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CERTIFICATE OF LIABILITY INSURANCE (3) TAMPBAY3 ACORDTM CERTIFICATE OF LIABILITY INSURANCE \ DATE (MM/DDIYYVY) 06/27/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Suncoast Insurance Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 22668 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Tampa, FL 33622-2668 813 289-5200 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Travelers Property Casualty 36161 TBE Group, Inc. INSURER B: St. Paul Fire & Marine Insurance Co 24767 380 Park Place Blvd. Suite 300 INSURER C: Travelers Cas and Surety 19038 Clearwater, FL 33759 INSURER D: XL Specialty Insurance Company 37885 INSURER E: St. Paul Mercury Insurance Company 24791 Client#" 3103 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. L TR NSRI TYPE OF INSURANCE POLICY NUMBER PJ>1-i~~ri~~6g~\E P~~$J i~,xJ,~~N A ~NERAL LIABILITY 6802248L72A 06/30/08 X COMMERCIAL GENERAL LIABILITY i CLAIMS MADE ~ OCCUR LIMITS $1 000 000 $1 000.000 $5.000 $1.000 000 $2 000.000 $2.000 000 EACH OCCURRENCE DAMAGE TO RENTED 06/30/09 MED EXP (Anyone person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG f-- - GEN'L AGGR:_EnGATE- LIMIT A.P tP=L1ErS PER: ~ PRO- . I POLICY JECT LOC ~TOMOBILE LIABILITY X ANY AUTO - _ ALL OWNED AUTOS 06/30/09 06/30/08 CA06614422 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 E ~ ~~ Ii '/I f~ i , '~" ". , 'Ip I . a ;-', . T, ~. [- BODILY INJURY (Per person) $ SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS - ~ ~ f-- BODILY INJURY (Per accident) JUL " . W:,' i ~ =---~.,.,..~..- ........,,- -".- .- ...\ ~. '-=~ r '~:.\-l:.':~C- <;1" 'I :(~ i"~C;I"IJ~ "'-. ._.._."........___......:.:....... \i ".; uL. ! PROPERTY DAMAGE (Per accident) $ $ $ $ $9 000.000 $9.000 000 $ $ $ AUTO ONLY - EA ACCIDENT RGARAGE LIABILITY ANY AUTO EA ACC AGG OTHER THAN AUTO ONLY: 06/30/09 EACH OCCURRENCE AGGREGATE 06/30/08 OK06501860 B ~ESS/UMBRELLA LIABILITY -K.J OCCUR 0 CLAIMS MADE h DEDUCTIBLE IX1 RETENTION $10000 C WORKERS COMPeNSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below D OTHER Professional Liability X I T~~J!~~~~ I 10J~- E.L. EACH ACCIDENT $1 000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 $5,000,000 per claim $5,000,000 annl aggr. It.. '(Fe 'fIt/ED 06/30/09 06/30/08 UB6399Y464 11/26/08 11/26/07 DPR9610258 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Professional Liability is written on a claims made and reported basis. - (',." . ...... CANCELLATION ~IVG'" UF 01 ,..._ __ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE C ts. ~"f~E EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~IIJ)"AYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO~O SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. A~ED REPR~TIVE . ""'" 0/... ,0---- RRK CERTIFICATE HOLDER City of Clearwater Engineering Dept. - Ste. 220 PO Box 4748 Clearwater, FL 33758-4748 @ ACORD CORPORATION 198 #M167430 ACORD 25 (2001/08) 1 of 2 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. ACORD 25-S (2001/08) 2 of 2 #M167430 AfQBDTM CERTIFICATE OF LIABILITY INSURANCE Client#: 3103 TAMPBAY3 PRODUCER Suncoast Insurance Associates P.O. Box 22668 Tampa, FL 33622-2668 813289-5200 DATE (MM/DD 06/27/08 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. TBE Group, Inc. 380 Park Place Blvd. Suite 300 Clearwater, FL 33759 INSURERS AFFORDING COVERAGE INSURER A: Travelers Property Casualty INSURER B: St. Paul Fire & Marine Insurance CO INSURER C: Travelers Cas and Surety INSURER 0: XL Specialty Insurance Company INSURER E: St. Paul Mercury Insurance Company NAIC# 36161 24767 19038 37885 24791 INSURED 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 P~H~~~~~gR,w\E P~~~l ftXJ/~mN LIMITS A GENERAL LIABILITY 6802248L72A 06/30/08 06/30/09 EACH OCCURRENCE $1 000 000 - DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY $1 000.000 I CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $5.000 PERSONAL & ADV INJURY $1.000 000 f-- f-- GENERAL AGGREGATE $2.000 000 ~'L AGGREAE ILlMIT APn PER: PRODUCTS - COMP/OP AGG $2.000 000 POLICY ~~gT LOC E ~OMOBILE LIABILITY CA06614422 06/30/08 06/30/09 COMBINED SINGLE LIMIT 1L ANY AUTO (Ea accident) $1,000,000 - ALL OWNED AUTOS RECEI VED BODILY INJURY $ SCHEDULED AUTOS (Per person) f-- ~ HIRED AUTOS JUL 23 008 BODILY INJURY $ ~ NON-OWNED AUTOS (Per accident) f-- ( FFICIAL RECO )05 AND PROPERTY DAMAGE $ (Per accident) RGE LIABILITY --... ... 1___ DEPT AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ B ~ESS/UMBRELLA LIABILITY OK06501860 06/30/08 06/30/09 EACH OCCURRENCE $9.000 000 X OCCUR 0 CLAIMS MADE AGGREGATE $9 000 000 $ f";1 DEDUCTIBLE $ X RETE~TI(~.tL_~ 0000 _...._ --.----------..--- . $ C WORKERS COMPENSATION AND UB6399Y464 06/30/08 06/30/09 X T WC STATU- I IOJ~- EMPLOYERS' LIABILITY $1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $1.000.000 If yes, describe under $1,000,000 SPECIAL PROVISIONS below E.L. DISEASE. POLICY LIMIT D OTHER Professional DPR9610258 11/26/07 11/26/08 $5,000,000 per claim Liability $5,000,000 annl aggr. DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Professional Liability is written on a claims made and reported basis. 1 COVERAGES CERTIFICATE HOLDER CANCELLATION ACORD 25 (2001/08) 1 of 2 #M167430 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL --3.0..- 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 REPRESENTATIVES. A~ED REPR~TIVE ....,.", Ol.. .to-- RRK @ ACORD CORPORATION 198 City of Clearwater %Public Works Administration 100 South Myrtle Avenue Clearwater, FL 33756