Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
CERTIFICATE OF LIABILITY INSURANCE
ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID DI DATE(MM/DD/YYYY) PERS002 10/09/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Bouchard-Clearwater ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 101 Starcrest Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O Box 6090 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. arwater FL 33758-6090 I one:727-447-6481 Fax: 727-449-1267 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Diamond State Insurance Co 42048 INSURER B: SUA Insurance Company 40134 Personal Enrichment Through Mental Health Services Inc INSURER C: Florida Retail Federation SIF 10700 11254 58th Street North INSURER D: Pinellas Park FL 33782 INSURER E: '08 OC T 14 fNi= 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YY DATE MM/DDfD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 B X COMMERCIAL GENERAL LIABILITY _ AGA0003566 10/01/08 10/01/09 PREMISES(Eaoccurence) $ 100,000 CLAIMS MADE F X] OCCUR MED EXP (Any one person) $ 10,000 X Prof Liab PERSONALS ADV INJURY $1,000,000 X $1Mi1/$3 Mil GENERAL AGGREGATE $3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 3,000,000 POLICY PRO LOC JECT Em Ben. 1,000,000 AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 C X ANY AUTO 10SRSNP000001CA0200 4 05/31/08 05/31/09 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) $ X Comp Ded $1,000 PROPERTY DAMAGE $ X Coll Ded $1,000 (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO EA ACC OTHER THAN $ AUTO ONLY AGG $ EXCESS/UMBRELLA LIABILITY - - EACH OCCURRENCE $ 1 CLAIMS MADE 1 OCCUR F AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND ' X TORY LIMITS ER A EMPLOYERS LIABILITY 052028658 07/01/08 07/01/09 E L EACH ACCIDENT $500000 ANY PROPRIETOR/PARTNER/EXECUTIVE . . OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ b I yes, d... be unde, SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 500000 OTHER A Professional Liab AGA0003566 10/01/08 10/01/09 -Ea-Claim.. $1,000,000 Aggregate $3,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS 0"1 2008 OF,' RECORDS '*ID CERTIFICATE HOLDER CANCELLATION CITYOFC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN CITY OF CLEARWATER CITY HALL NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL MICHAEL HOLMES 112 S OSCEOLA AVENUE IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR CLEARWATER FL 33756 REPRESENTATIVES. AUTHOR EP SENTA AUUKU Z5 (ZUU11US) © ACORD CORPORATION 1988