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
-
C ~ ANY AUTO 01CG34221301 05/01/03 05/01/04 (Ea accident)
ALL OWNED AUTOS BODILY INJURY
- (Per person) $
SCHEDULED AUTOS
-
~ HIRED AUTOS BODILY INJURY
$
~ NON.OWNED AUTOS (Per accident)
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
==J ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $1,000,000
B t!J OCCUR D CLAIMS MADE UMSOO13555 05/01/03 05/01/04 AGGREGATE $1,000,000
$
f;1 DEDUCTIBLE $
X RETENTION $10,000 $
WORKERS COMPE~SATION AIIID .- _. . X JTORYLlMrrsl ,iUelH. .
' ER
D EMPLOYERS' LIABILITY 0830-05801 04/01/03 04/01/04 E,L. EACH ACCIDENT $ 100000
E,L. DISEASE - EA EMPLOYEE $ 100000
E,L, DISEASE - POLICY LIMIT $ 500000
OTHER
DESCRIPTION OF OPERATIONSlLOCATIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Certificate Holder is listed as Additional Insured as respects to General
Liability subject to the terms, conditions and exclusions of the policy.
CERTIFICATE HOLDER I Y I ADDrrlONAL INSURED; INSURER LETTER: CANCELLATION
-." CICLOO1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
City of Clearwater NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Attn: Bldg Inspection Div
P.O. Box 4748 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Clearwater FL 34618 REPRESENJp.TIVES.
I AUTHOR\!y~
ACORD 25-5 (7/97)
@ACORDCORPORATION 1988