CERTIFICATE OF LIABILITY INSURANCE (88)Oct 23 08 03:28p Plisko Rrch 727447GS14 p.2
AC-000- CERTIFICATE OF LIABILITY INSURANCE 1012`3,2008 "
THIS CERTIFICATE IS ISSUED AS A VATTER OF INFORMATION
PRODUCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Suncoast Insurance Associates HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Box 22668
P
O ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
.
.
Tampa, FL 33622-2668
813 289-5200 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A: Phoenix insurance Company 25023
Plisko Architecture, P.A., AIA INSURER B: Travelers Casual and Sure Co 19038
800 Drew St INSURER c: XL Specialty Insurance Compan 37885
Clearwater, FL 33755 INSURER D: Travelers Indemnity Compan 25658
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED To THE IN5UHW NAMMU . vvw r ?. • ?_ ??•? • •• •- - - -- -
ACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTR
EXCLUSIONS AND CONDIT IONS OF SUCH
D HEREIN IS SUBJECT TO ALL THE TERMS
,
THE INSURANCE AFFORDED BY THE POLICIES DESCRIBE
MAY PERTAIN
,
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
POLICIES
.
POUC POL EXP TION LIMITS
MW WE LTR N TYPE OF INSURANCE POLICY NUMBER
008/08 06/18/09
EACH OCCURRENCE 1$1.0 O OO
A GENERAL LIABILITY 6604492M466 DAMAG TO RENTED $1 00 00
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE a OCCUR
MED EXP (Any one mon) 1$5,000
PERSONAL & ADV INJURY Si 000 000
GENERAL AGGREGATE 32,000,000
PRODUCTS. COMP/OPA $2000000
GEN-L AGGREGATE LIMIT APPLIES PER:
POLICY PRO- LOC
D AUT OMOBILE LIABILITY OM49ZM755 O6JISM OWN09 COMBINED SINGLE LIMIT $1,000,000
(Ea accident)
ANY AUTO
ALLOWNEDAUTOS BODILY INJURY
(Perporoon) $
SCHEDULED AUTOS
X HIRED AUTOS
INJURY
BODILY.)
ncr?
(Per
$
X NON-OWNED AUTOS
PROPERTY DAMAGE
(Per acadent) §
AUTO ONLY - EA ACCIDENT $
GARAGE LIABILITY C EA ACC S
H ANY AUTO ?TCR OTHER TI IAN
AU-MNLY. AGG $
EACH OCCURRENCE $
EXCESSIUMBRELLA LIABILITY C G pEp
` t,
ER`? AGGREGATE $
OCCUR CLAIMS MADE v G
S
$
DEDUCTIBLE
RETENTION $
UB708GY545
09/01/08
09/01/09 WC STATU OTH-
X
B WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY ACCIDENT
El EACH $100,000
ANY PROPRIETOR/IEXECUTIVE -
E L. DISEASE • EA EMPLOYEE $100 000
OFFICERrtvIEMBER EXCLUDED?
000
CY LIMIT 1$600
e6, describe una
of
r
,
E.L. DISEASE . POLI
1001
NS
VISIO
IAL
PC
OTHER Professional
DPR9617109
09/11/08
09/11/09
$1,000,000 per claim
$1,000,000 annl aggr.
r iability
OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
0.MRIP*rION
essional Liability is written on a claims made and reported basis. ? ?
CCj 312008
rceTlKlr+AT^ Hni nPA
City of Clearwater
PO Box 4748
Clearwater, FL 33758-4748
,El- ION IGIH?.ICw..
1,ANY OFTHE ABOVE DE BEFORE THE EXPIRATION
1EREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _3D_. DAYS WRITTEN
TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
A A070 REPREASEL4TA_TIV'E
Is Ic o ACORD CORPORATION 198E
ACORD 25 (2001/08)1 of 2 #5114141IMl / 1001