CERTIFICATE OF LIABILITY INSURANCE (9)
, .
ACORD~ CERTIFICATE OF LIABILITY INSURANCE OP IDS~ DATE (MM/DDIYYYY)
COMMU 9 07/02/08
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Brown & Brown Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
17757 US Highway 19 N, Ste 660 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 2456 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Clearwater FL 33757-2456
Phone: 727-461-6044 Fax:727-442-7695 INSURERS AFFORDING COVERAGE NAIC#
INSURED . INSURER A: Majestic Insurance Company 42269
i INSURER B: Arch Insurance Company 11150
Community Pride Child i INSURER c:
Care, Inc.
1235 Holt Ave. INSURER D:
Clearwater FL 33755 i INSURER 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 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.
LTR NSR[ TYPE OF INSURANCE POLICY NUMBER PD~~~Tri~lf~E P8k~1YI~~h'lf~~N LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1000000
~ ~REMISEs (Ea occurence)
B X X COMMERCIAL GENERAL LIABILITY NCPKG0068800 06/30/08 06/30/09 $ 100000
f--c.~ . , -.-- .'. 'CtAlI,,1SIIi1AOE'n~OCCUR ---- ". n . _ -CC__.,_ __ ...... . -_.- ...... MEDEXPiAnyonepersont...... -$-5-GOOc -"0. n -
PERSONAL & ADV INJURY $ 1000000
GENERAL AGGREGATE $2000000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1000000
I n PRO- nLOC Emp Ben. 1M/1M
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
~ $ 1000000
B ANY AUTO NCAUT0068800 06/30/08 06/30/09 (Ea accident)
~
ALL OWNED AUTOS BODILY INJURY
~ ,$
SCHEDULED AUTOS (Per person)
~
X HIRED AUTOS BODILY INJURY
~ (Per accident) $
X NON-OWNED AUTOS
~
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY REef." ~ED AUTO ONLY - EA ACCIDENT $
=1 ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY JUl V 01OD8" EACH OCCURRENCE $
~ OCCUR D CLAIMS MADE AGGREGATE $
OF ICtAL RECORI )5 AND $
=1 DEDUCTIBLE LEe ISLAT/VE SRVC S OEPl $
RETENTION $ $
WORKERS COMPENSATION AND X I TORY LIMITS I IU~~-
A EMPLOYERS' LIABILITY WCNC09081440801 04/01/08 04/01/09 $ 5000000
n >'<NT .-ROF'RI!:TORiI'AIHNEI'tiEXECUTI v E .. E.L. EACH ACCIDENT.
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 500000
~~~MtS~~~-Xs~6~s below E.L. DISEASE - POLICY LIMIT $ 500000
OTHER
B Crime NCPKG0068800 06/30/08 06/30/09 Employee 20000
Theft 1000 Ded
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Certificate Holder is listed as an Additional Insured as respects General
Liability only and only as respects the Named Insured.
CERTIFICATE HOLDER
CANCELLATION
City of Clearwater(Property)
Real Estate Services Manager
ATTN: Earl Barrett
POBOX 4748
Clearwater FL 33758-4748
CITYC-2 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
ACORD 25 (2001/08)
@ACORDCORPORATION 1988