CERTIFICATE OF LIABILITY INSURANCE (86)10/08/2008 13:10 7274934415 ASE PAGE 02/04
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ACORD. CERTIFICATE OF LIABILITY INSURANCE 1008/2008
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Suncoast Insurance Associates ONLY AND CONFERS NO RIGNTS UPON THE CERTIFICATE
HOLDER, THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
P.O. Box 22668 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Tampa, FL 33622-26SR
813 2895200 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A.- Phoenix Insurance Company 25623
Advanced Systems Engineering, Inc. u=RER9; Travelers Indemnity Company 25658
13555 Automobile Blvd. INSURERC: Travelers Casualty and Surety Co 99038
Suite 330 INSVRERD, XL Specialty insurance Company 37885
Clearwater, FL 33762 n4sURER E:
COVERAGES
THE POLICIES OF INSUHAMt 41STED BELOW MAVE BEEN iswaO To 77•IL- wieum D MAMBO ABOVE FOR THE PQI ICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT. TERM OR CONDRION 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 NHpTE1N IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
GY EFFRgMm Y L=TB
TYPE OF INSURANCE POLICY NUMBER
11L Ism --- A GENERALLIA81LTTY 66MSIL26A 10/02108 10102109 EACH OCCURRENCE P40nonnononon
00A REATa D 00_ 0 000 nneal X t;OMMERc1AL OCHCnAL L"MrrV
CLAIMS MADE CE OCCUR ME0 V0 A onepornon 00ov IN.IURY PERSONAL 8 A
At'ARF ATF
A s2
000
1,
CENER
AGG ,
S2
000
000
GEN-L AGGREGATE LIMIT APPLIES PER
POLICY X PR°' Loc PRODUCTS-COMProP ,
,
B mnoMoWLE LIABILITY BA4883L691 08117108 08117!09 COMBINED BINGLI: LIMIT fEe
eeddenl) 11,000,000
ANY AUTO
ALL OWNED A1TOG RECEI VED
BODILY tw 1RY
(Perpenlon)
SCHEDULED AUTOS
OCT 1 1 4 ((??
LOU8
Px? 1
$
X NON-OWNmAUTOS
PROPERTY DAMAOF
AurooNLY-eaACaDENr $
CARA"LIABILITY ENGINEERING D PARTMENT EA ACC
O Is
ANY AUTO THERTHAN
AUTO ONLY; Ara
I 9
B EXOSSSAIMBRELLA LIAMLIY
X OCCUR El CLAIMS MADE
H DEDUCTIBLE
x R0TCNTIf7N S 0
C WORKERS COMPENSATION AND
EMPLOYERS' UAIMLTfV
ANY PROPRIETORIPARTNERlEXECUr7VE
OFFICERNEMOCR CXCLUD=
ITy M d under
SP5 NS bel
D OTHER Professional
OESCSIPnON OF OPERATIONS y LOCATIONS/ VEHICLES !EXCLUSIONS ADDED GY F.NDORNE11103Ir 19PECU
Professional Liability Is claims made and reported.
Certificate holder Is listed as an additional insured with respect$ to
Goncral Liability, A7,to Liability and Excess Liability policies on a
primary and noncontributory basis. Waiver of Subrogation In favor of the
(See Attached Descriptions)
City of Clearwater
Attn: City Clerk
PO Box 4748
Clearwater, FL 33758-1748
ACORD 26 (2001/08)1 of 3 #5173
08117/08 108117109
08117108 08117109
S
E,L, p18 A4ti-Y II T IM'1 =
0311=9 $2,W0,000 Per claim
;2,000,000 annl e99r.
acloNS
C aT i 2008
I ;, I RECORDS A1,412
Lb ANY OF THE ABOVE DESCRIBED POLICE RE CANCEL,LEO BEFORE THE EV RATaON
TNEREoR, THE ISSUING INSURER YELL ENDEAVOR TO MAIL _W_ DAYS WRITTEN
IE To THE CERTIFICATE HOLDER NAMED TO THE LEFT, BuT PAILURE TD DO SO 814ALL
K NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
A 6--
IWS 4, ACORD CORPORATION 1988
10/08/2008 13:10 7274934415 ASE PAGE 03/04
IMPORTANT
If the cortifwate holder is an AnniTIONAL INSURED. the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terns and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of insurance on the reverse bide of this form dxs not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or after the coverage afforded by the policies listed therm.
ACORD 25-9 (2001X18) 2 of 3 9511325 M17258T
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