CERTIFICATE OF INSURANCE (226)
ACOBLt CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY)
07/03/2003
PRODUCER (904)448-9777 FAX (904)448-9788 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Insurance Office of America, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
2700 University Blvd.West HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Building B
Jacksonville, FL32217 INSURERS AFFORDING COVERAGE NAIC#
INSURED Earth Resource Management,Inc INSURER A: Evanston Ins. Co.
dba Liberty Waste & Recycling INSURER B: Continental Casualty Ins. Co.
1601 N 34th St North INSURER c: American Int'l Specialty Lines
Tampa, Fl 33605 INSURER D: American Casualty Co of Reading
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDINI
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.
INSR DD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
GENERAL LIABILITY 03PKG00920 01/16/2003 01/16/2004 EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,OO(J
ICLAlMS~;';DE,[g:]OCCUR MED EXP (Anyone person) $ 25,OO(J
A X PERSONAL & ADV INJURY $ I,OOO,OO(J
GENERAL AGGREGATE $ 2,OOO,OO(J
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COM~OPAGG $ I,OOO,OO(J
I 'nPRO- n
POLICY JECT LOC
AUTOMOBILE LIABILITY BUA247857199 LIAB 07/01/2003 04/01/2004 COMBINED SINGLE LIMIT
- $
X ANY AUTO (Ea accident) I,OOO.OO(J
-
ALL OWNED AUTOS BODILY INJURY
- (Per person) $
SCHEDULED AUTOS
B X
HIRED AUTOS BODILY INJURY
X (Per accident) $
NON-OWNED AUTOS
-
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
==1 ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY 9744928 01/16/2003 01/16/2004 EACH OCCURRENCE $ 5 ,000 , OO(J
~ OCCUR D CLAIMS MADE AGGREGATE $ 5,OOO,OO(J
C $
=l DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND WC247856795 07/01/2003 07/01/2004 I T"X~~T~r,~~ I X 10,J,tt-
EMPLOYERS' LIABILITY $ I,OOO,OO(J
-, 1) - ~y FROPR.IE:rGRl?ARTi.,jER:exEGt:;Ti~E-- E.L. EACH ACCIDENT
--.-'-- --~--- ~----.- - ~--- --, - - --- ,-. ~-==....-, 1,000,000 -,
OFFICER/MEMBER EXCLUDED? E.L. DISEASE. EA EMPLOYEE $
If yes, describe under E.L. DISEASE - POLICY LIMIT $ I,OOO,OO(J
SPECIAL PROVISIONS below
OTHER
~ESCRJPTION OF OPERATIONS / LqCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Liability Coverage.
~ertificate holder 1S named Additional Insured in regards to General
CE ni=rl 14TlnllJ
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,
City of Clearwater BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
1701 N. Hercules Ave. OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES.
Clearwater, FL 33765 AUTHORIZED REPRESENTATIVE ~$~
David Naughton/KATHY
ACORD 25 (2001/08) FAX: (727) 562-4939 @ACORD CORPORATION 1988
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
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JUt 1 6 2003
CITY O;::P/"r-HMENT
ACORD 25 (2001/08)