CERTIFICATE OF LIABILITY INSURANCE
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CERTIFICATE OF LIABILITY INSURANC~LB2~l~ DA~E~~~o;';o)3
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
Bouehard-atarerest
101 Starerest Drive
POBox 6090
Clearwater FL 33758-6090
PhoneI727-447-6481 FaxI727-449-1267
INSURED C earwa ter Au tomot ve, Inc.
Pasco Auto Salvage Inc.
Hudson Auto & T~ck Parts, Ine
Salvage Properties
Joel Kehrer & Frank L McKinley
205 Greenwood Avenue South
Clearwater FL 33756
INSURER k
INSURER B:
INSURER C:
INSURER 0:
INSURER E:
INSURERS AFFORDING COVERAGE
VALLBY FORGB INSURANCE CO
SCOTTSDALE INSURANCE COMPANY
AKBRICAN STATES INSURANCE CO
BRIDGBPIBLD EMPLOYERS INS CO
COVERAGES
THE POliCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEOAIIOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT. TERM OR CONDITION OF AN'( CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HE~ IS SUBJECT TO AlL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAlO CLAIMS.
'~f~ TYPE OF INSURANCE POLICY NUMBER IlI.TE lMM/DfiIYYj , DATE 1rJ6~N LIMITS
GENERAL LIABILITY EACH OCCURRENCE 51,000,000
r-- 05/01/03 05/01/04
A X COMMERCIAL GENERAL LIABILITY C4000555817 FIRE DAMAGE (Anyone fire) 550,000
_...o.._ ~ -' lAiMS"MADe- [!] OCCUR -= -..."-=,. -_._-,_.,'-'~.__. - .-' -_.~~- __~.;.___...J.__ . "-,,-.,--.-. -._- ::- MEOW (Anyone PeBQnl 5 '5-; U-O lr-'""~
PERSONAL & AOV INJURY 51,000,000
r--
GENERAL AGGREGATE $2,000,000
r--
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS.COM~OPAGG $ 2,000,000
n POLICY n ~~8r n LOC
AUTOMOBILE LIABIUTY COMBINED SINGLE LIMIT $1,000,000
-
C X ANY AUTO 01CG34221301 05/01/03 05/01/04 (Ea aeddent)
-
AlL OWNED AUTOS BODILY INJURY
- S
SCHEOULED AUTOS (Per penon)
-
X HIRED AUTOS BOOIL Y INJURY
- 5
..!. NON-QWNED AUTOS (Per accident)
- PROPERTY DAMAGE 5
(Per accident)
GARAGE LIABILITY AUTO ONLY. EA ACCIDENT 5
~ ANY AUTO OTHER THAN EA ACC 5
AUTO ONLY: AGG 5
EXCESS LlA8IUTY EACH OCCURRENCE 51,000,000
B :!J OCCUR D CLAIMS MADe UMSOO13555 05/01/03 05/01/04 AGGREGATE 51,000,000
5
;::1 DEDUCTIBLE 5
X RETENTION S 10, 000 $
. WORKERS COMPENSATION AND ' - . '". .-.... X hORYUMrrsl ',_Iu~~. "
D EMPLOYERS' LIABILITY 0830-05801 04/01/03 04/01/04 E.L EACH ACCIDENT $ 100000
E.L. DISEASE. EA EMPLOYEE S 100000
E.L. DISEASE. POLICY LIMIT S 500000
OTHER
DESCRIPTION OF OPERATIONSIlOCATIONS/VEHICLE.SIEXCLUSIONS ADDED BY ENDORSEMENTISPEClAl PROVISIOHlI
Certificate Holder is listed as Additional Insured as respects to General
Liability subject to the terms, conditions and exclusions of the policy~
CERTIFICATE HOLDER I y I ADDITIONAL lNSUlWl; INSURER LETTER: CANCELLATION
-..,.- .-. - .-- ' . C:ICIoOOl SHOULD IU4Y OF THE ABOVE DESCRIBED .POUCIES BE CA/tlCELLED BEFORE T.HE EXPIRATION
DATI! THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ....3.ll...- DAYS WRITTEN
City of Clearwater NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Attnl Bldg :Inspection Div
P.O. Box 4748 IMPOSE NO OBUGATION OR UA8lUTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Clearwater FL 34618 REPRISE IL'TIVES.
I AUTHO .~ y~
ACORD 2S-S (7/97)
CACORD CORPORATION 1988