CLEARWATER BEACH LIBRARY & RECREATION CENTER CONSOLIDATION - 07-0044-PR - CERTIFICATE OF LIABILITY INSURANCE
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ACORD. CERTIFICA TE OF LIABILITY INSURANCE OP 10 D~ DATE (MMIDDIl'YYYj
OAKHU-1 07/02.108
PRODUCER THIS CERTIFICATE IS ISSUED 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
P o Box 6090 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
clearwater FL 33758-6090 .1 NAIC#
Phone: 727-447-6481 Fax:727-449-1267 INSURERS AFFORDING COVERAGE
INSURED INSURER A: Westfield In3uranc8 COMp.any ,
i INSURER ~.: ------.--.--,--------
Aaerican EconoJlY Insurance CC
Oakhurst Construction Co. Inc. "-~~-~----~
Susan Darcan~elo INSURER C Auto-~r:s Insuranc., COIlp.a.ny i 18988
7497 135th S reet INSL;RER D I
seminole FL 33776
ItISL'RER E: !
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE 1',jSURED t-1AMED ABOVE FOR THE PeA-ICY PERIOD INDICATED_ N01WITHSTA"DING
ANY REQU:REMEi,T, TERM OR CCI'jDiT!CJN OF ANY COHTRACT OR OTHER DOCUMENT WiTH RESPECT TO WHICH THIS CERTiFlCA1E MAY BE ISSUED OR
Mi\Y PERTAIN, 1HE 116URN;CE AFFORDED BY THE POLICIES DESCillEED ,..EREII, IS SUE,IECT TO AlL THE TERMS, EXCLUSIONS AN') CONDITIONS OF SUCH
POliCIES. AGGREGATE LIMITS SHOWN MAY HlWE BEEN REDUCED BY PAD CLAIM'>
INS D
L TR tlSR TYPE OF INSURANCE
I GENERAL LIABILITY
A X rBI X OcMMERC'AL C-.ENERAL L1ABILlT"
CLAIMS MADE ~ OCCUR
i- -~
i GEN'L AGGREGATE L1MIT^PPlIES PER'
iX I ~;2T LOC
AUTOMOBILE LIABILITY
POLICY NUMBER
!~M!DOIYY~
8rrW(~<f !
LIMITS
C:WP3987102
06/22/08
06/22/09
! EACHOCCL;RRENCE : $ 1000000
r~m-l-<t:NlcU I 150000
I PiiEMISES (Ea ,'cccrence) I $
: ~~ED EXP (Any ene person) i $ 10000
;;~RSONI\L&ADVINJURY ! $1000000
! GENERALAGGREGi\1E i $ 2000000
!PRODL;-CTS - CO'-'PIOP AGG- $ 200 0 0 oo~--
B
ANY ALiTO
02CE1097363
06/22/08
06/22/09
I
II COMBINED SJ-lGUE liMIT 1$1000000
lEa aCCI'JenlJ I ~ J.'
'---------I~--
I EOOIL Y INclURY i $
(Per person) 1
N..L OWNED AUTOS
SCHEDULED A.UTCS
HIRED ALTOS
NON-O'M-JED AUTOS
I EODIL'i IN-JURY
I (p~~r r3(;crdertj
i
I
If
1-- ----------------
! p"OPEr<TY DAIv'AC-.E
: (p.,r aCG.ds-~t)
1$
tll'>.V nnnr)f)!(;"T00Innnn.!;;;n,-~,'l;;;r: ITI~,-.:;
tJfl-lCERiMEJ.1BER EXClUCEO?
if yl:1S, oe:"iC'%ibe uIllj8r
SPECtA.L PROVISIONS beItJw
20645544
12/20/07
, )llJlO Ofol_ Y - EA ACCIDE','T I $
r-~---.:--~-r---'--~----------"
i OTHER THA1\l t.A A...- - $
! AlJTO 01... Y- AGG I $
i FAC,H ncn 1fi'Rf'ti\:t' .~
i .AJ.:.GREGA TE $
j----------- --.--.--------------
$
$
r-------------t------
; I.
I X i TOR':'( t lMIT:;
12/20 lOB I-~~CH AC'Z'~ENTS-500 0 0 0 ----
i EL DISEPSE-EAEMPLOYEEi $ 500000
E.LDlSEASE-POLlCYLlMiT 1$500000
ANY AUTO
i
pF~~~~i~~RRFII Lj~~~M3 rvlf'OC
I
DEDUCTiBLE
r----
C
RtiENlION
WORKERS COOPENSATlOt-I AND
EMPLOYERS' UABIUTY
I OTHER
i .
A I Equ1pment Floater
C:WP3987102
06/22/08
06/22/09 I
All equip
Ded
$113,797
$1,000
I
I
DESCRIPTION OF OPERATIONS I LOCA"TIONS I VEHICLES I EXCLUSIONS ADDED BY EtlOORSEMENT I SPECIAl PROIIISIONS
PROJECT: CLEARWATER BEACH LIBRARY RECREATION CONSOLIDATION (07-0044-PR)
CERTIFICATE KOLDER IS ADDITIONAL INSURED WITK RESPECTS TO GENERAL LIABLITY
SUBJECT TO ALL TE~S I CONDITIONS AND EXCLUSIONS OF THE POLICIES.
FAX: 727-462-6989
CERTIFICATE HOLDER
CANCELLATION
CITYOFC
$l.fOULD MlY OF THE ABOVE DESCRIBED POlICIES BE CMlCEllED BEFORE T1-E EXPIRATION
DATE Il1EREOF. TJ-iE ISSUING INSURER WLL EtlJEAVOR TO MAIl 30
DAYS WRITTEN
CITY OF CLEARWATER
100 SO MYRTLE AVE STE 220
POBOX 4748
CLEARWATER FL 33758
NOTICE TO 1l1E CERTFICATE HOlDER NAMED TO THE LEFT, BUT FAJLURE TO 00 SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY Klt-lO UPON THE INSURER. ITS AGENTS OR
@ ACORD CORPORATION 1988
ACORD 25 (2001 lOB)
.
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IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on thiscertificate 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 tile 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.
ACORD 25 (2001/08)