CERTIFICATE OF LIABILITY INSURANCE (3)
ACORDN
CERTIFICATE OF LIABILITY INSURANCE
OP ID DATE (MM/DDNYYY)
CIVIL-1 08 29 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
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PRODUCER
Huntleigh McGehee
8235 Forsyth Boulevard, #1200
Clayton MO 63105
Phone: 314-746-4700 Fax:314-889-3700
INSURED
INSURERS AFFORDING COVERAGE
INSURER A: Old Re ublic Insurance
INSURER B: St. Paul Travelers
INSURER C:
INSURER 0:
INSURER E:
NAIC#
Co.
Civil Air Patrol Inc.
Bldg714,Maxwell Air Force Base
Montgomery AL 36112-6332
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSI,IRED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OFANY 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,
LTR NSRI TYPE OF INSURANCE POLICY NUMBER ~~l'E iMM/DDNYI I POLICY EXP'!R~.T.!,.~N LIMITS
DATE MM/DDNY
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
~
A X COMMERCIAL GENERAL LIABILITY AP690409 09/01/05 03/01/07 PREMISES (Ea occurence) $100,000
I CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 25,000
PERSONAL & ADV INJURY $1,000,000
GENERAL AGGREGATE $2,000,000
GEN'L AGGREGATE LIMIT APnS PER: PRODUCTS - COMP/OP AGG $ 2,000,000
Xl ,n PRO-
X POLICY JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
-
B ~ ANY AUTO PBI0507DI067TCT05 - ADS 09/01/05 09/01/06 (Ea accident)
ALL OWNED AUrOS POCAP515D013805 - 'l?c 09/01/05 09/01/06 BODILY INJURY
I--- $
SCHEDULED AUTOS PBI032BD4643TIL05 - HI 09/01/05 09/01/06 (Per person>
~
~ HIRED AUTOS BODILY INJURY
(Per accident) $
~ NON-OWNED AUTOS
,,' "
PROPERTY DAMAGE $
(Per accident)
RRAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
o OCCUR o CLAIMS MADE AGGREGATE $
$
R DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND X ITb'~iLI~:-VS I IU~~-
A EMPLOYERS' LIABILITY OCAWOl779705 09/01/05 09/01/06 EL. EACH ACCIDENT $1,000,000
ANY PROPRIETOR/PARTNERlEXECUTIVE
OFFICERlMEMBER EXCLUDED? EL. DISEASE - EA EMPLOYEE $ 1,000,000
g~E(:I~Ls~~OV~~?O~S below EL. DISEASE - POLICY LIMIT $ 1,000,000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
City of Clearwater is included as an additional insured in relation to the
general liability regarding the trailer at 1000 Hercules Ave.
CITOFCL
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
CERTIFICATE HOLDER
City of Clearwater
Clearwater Municipal Marina
25 Causeway Blvd
Clearwater FL 33767
@ACORDCORPORATION 1988
ACORD 25 (2001/08)