CERTIFICATE OF LIABILITY INSURANCE (82)
ACORD.M CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNYYY)
9/2/2008
PRODUCER Phone: 727 461-6044 Fax: 727 442-7695 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Brown & Brown Insurance - Clearwater ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P.O. Box 2456 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Suite 660 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Clearwater FL 33757-2456
INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURERA:Hartford Fire Insurance Co. 19682
Kisinger Campo & Assoc. Corp. INSURERB:Hartford Casualtv Insurance C 29424
KCCS, Inc INSURERC:Lexinaton Insurance Co.
201 N. Franklin Street, Ste 400 19437
Tampa FL 33602 INSURER D:
INSURER E:
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.
I~:: ~~~~ POLICY NUMBER POLICY EFFECTIVE P~~fl,~~~~N LIMITS
A X ~NERAL LIABILITY 21UUNAG7547 9/1/2008 9/1/2009 EACH OCCURRENCE $ 1 000 000
eX- COMMERCIAL GENERAL LIABILITY ~~~~~i~9E~~~~~~nce ) $100 000
I--- ~ CLAIMS MADE Ii] OCCUR MED EXP (Anyone person) $ 5 000
I--- PERSONAL & ADV INJURY $ 1 000 000
GENERAL AGGREGATE $2 000 000
I---
GEN'L AGGREGATE LIMIT APnS PER: PRODUCTS - COMP/OP AGG $2 000 000
rxl POLICY n ~f8;: LOC
A X AUTOMOBILE LIABILITY 21UUNAG7547 9/1/2008 9/1/2009 COMBINED SINGLE LIMIT
r-- $1,000,000
X- ANY AUTO (Ea accident)
- ALL OWNED AUTOS !~ECEIVE D BODILY INJURY
$
SCHEDULED AUTOS (Per person)
-
L HIRED AUTOS o 320m BODILY INJURY
,..~'" $
NON-OWNED AUTOS ....:.... (Per accident)
-
- PROPERTY DAMAGE $
I "\ (Per accident)
GARAGE LIABILITY LEGI~ LAllVE SRVCS )EPT AUTO ONLY - EA ACCIDENT $
1 ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
B X EXCESs/UMBRELLA LIABILITY 21XHUAG7607 9/1/2008 9/1/2009 EACH OCCURRENCE $2 000 000
iJ OCCUR D CLAIMS MADE AGGREGATE $2 000 000
$
;l DEDUCTIBLE $
X RETENTION $10 000 $
A WORKERS COMPENSATION AND 21WBNW1033 10/3/2007 10/3/2008 X I TVX~~T~I8<: I IOJ~-
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $500 000
---- Ol'FIC-eRlMEMBER EXCLUDED? -- -...-" --_.'-- --- _..~ -------- - - - --~-- ---,- -- --- --- -". --- Errns-EASE - EAEMi5I.O Ycc ~500 000 --
~PE~~~~~o~rs1~NS below E.L. DISEASE - POLICY LIMIT $500 000
C OTHER 0530377 11/2/2007 11/2/2008 Per Claim 2,000,000
Professional Liability ~ggregate 5,000,000
Claims Made Deductible 200,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
rertificate Holder is an additional insured with respect to general liability, auto liability and umbrella liability.
~ndorsements available upon request. Waiver of Subrogation applies to general liability and workers compensation. *10
~ays for Non Payment.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
City of Clearwater BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER
WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN NOTICE TO THE
Attn: City Clerk CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO
POBox 4748 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON
Clearwater FL 33758-4748 THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE ~1!.~
ACORD 25 (2001/08)
@ACORDCORPORATION 1988