NATIONAL GUARD ARMORY RENOVATIONS (06-0036-PR) - CERTIFICATE OF LIABILITY INSURANCE
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ACORD.. CERTIFICA TE OF LIABILITY INSURANCE OP 10 DII DATE iMMiDOry)'yy)
OAKHU 1 07/02/08
PRODUCER THIS CERTIFICATE IS ISSU ED AS A MATTER OF INFORMATION
Bouchard-Clearwater ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
101 Starcrest Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
POBox 6090 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Clearwater FL 33758-6090
Phone: 727-447-6481 Fax:727-449-1267 INSURERS AFFORDING COVERAGE NAlC #
INSURED INSURER "" Westfield Insuranc.e Company
'--- -- ---"-"-- ..----
INSL'RER 8: b_~rican EconOMY !nsu.t'''nc~ Co
Oakhurst constr.uetion Co. Ine.
Susan Darean~elo INSURER C Auto-Qwn.ers Insur.uu:@ COMpany 18988
----- ----
7497 135th S reet iN'3URER D
Seminole FL 33776
\t-SJRER E:
COVERAGES
THE POLICIES OF INSURJ'NCE LISTED BELOW HAVE BEEN IWkD TO 1l-tE II1SIPED NM1ED ABO"E FOR THE POLICY PERIOD INDICATED NOT\VITHSTANDING
ANY REQUIREMENT TERM OR CO~,OITlON OF MN COUTRACT OR OTHER DOCl"t,1ENT WITH RESPECT TO VIHICH 1l-tIS CERTiFICATE M"Y BE ISSUED OR
M.AY FERTi'1i1 HE INSLiRH.CE ."!'FORCED BY Ttf: POliCIES DESCRIBED HEREIN IS Sl~ECT TO AlL THE TER~tS" EXCLUSiONS AND CONDITlOr,S OF SUCH
POLICIES /I,GGREGATE UMJTS SHOV.JN ~iAY HA.VE BEEN REDUCED BY PAID CLAIMS
'LT~ ~S~~ TYPE OF INSURANCE POLK;Y NUMBER DATE (MMIOOffil~ DATE (MMIDDIYYl I LIMITS
l GENERAL LIABILITY ~"CH OCCURRENCE $ 1000000
,;q.;"J"-ht:. I U K1=N I I::U ---
A X ~~'W'ffi~A"m"'~ CWP3987102 06/22/08 06/22/09 I PREMISESIEao<'cur"nce) $ 150000
i i CLAIMS MADE ~ OCCUR i MED EX? ~Any OM porson, $ 10000
F'ERSONAL & KJV IN,JURY $ 1000000
I l- GENERAL "GGREGATE $2000000
r--- ----------~---" -..-..-----.---.- ----_.._._.~".~,-
Ifl~:::EfTE!L;,~ 71P~:c i PRCDUCTS - C~i='/OF' .AGG $ 2000000
I-----.._----~ ~-_.._-_.._---- ---.-..-.-
~OMOBILE L1ABlLffi' COMBINED SINGLE LiMIT $ 1000000
B ~ ANY AU;O 02CEI097363 06/22/08 06/22/09 (Ee accident)
!X ,.iJ...L OVV:....~D AuTOS ,
: BODILY IN.AJRY $
S(l--EDiJLED J..lJTJS ; ~Per person)
;
~- r-- - --~-----~
f-- H:RED AUTOS i "IODIL Y INJURY
i (PBf c"lccident) $
~ NOl'+-O'vVNED <'iLITOS
! PROPERTY DAMAC.fC $
I ;Fer accident)
GARAGE LIABILITY , ".uTO ONLY" EA ACCIDENT $
=1 ANY NJiO (-- -"-
! On--IER 1HAN EA ACC $
: AUTO ONLY AGG $
EXCESSIUI4BRELLA LIABILITY EACH OCCURRE~..;CE $
1----" OCCUR Ii rLAI,...S ~,WY= 'IGGREGATE $
L-J.~ . ,L -~----_._--- --_..~-
i $
R DEDUCTIBLE I $
i
l RE1ENT10~~ $ i $
WORKERS COMPENSATlON AND P{ ~\1mm; [ ['-'~~
EMPLOYERS' LIABILITY ---
C ,oNY PtK)f-.r~iETOPjF'ARn_l:::RiEXEOJnVE 20645544 12/20/07 12/20/08 i =L EACH AeCIDE! JT $ 500000
1-------- c-~___"_______
(lFFICFR1AFMRFR FXClI !f)FD~. ! C.L.. DISCAGC - CA D.,PLO'{r:C $ 500000
jf yes, describe undfJr ~-. DISEASE - POLiC'I' LIMiT $ 500000
SPECIAL PRCV:SIOIJS bo:o"
! OTHER I i
I CWP3987102 I
A I Equipment Floater 06/22/08 06/22/09 I All equip $113,797
I I
, I Ded $1,000
I
DESCRIPTlON OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY EtDORSEMENT I SPECIAL PROVISIONS
RE: NATIONAL GUARD ARMORY RENOVATIONS l06-0036-R
CERTIFICATE HOLDER IS ADDITIONAL INSURED NITH RESPECTS TO GENERAL LIABLITY
SUBJECT TO ALL TERNS, CONDITIONS AND EXCLUSIONS OF THE POLICIES.
CERTIFICATE HOLDER
CANCELLATION
CITYCLE
SHOIA.D AtN Of' THE ABOVE DESCRIlED POLICES BE CAtJCELLED BEFORE THE EXPIRATlON
DATE THEREOF, THE ISSU~~G INS~ER ~',I1l.L ENDEAVOR TO ~WL 30
DAYS WRITTEN
CITY OF CLEARWATER
100 SO MYRTLE AVE STE 220
CLEARWATER FL 33756
NOTlCE TO 1llE CERTlFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Ih'f'OSE rro OBLIGATION OR lIABLITY OF AtN KIND UPON TliE INSURER. ITS "A.GENTS OR
ACORD 25 (2001/0B)
@ACORD CORPORATION 1988
IMPORTANT
Ifthe 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 betvveen
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.
ACORD 25 (2001i08j