CERTIFICATE OF LIABILITY INSURANCE (90)OCT-23-2008 01:34P FROM:AUDE SHAND 7275390099 TO:5624755
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ACORD. CERTIFICATE OF LIABILITY INSURANCE
o %29/08°'Yr''
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
PRODUCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Suneoast Insurance Associates HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P
O. Box 22668 ALTER THE COVERAGE AFFORDED 13Y THE POLICIES BELOW.
,
Tampa, FL 33622-2668
813 289-5200 INSURERS AFFORDING COVERAGE NAIL #
INSURED INSURERa Old Dominion Insurance Com an 40231
Robert Aude Associates Inc AIA INSURER em Travelers Indemnity Company 25658
19353 U.S. Hwy 19 N INSURER C: Travelers Casualty and Surety Co 19036
Ste 101 INSURER D. XL Specialty Insurance Company 37885
Clearwater, FL 33764 INSURER E: Charter Oak Fire Insurance Company 25615
COVERAGEb
EEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
THE POLICIES OF INSURANCE LISTED BELOW HAVE B
R OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT O
EXCLUSIONS AND CONDITIONS OF SUCH
SCRIBED HEREIN IS SUBJECT TO ALL THE TERMS
,
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DE
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
POLICY F ECTIVE EXPIRATION
POLICY
LIMITS
NSW WD1
S
TYPE OF INSURANCE
POLICY NUMBER
MMID I
VY)
417 07122108 07122109
0
EAC
CE $1,000,00
E
H OCCU
A GEN ERAL LIABILITY BPG98 RR
N
AMAGI
3500 000
X COMMERCIAL GENERAL LIABILITY
a MED EXP An one Person) $5,000
OCCUR
CLAIMS MADE PERSONAL A ADV INJURY s1 000 000
1
!
GENERAL AGGREGATE 000
000
s2
PRODUCTS • COMP/OP AGG $2,000,000
GENL AGGREGATE LIMIT APPLIES PER:
POLICY PR LOG
E AUT OMOBILE LIABILITY BA2951L75208 08107108 06107109 COMBINED SINGLE LIMIT 81
000,000
(Ee scadent) ,
X ANY AUTO
ALL OWNED AUTOS BODILY INJURY $
(Per person)
SCHEDULEOAUTOS
X HIREDAUTOS BODILY INJURY
(Per accident) s
X NOWOWNEO AUTOS
PROPERTY DAMAGE S
(Per ncddent)
AUTO ONLY - EA ACCIDENT S
GA RAGE LIABILITY
R THAN EA ACC $
ANY AUTO OTHE
AUTO ONLY AGG 8
CUP7113YO95IND08 07122108 07122109 EACH OCCURRENCE $1.000,000
B EXCESSIUMBR£LLA LIABILITY
El AGGREGATE $1.000,000
CLAIMS MADE
X OCCUR
S
$
DEDUCTIBLE
X RETENTION $10000
UB7080Y385
09101108
09101/09
STU• O R
X OR TA $
C WORKERS COMPENSATION AND 000
EMPLOYERS' LIABILITY E,L, EACH ACCIDENT $500,
ANY PROPRIETORIPARTNER/EXECUTIVE
MEMBER EXCLUDED7
E.L. DISEASE- EA EMPLOYEE
$600,000
OFFICER(
If yes, describe under
E16 DISEASE -POLICY LIMIT
MUM
SPECIAL PROVISIONS below
D OTHER Professional DPR9613711 07/20108 07120109 $2,000,000 per claim
000,000 annl aggr.
$2
Liability ,
DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES I EXCLUSIONS ADDED BY ENDORBEMENT I SPECIAL PROVISIONS
Professional Liability Is claims made and reported
City of Clearwater is an additional Insured wlrespect to General Liability
and Auto Liability. Waiver of Subrogation is included except for Workers CCU 31 2008
Compensation.
City of Clearwater
Attn: City Clerk
P.O. Box 4748
Clearwater, FL 33758-4748
SHOULD ANY OF THE ABOVE DBSCRIBED POLICI" BH CANCELCEU-BEFORL?TPI01 CAVINArM
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL An 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
AU ORIZED REPRES TATIVE
- nn00n12ATlnk1 10019
ACORD 25 (2001108) 1 of 2 NS1691371M169135 nco