CERTIFICATE OF LIABILITY INSURANCE
IL70RD CERTIFICATE OF LIABILITY INSURANCE CSR AD DATE(MM/DD/YYYY)
FOUNVIL 10/17/07
PfC ,R THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Greg Roe Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
9851 State Road 54 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
w Port Richey FL 34655
one:727-376-0030 Fax:727-376-2262 INSURERS AFFORDING COVERAGE NAIC#
SURED INSURER A: Riverport Insurance Company 04377
Foundation Village
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l INSURER B: Underwriters at Lloyd's
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y Center, Inc
Family Center, Inc.
o- INSURER C:
918 W
odlawn t .
Clearwater FL 33756 INSURER D:
INSURER E:
%1vvCr%AWC0
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 SUC1407 OC T 18 Am11:41
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER I Y E TIVE
DATE MM/DD/YY POLICY P RATION
DATE MM/DD/YY
LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
A X COMMERCIAL GENERAL LIABILITY NIA1813818 10/01/07 10/01/08 PREMISES (Eaoccurence) $10 0,000
CLAIMS MADE OCCUR MED EXP (Any one person)
0 Q
$5,0
PERSONAL & ADV INJURY $ 1
0 0 0
0 0 0
,
,
GENERAL AGGREGATE s3
000
000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRO PRODUCTS - COMP/OP AGG ,
,
s3,000,000
POLICY
LOC
JECT
AU TOMOBILE LIABILITY
ANY AUTO COMBINED SINGLE LIMIT
(Ea accident) $1,000,000
ALL OWNED AUTOS
A
X
SCHEDULED AUTOS
NIA1813818
10/01/07
10/01/08 BODILY INJURY
(Per person)
$
A X HIRED AUTOS NIA1813818 10/01/07 10/01/08
A
X
NON-OWNED AUTOS
NIA1813818
10/01/07
10/01/08 BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO
OTHER THAN EA ACC
$
AUTO ONLY: AGG $
EXCESSWMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR 71 CLAIMS MADE AGGREGATE $
DEDUCTIBLE
RETENTION $ $
WORKERS COMPENSATION AND T
EMPLOYERS' LIABILITY . _
TORY LIMITS ER
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFIC E.L. EACH ACCIDENT $
ER/MEMBER EXCLUDED?
If yes, describe under
E.L. DISEASE - EA EMPLOYEE
$
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $
OTHER
A Sexual/Prof Liab NIA1813818 10/01/07 10/01/08 Sxl/Prof 1,000,000
B Building Cov 7255 02/22/07 02/22/08 Bldg Cov 303,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ^? ^ ^
,
FAXED TO 727 562 4037.,
NO ? ' _ 200
( 9F \L RECORDS AND
(_FRTICIf`ATC unr nCo
14411111 At (VC Jf%V --
CITYCLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
CITY OF CLEARWATER DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
• ATTN: MARIE ORSELLO NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
112 So. OSCEOLA AVENUE IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
CLEARWATER FL 33756 REPRESENTATIVES.
AU
1Z D REPRESENTATIV
77
ACORD 25 f200110R1
v ACURO CORPORATION 1988