CERTIFICATE OF INSURANCE (3)
~
CERTIFICATE OF LIABILITY INSURANCE
PRODUCER
Barber Agency
2321 SR 580
Clearwater,FL,33763
727-733-9385
INSURED Harbor Barber
..~ '....
DATE (MMIDDIYYYY)
3/25/2004
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
AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
& Beauty Salon Inc.
INSURERS AFFORDING COVERAGE
INSURER A: Hartford
INSURER B:
INSURE~ 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 NMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERnFICATE MAY BE ISSUED OR
MAY PERTAIN, TI-'E INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREII\ IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY I-'AVE BEEN REDUCED BY PAID ClAII.t1S.
INSR ~O;:;~ I TYPE no: INSURANCE POLICY NUMBER re.Y~~~~E 'd'.kii;~~~8~.J.}~N 1I MrTS
LTR
GENERAL LIABILJlY I EACH OCCURRENCE Is 1,OOO,OGO
~""""'" G,,,.... ""'''''' PREMISES lea. 10ccurencel S 50,000
CLAIMS MADE ~ OCCUR: ,\.1ED EXP (Aty tw1e person) $ 5,000
A 21 SEM 8M 2130 DV 4/23/2004 4/23/2005 PERSONAL & ArW INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
i--' . 1,000,000
GE,'1'L AGGRrlE LIMIT APPLIES PER: PRODUCTS. COMPIDP AGG , $
~I PRO- II
POLICY JEeT LOC
AUTOMQBILELIABILITY COMBINED SINGLE LIMIT S
ANVAUTO I (Ea accident)
I
ALL OWNED AUTOS BOD'L Y INJURY
SCHEDULED AUTOS (Per person)
, HIRED AUTOS BODLY/NJURY
~ ~roMITOO (Peracddenl) $
PROPERTY DAMAGE $
(PeraOCidenl)
GARAGE LIABILITY AUTO ONLY - EA '-CCIDENT S
R ANY AUTO OTHER THAN EAACC $
AUTO ONLY: AGG $
pM''''''' U~""y EliCH OCCURRENCE S
OCCUR C CLAIMS MADE I ~"''''''' I: ,
~
I
R DEDUCTIBLE S
RETENTION S $
, I T~~~I~JI'=fS ! IUlr-
WORKERSCOMPENSATlONAND I ER
el.1PLOVERS' LIABILITY EL EAOHACCIOetT S
AN' PROPRIETO~PARTNERlEXECUTlVE
OFFICERiMEMBl::R EXCLUDED? EL DISEASE. EA. EMPLOYEIi $
If yes. describe u.1der E,L DISEASE. POLICY UMrT I $
SPECIAL PROVISIONS below
OTHER
s
$
. DESCRIPTION OF OPERA nONS I LOCATIONS /VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
25 Causeway Blvd Clearwater, FL 33767
Certificate holder is listed as additional insured
CERTIRCATE HOLDER
CANCElLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE C.'UIlCELL::D BEFORE THE EXPJRATIO
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0 DAYS WRITTEN '
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT F~ TO D:> SO SHALL I
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES. .
IZED REPRESEplfATIVE
'{)~ /~
City of Clearwater
25 Causeway Blvd
Clearwater, FL 33767
@ACORDCORPORATlON1988
a'd
SE:ZE:SZl.l.al.
A~H.J3~l:j ~38~l:j8
daa:ao vD sa .J~h1