CERTIFICATE OF INSURANCE POLICY # CPP0710364
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CERTIFICA lE OF LIABILITY INSU
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NC-= OP 10 S
~LLI-2 11/02/01
THIS CERTIFICATE IS SUED 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.
DATE (MMIDDfYY)
PRODUCER
The Connelly Insurance Group
630 Chestnut Street
P.O. Box 2456
Clearwater FL 33757-2456
Phone: 727-461-6044 Fax:727-442-7695
INSURED
INSURERS AFFORDING COVERAGE
Lee Arnold & Associates
dba Colliers Arnold
121 North Osceola Avenue
Clearwater FL 33755
INSURER A
INSURER B:
INSURER C
INSURER D
INSURER E
Cincinnati Insurance Co
Hartford Insurance Group
Hartford Fire Insurance Co.
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,
Irif TYPE OF INSURANCE POLICY NUMBER b~~~iM'f[,~~9J.W Pgk+~~9~r6~~?N LIMITS
GENERAL LIABILITY
t-----
A X COMMERCIAL GENERAL LIABILITY CPP0710364
I CLAIMS MADE ~ OCCUR
~
~
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
EACH OCCURRENCE $1,000,000
11/01/01 11/01/02 FIRE DAMAGE (Anyone fire) $ 100,000
MED EXP (Anyone person) $ 5,000
PERSONAL & ADV INJURY $1,000,000
GENERAL AGGREGATE $ Unlimi ted
PRODUCTS - COMP/OP AGG $2,000,000
COMBINED SINGLE LIMIT $500,000
11/01/01 11/01/02 (Ea accident)
BODILY INJURY $
(Per person)
f-- .--".
BODILY INJURY $
(Per accident)
----~,-
PROPERTY DAMAGE $
I (Per accident)
AUTO ONLY - EA ACCiDENT $
OTHER THAN EA ACC $
._--
AUTO ONLY: AGG $
EACH OCCURRENCE $5,000,000
11/01/01 11/01/02 AGGREGATE $5,000,000
$
~
~--
GEN'L AGGREGATE LIMIT APPLIES PER:
I POLICY n jrc?T n LOC
~TOMOBILE LIABILITY
A i X ANY AUTO CPP0710364
~
~
-
~
GARAGE LIABILITY
=1 ANY AUTO
EXCESS LIABILITY
A ~ OCCUR D CLAIMS MADE CCC4407054
R- DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
:-. -.-- ---
$
$
--,-
C
21WBEU3012
___OlIO 1 / 0 1-_~OljQ:!' LO?
x I TORy'UMITS] IU~~-
E,L, EACH ACCIDENT $
E.L DISEASE - EA EMPLOYEE $
EL. DISEASE - POLICY LIMIT $
50P,QOO__
500,000
500,000
OTHER
B Crime Section
21DDDLA4133
11/01/01
11/01/02
See below
See below
DESCRIPTION OF OPERATlONS/LOCATlONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Re: 121 N. Osceola Avenue, Clearwater, FL. Certificate Holder is
as Additional Insured.
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CERTIFICATE HOLDER
I N I ADDITIONAL INSURED; INSURER LETTER:
CANCELLATION
I"TV nr ,...--1
L.II r I.t- I, < '7~'.J
rUHI h, WoRKS AO;':'iiSiRATlON
CITY080
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ....3L 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!!!!:!.O~ED REPRESENTATIVE a
r nall,mll J , .
City of Clearwater
Attn: Earl Barrett
Public Works Administration
P.O. Box 4748
Clearwater FL 33758-4748
I
ACORD 25-S (7/97)
.
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@ACORD'eORPORATION 1988