CERTIFICATE OF LIABILITY INSURANCE (9)
II
Client#. 6108
GRIMCRA3
. ,1: I
':4 CORDm CERTIFICATE OF LIABILITY INSURANCE DATE (MMJDDIYY)
10/18/05
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
813289-5200 INSURERS AFFORDING COVERAGE
INSURED INSURER A: United States Fidelity & Guaranty
Grimail Crawford, Inc. INSURER B: St Paul Fire & Marine
5444 Bay Center Dr. INSURER C: Hudson Ins Company
Suite 204 INSURER D:
, I Tampa, FL 33609 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.
INSR TYPE OF INSURANCE POLICY NUMBER Pgk!fl EFFECTIVE P~~il trlrrJ~N LIMITS
LTR
A GENERAL LIABILITY BK01231322 10/14/05 10/14/06 EACH OCCURRENCE $1 000000
e--
eX- COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $300 000
e-- ~ CLAIMS MADE [X] OCCUR MED EXP (Anyone person) $10000
PERSONAL & ADV INJURY $1 000 000
GENERAL AGGREGATE $2 000 000
n'L AGGRErii L1M IT APnS PER: PRODUCTS -COMP/OP AGG $2 000 000
POLICY X P,W,: LOC
~TOMOBIL~ LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)
f--
ALL OWNED AUTOS BODILY INJURY
I-- $
SCHEDULED AUTOS (Per person)
I--
I-- HIRED AUTOS BODILY INJURY
$
NON-OWNED AUTOS (Per accident)
I--
I-- PROPERTY DAMAGE $
(Per accident)
RRAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $
tJ OCCUR D CLAIMS MADE AGGREGATE $
$
R IDEDUCTIBLE $
RETENTION- $ ..,,' __,c - -- -'-- - - - $
B WORKERS COMPENSATION AND WVA7753374 OS/22/05 OS/22/06 X IT~~~TfJI~i- I IOJ~-
EMPLOYERS' LIABILITY $1,000,000
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPL OYEE $1,000,000
E.L. DISEASE - POLICY LIMIT $1,000,000
C OTHER AEE7137100 OS/29/05 OS/29/06 $1,000,000 per claim
Professional $1,000,000 aggregate
Liabilitv
DESCRIPTION OF OPERA TIONS/LOCA TIONSIVEHICLESJEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Professional Liability is claims made and reported.
RE: Engineer of Record - Mike Crawford
CERTIFICATE HOLDER I I ADDmONALINSURED'INSURERLETTER: CANCELLATION
SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Clearwater DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30....- DAYS WRITTEN
Susan Chase, Document & Records Supervisor NOTICETOTHE CERTIFICATE HOLDER NAMED TOTHELEFT, BUTFAlLURE TODOSOSHALL
PO Box 4748 IMPOSE NO OBLIGATION OR LIABILITYOF ANY KIND UPON THE INSURER,ITS AGENTS OR
Clearwater, FL 33758-4748 REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
I J).-1 ~ ~ A:2 --..
ACORD 25-5 (7/97)1 of 2
#M112721
KEB
@ ACORD CORPORATION 1988