CERTIFICATE OF LIABILITY INSURANCE (57)
~ '-ORDw CERTIFICATE OF LIABILITY INSURANCE I DATE IMM/DDIYYI
6/10/08
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
WELLS FARGO INSURANCE SERVICES ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P.O. Box 31666 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Tampa, FL 33631-3666
727 -796-6666 INSURERS AFFORDING COVERAGE
INSURED INSURER A: ZURICH-AMERICAN-09593
Ruth Eckerd Hall, Inc. INSURER B: ZENITH INSURANCE CO-DB
1111 McMullen Booth Road INSURER C: ZURICH-AMERI CAN-095 93
Clearwater FL 33759 INSURER D:
, I INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING
MY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MA Y PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
l'OLlCIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IN:! ------ TYPE -;;;;~'~URANCE POLICY NUMBER POLICY EFFECTI~~ PRk'iN.~~)~~JJ$~ LIMITS
A I GENERAL LIABILITY BIND636907 5/31/08 5/31/09 EACH OCCURRENCE $ 1000000
.....-~
WM'ec'~ ",,"^, "'"'"'' FIRE DAMAGE (Anyone fire! $ 100000
CLAIMS MADE W OCCUR M ED EXP (Anyone person! $ 10000
PERSONAL & ADV INJURY $ 1000000
GENERAL AGGREGATE $ 2000000
h'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2000000
, II PRO- !Xl
I POLICY JECT X LOC
A AUTOMOBILE LIABILITY BIND636907 5/31/08 5/31/09 COMBINED SINGLE LIMIT
----- ! $ 1000000
ANY AUTO i lEa accident)
--- I
ALL OWNED AUTOS BODILY INJURY
.... $
---~., SCHEDULED AUTOS {Per person!
iX HIRED AUTOS BODILY INJURY
$
~ NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
I {Per accident!
I
I AUTO ONLY - EA ACCIDENT $
:~AGE LIABILITY
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
C EXCESS LIABILITY BIND636908 5/31/08 5/31/09 EACH OCCURRENCE $ 10000000
><_! OCCUR D CLAIMS MADE AGGREGATE $ 10000000
I
$
---,
: DEDUCTIBLE $
=_l:9~l'ENTION $ $
. WORI<ERSCOMPENSATIOf;rAND I ] WC STATU-} IOTH-
B ;~z-a-j6G9424-5 -----"--> - .- -- '" i- llQl/Q8 1/01/09 . ,X TORYLlMITS ER
EMPLOYERS' LIABILITY I --
E.L. EACH ACCIDENt $ - -100-0000- -,-
I
I E.L. DISEASE. EA EMPLOYEE $ 1000000
I
i , E.L. DISEASE - POLICY LIMIT $ 1000000
. OTHER i
i RECEIVED
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CITY IS ADDITIONAL INSURED FOR INTEREST HELD IN PREMISES OF JUN 1 1 2008
RUTH ECKERED HALL.
RISK MANAGEMENT
: *10 DAYS NOTICE OF CANCELLATION APPLIES FOR NON PAYMENT.*
CERTIFICATE HOLDER I X i ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
CITY OF CLEARWATER DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
ATTN: LEO SCHRADER, RISK MGMT NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL
POBOX 4748 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR
CLEARWATER FL 33758-4748 REPRESENlATIVES. )
AUTH A1J( 1PtI
I '-'" -- r"
ACORD 25-S (7/97) ll€-\. ~ ~ Q..L~
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46- 64
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@ ACORD CORPORATION 1988
At~t.I!I.~ .........ell.lgIJ1611::IIIIIIIIIIRIIIIIJ_6.~?.....................
DATE IMM/DD/YYI
6/1 0/08
THIS IS EVIDENCE THAT INSURANCE AS IDENTIFIED BELOW HAS BEEN ISSUED, IS IN FORCE, AND CONVEYS ALL THE
RIGHTS AND PRIVILEGES AFFORDED UNDER THE POLICY.
PRODUCER
727-796-6666
WELLS FARGO INSURANCE SERVICES
PO Box 31666
Tampa, FL 33631-3666
COMPANY
American Zurich Ins Co-09080
CODE:
AGENCY
CUSTOMER 10 #:
INSURED
SUB CODE:
PER54440
Ruth Eckerd Hall, Inc.
1111 McMullen Booth Road
Clearwater FL 33759-
EFFECTIVE DATE
5/31/08
EXPIRATION DATE
5/31/09
CONTINUED UNTIL
TERMINATED IF CHECKED
LOAN NUMBER
POLICY NUMBER
81ND636907
THIS REPLACES PRIOR EVIDENCE DATED:
6/1 0/08
LOCATION/DESCRIPTION
1111 McMullen Booth Rd.
Clearwater FL 33759
COVERAGE/PERILS/FORMS
AMOUNT OF INSURANCE
DEDUCTIBLE
Building Replacement Cost Special
Business Personal Pr Replacement Cost Special
Business Income with Agreed Value Special
EDP Hardware Replacement Cost Special
Flood Replacement Cost Flood
40755280
1565000
2000000
289000
5000000
5000
5000
1000
500000
E1uilcling Ordinance D
50000
\'jllld/Hail Deductible $3,000,000
CITY IS ADDITIONAL INSURED FOR INTEREST HELD IN PREMISES OF
RUTH ECKERED HALL.
CITY OF CLEARWATER
ATTN: LEO SCHRADER, RISK MGMT
POBOX 4748
CLEARWATER FL 33758-4748
DlU t;;: Ct. Ee- ~
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......."""'.',,.,.................,.
AUTHORIZED REPRESENTATIVE
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