CERTIFICATE OF LIABILITY INSURANCE (2)
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CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDNYI
02/24/05
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.
PRODUCER
Acordia Southeast, Inc.
P.O. Box 31666
Tampa, FL 33631-3666
727-796-6666
INSURERS AFFORDING COVERAGE
INSURED
INSURER A:
INSURER B:
INSURER C:
INSURER D:
INSURER E:
Hartford Ins Co of SE-01391
Le'azon Technology Institute
Inc.
1250 Palmetto Street
Clearwater FL 33756
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 ~9S~YJ~~~%'R.~~ Pgk!f~Y,~~)~~JJ~~ LIMITS
LTR
A ~ERAL LIABILITY BIND542075 2/18/05 2/18/06 EACH OCCURRENCE $ 1000000
~ COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ 300000
f--- =:J CLAIMS MADE W OCCUR MED EXP (Anyone personl $ 10000
L-- PERSONAL & ADV INJURY $ 1000000
- GENERAL AGGREGATE $ 2000000
~'L AGGREfl LIMIT APn PER: PRODUCTS - COMP/OP AGG $ 2000000
POLICY ~~,9T LOC
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident!
-
- ALL OWNED AUTOS BODILY INJURY
$
SCHEDULED AUTOS (Per person)
-
- HIRED AUTOS BODILY INJURY
$
NON-OWNED AUTOS (Per accident I
-
- PROPERTY DAMAGE $
(Per accident)
==jAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $
~ OCCUR D CLAIMS MADE AGGREGATE $
$
~ DEDUCTIBLE $
RETENTION $ $
. WORKERS. COlv!PENSATIONANli .. . .... I,WC STATUS [ lC;nH- . ~ -
EMPLOYERS' LIABILITY TORY LIMITS ER
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $
E,L DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CITY OF CLEARWATER IS NAMED AS ADDITIONAL INSURED MANAGER OR LESSOR
OF PREMISES AS RESEPCTS TO LOCATION AT 1250 PALMETTO STREET,
CLEARWATER, FL 33756
CERTIFICATE HOLDER I I ADDITIONAL INSUR.ED; INSURER LETTER: CANCELLATION
CITY OF CLEARWATER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
EARL BARRETT/ENGINEERING DEPT NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
P.O. BOX 4748 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
CLEARWATER, FL 33758-4748 REPRESENT J61VES, ./J
AUT~~PR;r;~ V/
I
ACORD 25-S (7/97) 45- 66 ,r f./ V F @ACORD CORPORATION 1988