CERTIFICATE OF LIABILITY INSURANCE (4)
From:Go Xayasone FaxlD:Barber Agency
Page 2 012
Date:4/29I2DD8 12:35 PM Page:2 of 2
ACORD. CERTIFICATE OF LIABILITY INSURANCE OP ID GX DATE(MM/DDNYVY)
HARBO-1 04/29/08
PRODUCER THIS CERTIFICATE IS ISSUED AS A MAnE ~ OF INFORMATIOII
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Barber Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
2321 State Road 580 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Clearwater FL 33763
Phone: 727-733-9385 Fax: 727-734-5252 INSURERS AFFORDING COVERAGE NAlC#
INSURED INSURER A" Zurich Insurance
INSURER B Citizens Insurance
Harbor Barber & Beauty Salon IN SURER C
25 Causeway Blvd INSURER 0:
Clearwater Beach FL 33767
IllSURER 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 DOCUMENTWITH RESPECT TO WHICH THIS CERTIFICATE MA.'V BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIOOS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
POliCY NUMBER P~~~~8JW' POLICY EXPIRATION LIMITS
LTR NSR TYPE OF INSURANCE DATE (MMJODIl'Y)
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
-
A X ~ 3MERCIAL GENERAL LIABILITY PAS00848160 04/23/08 04/23/09 PREMISES (Ea occu...""'e) $ 50,000
- CLAIM S MADE [K] OCCUR MED EX? (Anyone person) $ 5,000
PERSONAl. & ADV IN.AJRY $1,000,000
GENERAL AGGREGATE $2,000,000
~'L AGGREGATE L1Mrr APPr!r PER: PRODUCTS - COMPIOP AGG $1,000,000
nPRO-
POLICY JECT LOC
~OMOBILE LIABILITY COMBINED SINGLE LMIT $
ANY AUTO (Ea accident)
-
ALL OWNED AUTOS BODILY INJJRY
- (Per person) $
- SCHEDULED AUTOS
- HIRED AUTOS BODILY iIIJJRY
(Per accident) $
- NON-OWNED AUTOS
PROPERTY DAMAGE $
, (Per accident)
-
GARAGE LIABILITY - -. AUTO ONL Y - EA ACCIlENT $
==i ANY AUTO I'AY 0 1 OTHER THAN ElJ\.ACC $
AUTO ONLY AGG $
"""
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
~ OCCUR D CLAIMS MADE -~~ ~ ~--.... -- -:ECOR,} AGGREGATE $
$
==i DEDUCTIBLE - , ,: t." $
RETENTION $ $
WORKERS COMPENSATION AND 1rb"R-'y l:~I~Us I IOJl1-
EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE E.L. EACH ACCiDENT $
OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMALOYEE $
If yes. describe under E.L. DISEASE - POLlCYLIMrr $
SPECiAL PROVISIONS below
OTHER
B Windstorm 1408376 06/06/06 06/06/07 Contents 2,000
DESCRlPTlON OF OPERATIONS / LOCATIONS /VEHlCLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
The below named certificate holder is named an additional insured as their
interests may appear.
CERTIFICATE HOLDER CANCELLATION
City of Clearwater
25 Causeway Blvd
Clearwater FL 33767
CLEARWC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO "AIL ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, !BUT FAILURE Tn DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPONlME INSURER. ITS AGENTS OR
ACORD 25 (2001/08)
@ACORD CORPORATION 1