CERTIFICATE OF LIABILITY INSURANCE (6)
~1 ACORDTM CERTIFICATE OF LIABILITY INSURANCE
::!RODUCER
7
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.
AIM Insurance Group, Inc.
AIM INSURANCE AGENCY
P.O. Box 860
INSURERS AFFORDING COVERAGE
NAIC#
,INSURED
Clearwater Group A.A.
P.O.Box 518
Clearwater, FL 33757
INSURER A:
INSURER B:
INSURER C:
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,
,':ISR ~DD'L POLICY NUMBER ~~';!~YME~~6gT~~E Pgk~CE~~~I~~WN LIMITS
'. TR NSRD
_,A GENERAL LIABILITY CPS0556826 12/08/2003 12/08/2004 EACH OCCURRENCE $
- ~~~~~~sT~aR~~J~~ncel
:::' X COMMERCIAL GENERAL LIABILITY $ 1
~ I CLAIMS MADE ~ OCCUR - MED EXP (Anyone person) $ 'innn
"
"~ -X. PR1i:MTSES/OPRRATIO if PERSONAL & ADV INJURY $
-X. GENERAL AGGREGATE $ 1
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $
I POLICY 1;1 P'~Ri- n LOC
'If ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO lEa accident)
~ f-----
ALL OWNED AUTOS BODILY INJURY
f----- $
SCHEDULED AUTOS IPer person)
f-----
HIRED AUTOS BODILY INJURY
f----- $
NON-OWNED AUTOS IPer accident}
-- f-----
(
f----- PROPERTY DAMAGE $
(Per accident)
RAGE LIABILITY ~ ~ rn rn ~"I AUTO ONLY - EA ACCIDENT $
ANY AUTO 0 ~ ~ W OTHER THAN EA ACC $
IN , r
AUTO ONLY: AGG $
-
., EXCESS/UMBRELLA LIABILITY R. MN I 2 200fJ ~ EACH OCCURRENCE $
;"'; o OCCUR D CLAIMS MADE AGGREGATE $
/,
$
:ti
R DEDUCTIBLE ( ITY OF ClEAR\-"', r HI $
PtlBlI WORKS ADMiN!SI 'Mlr:N
RETENTION $ $
WORKERS COMPENSATION AND I TVX~~I{iJI~S I IOJ~-
EMPLOYERS' LIABILITY
- E,L. EACH ACCIDENT $
----- .AI\IY PROf'RIHD RIP ABINEBL~)(E C UTIYE .. - --- --- ---- ~~- ---_._--~ --- - ~ ~. - --._----- ,---- "n~_ ------. --------. . "-------
'. OFFICER/MEMBER EXCLUDED? E,L, DISEASE - EA EMPLOYEE $
:<
l If yes. describe under
SPECIAL PROVISIONS below E,L, DISEASE - POLICY LIMIT $
A OTHER CPS0556826 12/08/1993 12/08/2004 $53,000 ACV Spec. Form Bldg.
Property 10% Wind Ded I $6,000 ACV Spec. Form Conts.
- i
,,:JESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
(
-
-
,City OI Clearwater is hereby named as Additional Insured, as their interest may appear.
if
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~= ....
-GERTIFICATE HOLDER
CANCELLATION
;{
,..'1
..
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City OI Clearwater
Earl Barrett
Real Estate Services Manager
P.O. Box 4748
Clearwater, FL 33758-4748
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL J.-O- 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
_,\CORD25 (2001/08) @ ACORD CORPORATION 1988