CERTIFICATE OF INSURANCE (2)
ACDROM
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDIYYYY)
3/12/2003
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.
PRODUCER
BARBER AGENCY
2321 SR 580
CLEARWATER, FL 33763
727-733-9385
INSURED HARBOR BARBER & BEAUTY
SALON INC
INSURERS AFFORDING COVERAGE
INSURER A: NATIONWIDE
INSURER B:
INSURER C:
INSURER 0:
INSURER E:
NAIC#
25 CAUSEWAY BLVD
CLEARWATER, FL 33767
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 DD'L POLICY NUMBER b~Y~rM~b5~YE P8k+~~~~6~J}?N LIMITS
LTR NSRD TYPE OF INSURANCE
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
- P~~~;SES (E~<=o~~~~nce\
1f. COMMERCIAL GENERAL LIABILITY $ 50,000
=1 CLAIMS MADE ~I OCCUR MED EXP (Anyone person) $ 5,000
I:- 77B0718051-3001 3-20-03 3-20-04 1,000,000
A PERSONAL & ADV INJURY $
t-- 2,000,000
GENERAL AGGREGATE $
t--
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS,COM~OPAGG $ 1,000,000
!Xl POLICY II ~r8T II LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
'-- (Ea accident) $
ANY AUTO
-
ALL OWNED AUTOS BODILY INJURY
- (Per person) $
SCHEDULED AUTOS
-
HIRED AUTOS BODILY INJURY
~ (Per accident) $
NON,OWNED AUTOS
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
=1 ANYAUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
:=1 OCCUR [] CLAIMS MADE AGGREGATE $
$
R DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSA TIONAND I. W~~TATU- I 10TH-
TORY LIMITS ER
EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $
ANY PROPRIETORlPARTNERlEXECUTIVE
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
II yes, describe under EL. DISEASE - POLICY LIMIT $
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
RE:25 CAUSEWAY BLVD CLEARWATER, FL 33767
CERT HOLDER IS ADDED. AS ADDITIONAL INSURED
CERTIFICATE HOLDER
CITY OF CLEARWATER
25 CAUSEWAY BLVD
CLEARWATER, FL 33767
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL~ 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
ACORD 25 (2001108)
@ ACORD CORPORATION 1988