CERTIFICATE OF LIABILITY INSURANCE (79)
ACORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY)
02/20/08
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
813 289~5~ INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Phoenix Insurance Company 25623
Advanced Engineering & Design, Inc. INSURER B: Travelers Casualty and Surety Co 19038
3931 68th Avenue North INSURER C: XL Specialty Insurance Company 37885
Pinellas Park, FL 33781 INSURER D: Travelers Indemnity Company 25658
INSURER E:
Client#: 5243
ADVAENG3
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITI;iSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TE~MS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I~T5: ~~~ TYPE OF INSURANCE POLICY NUMBER PJll-{~~::~8~E ~~flf~~~~N LIMITS
A GENERAL LIABILITY 6808134L554 02/15/08 02/15/09 EACH OCCURRENCE $1 000 000
I-- DAMAGE TO RENTED
eX- COMMERCIAL GENERAL LIABILITY $1 000000
I-- ~ CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $5 000
PERSONAL & ADV INJURY $1 000000
GENERAL AGGREGATE $2 000 000
~'L AGGREnE LIMIT APFlS PER: PRODUCTS - COMP/OP AGG $2 000 000
POLICY j~8T LOC
D ~TOMOBILE LIABILITY BA1268M149 02/15/08 02115/09 COMBINED SINGLE LIMIT
ANY AUTO (Ea accident) $1,000,000
-
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS (Per person)
-
~ HIRED AUTOS BODILY INJURY
~ NON-OWNED AUTOS (Per accident) $
- PROPERTY DAMAGE $
(Per accident)
~RAGE LIABILITY AUTO ONLY. EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
::=JESS/UMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR D CLAIMS MADE AGGREGATE $
$
=1 DEDUCTIBLE $
RETENTION $ $
B WORKERS COMPENSATION AND UB7080Y49 09/01/07 09/01/08 X I T~~~!ffJ,~;" I 10J~'
EMPLOYERS' LIABILITY $100,000
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? E.L. DISEASE. EA EMPLOYEE $100,000
If yes. describe under $500,000
SPECIAL PROVISIONS below E.L. DISEASE. POLICY LIMIT
C OTHER Professional DPF9611125 02115/08 02/15/09 $2,000,000 per claim
Liability $2,000,000 annl aggr.
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Professional Liability is written on a claims made and reported basis.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Clearwater DATE TliEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ----30.... DAYS WRITTEN
Attn: Kathy Bedini 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 REPRESENTATIVES. ,
~ED REPR~TIVE
.,.,... Ql.., .4l ~
ACORD 25 (2001/08) 1 of 2
#M159795
KHK
@ ACORD CORPORATION 1988