CERTIFICATE OF LIABILITY INSURANCE (2)
ACORD..
CERTIFICATE OF LIABILITY INSURANCE
OP IDew
CIVIL-l 08/30/04
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.
IIM.TE (MMIDDIYY)
PRODUCER
Huntleigh McGehee
1401 S.Brentwood Blvd.,Ste.625
St. Louis MO 63144
Phone: 314-961-8600
Fax: 314-961-7606
INSURERS AFFORDING COVERAGE
INSURED
INSURER A:
Old Republic Insurance Co.
The Travelers Insurance Co.
INSURER B'
Civil Air Patrol, Inc.
Bldg714,Maxwell Air Force Base
Montgomery AL 36112-6332
INSURER C'
INSURER O.
INSURER E
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWrrHSTANDING
ANY REQUIREMENT, TERM OR CONDIOON OF ANY CON'TRACY 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 CONOJTlONS OF SUCH
POliCIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAlO ClAIMS.
INSR POLICY NUMBER POUCY EFFEClTYE POLICY EXPIRA nON
LTR TYPE OF INSURANCE DATE tMUlDOtYY) DATE (llMlDOIVY) LIMITS
GENERAL UABUTY EACH OCCURRENCE " 3.,000,000
-
A X COMMERCIAL GENERAL lIABILITY AP690407 09/01/02 09/01/05 FIRE DAMAGE (Anyone fire) " 100,000
I CLAlMSMADE ~ OCCUR MED EXP (Anyone person) " 25,000
PERSONAL & AOV INJURY " 1,000,000
I--
GENERAL AGGREGATE " 2,000,000
I--
rx9AGGREGATEAP:~:~PER n PRODUCTS - COMPIOP AGG . 2,000,000
X POLICY JECT lOC
AUTOMOBilE UABllITY COMBINED SINGLE LIMIT
- " 3.,000,000
B X ANY AUTO P810507D1067TIL04 09/01/04 09/01/05 (Ell IIcddenQ
-
ALL OWNED AUTOS BODilY INJURY
- "
SCHEDULED AUTOS CAP515D0138COF04- TBX11B 09/01/04 09/01/05 (Per person)
-
~ HIRED AUTOS BODILY INJURY
.
X NON-OWNED AUTOS "1032804 643TILO 4 -BAIIiU I 09/01/04 09/01/05 (Per accident)
-
- PROPERTY DAMAGE .'
(Pereccident)
GARAGE LIABiliTY AUTO ONLY - EA ACCIDENT .'
=l ANY AUTO OTHER THAN EA ACC "
AUTO ONLY: AGG .
EXCESS lIABILfTY EACH OCCURRENCE .
~ OCCUR o CLAIMS MADE AGGREGATE .'
.'
=l OEOUCTtBLE .
RETENTION . .
X I ~~~T~~~;s I IOTH-
WORKERS COMPENSATION AND ER
EMPLOYERS' LIABILITY OCAWOl779704 09/01/04 09/01/05 3.,000,000
A E.L. EACH ACCIDENT .
E.L. DISEASE. EA EMPLOYEE . 1,000,000
EL DISEASE. POLICY lIMIT " 3.,000,000
OTHER
DESCRIPTtoN Of OPERA nONSJLOCATIONSNEHICLESlEXCLUSIONS ADDED BY ENDOR8EMENTISPECLAl PROVlSIONS
City of Clearwater is included as an additiona1-insured in relation to the
general liability regarding the trailer at 1000 Hercu1es Ave.
CERTIFICATE HOLDER I y I ADDmoNA.L INSUREDj INSURER LETTER: CANCELLATION
CITOFCL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCElLED BEFORE THE EXPIRA nON
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ..3!IL.- DAYS WRITTEN
City of Clearwater NOncE TO THE CERTlFtcA TE HOLDER NAMED TO THE LEFT, BUT FAD..URE TO DO 80 SHALL
Clearwater MUnicipal Marina
IMPOSE NO OBUGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
25 Causeway Blvd
C1earwater FL 33767 REPREsENTAnves.
I AUT~ESENT7_ ~'M ~ U~ A. ~
ACORD 25-S (7/97)
@ACORDCORFORATION1988