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CERTIFICATE OF LIABILITY INSURANCE (91)
ACORDCERTIFICATE OF LIABILITY INSURANCE 10/2312 8 PRODUCER (727) 391-9791 FAX: (727) 393-5623 Stahl & Associates Insurance, Inc. 110 Carillon Parkway THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. St. Petersburg FL 33716 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A. American States Ins CO 19704 WANNEMACHER JENSEN ARCHITECTS INSURERB:First National Ins Co of 24724 180 MIRROR LAKE DR N INSURERc:New Ham shire Ins Cc INSURER D: SAINT PETERSBURG FL 33701 INSURER E: OVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING AN 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. I REG kTE LIMITS SHOWN MAY HAVE BE q REDUCED BY PAID CLAIMS, ADD'L RD TYPE OF INSURANCE POLICY NUMBER DATEYMWDDIM DATE EXPIRATION LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 r X COMMERCIAL GENERAL LIABILITY PR DAMAG TO EMI ES occRENTEDurrenre) $ 200,000 A CLAIMS MADE 7 OCCUR 01CIO5802310 8/29/2008 8/29/2009 MEDEXP An one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY J ROT LOC AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT 1 000 000 X ANYAUTO (Ea accident) , , $ B ALL OWNED AUTOS 25CC23694010 8/20/2008 8/20/2009 BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC AUTO ONLY: A EXCESS/UMBRELLALIABILRY EACH OCCURRENCE $ 2,000,000 X OCCUR F1 CLAIMS MADE AGGREGATE $ A DEDUCTIBLE 01SU40834201 8/29/2008 8/29/2009 $ RETENTION A WORKERS COMPENSATION AND X F W_ OTH- Toaf LIM S1 I EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED? 01WC25716510 8/20/2008 8/20/2009 E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 C OTHER Professional Liab. Ded. $25,000 43924020 08/29/2008 08/29/2009 $i,ooo,ooo Per Occur. $2,000,000 Aggregate DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Certificate Holder is listed as additional insured with respects to General Liability subject to policy forms & conditions. /?? g " '? IF, City Of Clearwater Central Permitting Attn: KathyBedini 100 S Myrtle Avenue Clearwater, FL 34616 ACORD 25 (2001/08) lucn-jjz4NI,G- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISOM YlyRLRRE(JVI` C 'M TO MAIL 10 DAYS WRITTEN NOTICE TO THE 4_L7i117G)SM(;)r LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE :telly Petzold/GREEN © ACORD CORPORATION 1988 Dena 1 of 9