CERTIFICATE OF INSURANCE (4)
ACORD...
CERTIFICATE OF LIABILITY INSURANC~Ti>r~~ J DA~E2(;~~D;;4
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
Mutual Insurance Agency
at Clearwater, Inc.
P.O. Box 1779
Clearwater FL 33757-1779
Phone: 727-446-6064 Fax:727-442-9751
INSURERS AFFORDING COVERAGE
INSURED
Bruce Littler! Inc.
25 Causeway B vd.
Clearwater FL 33767-2064
INSURER A:
INSURER B:
INSURER C:
INSURER 0:
INSURER E:
Auto Owners
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 MAYBE 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 ~TEIMM/DDcmyE DAfE'IM~rJ'fimN LIMITS
LTR
GENERAL LIABILITY EACH OCCURRENCE $ 1000000
-
A X COMMERCIAL GENERAL LIABILITY 91-130168-00 04/01/04 04/01/05 FIRE DAMAGE (Anyone fire) $ 50000
I CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 5000
PERSONAL & ADV INJURY $ Excl.
GENERAL AGGREGATE $1000000
,--
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COM~OPAGG $
4 POLICY n ~~g: n LOC
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)
~
~ ALL OWNED AUTOS BODILY INJURY
(Per person) $
SCHEDULED AUTOS
-
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 $
EXCESS LIABILITY EACH OCCURRENCE $
~ OCCUR D CLAIMS MADE AGGREGATE $
$
R DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND I TORY L1wrs I IO~
ER
EMPLOYERS' LIABILITY E.L. EACH ACCIDENT
$
'.____o._
E.L. DISEASE - EA EMPLOYEE $
EL DISEASE - POLICY LIMIT $
OTHER
A Plate glass 04/01/04 04/01/05 AC:V
DESCRIPTION OF OPERATlONSlLOCATIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAl PROVISIONS
Gift shop
City of Clearwater is named as an Additional Insured.
CERTIFICATE HOLDER I N I ADDmONAL INSURED; INSURER LETTER: CANCELLATION
CITYOO1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYSWRmEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
City of Clearwater IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Bill Morris - Harbormaster
25 Causeway Blvd REPRESENTATIVES.
Clearwater FL 33767-2604 AUTHORIZED REPONTAZE ~,.
I John Gav .-X'"
ACORD 25-5 (7/97) U () @ACORDCORPORATION 1988