CERTIFICATE OF LIABILITY INSURANCE (2)Client: 2476
HARVJOL3
ACORD- CERTIFICATE OF LIABILITY INSURANCE 12/29
08D"YYY)
1
PRODUCER THIS CERTIFICATE,IS ISSUED AS A MATTER OF INFORMATION
Suncoast Insurance Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P.O. Box 22668 RECEP THIS CERTIFICATE DOES NOT AMEND, EXTEND
E COVERAGE AFFORDED BY THE POLICIES BELOW.
&
K
Tampa, FL 33622.2668 T
L.
1.0
813 289-5200 INSURERS AFFORDING COVERAGE NAIC #
INSURED JAN 2 1 A: Phoenix Insurance Company 25623
Harvard Jolly, Inc. INSURER B: Travelers Casualty and Surety Co 19038
2714 Dr. Martin Luther King Jr St N INSURER C: XL Specialty Insurance Company 37885
St Petersburg, FL 33704 CITY OF CLEA RWAM:
BNGMERIN
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.
INSR
LTR DP
NSR
TYPE OF INSURANCE
POLICY NUMBER POLICY EFFECTIVE
DATE (MMrP.QCM_ POLICY EXPIRATION
T M D
LIMITS
A GENERAL LIABILITY 66065141-487 11/08/08 11/08/09 EACH OCCURRENCE $1,000,000
X COMMERCIAL GENERAL LIABILITY DAMAGES 1 RENTED $1,000,000
CLAIMS MADE 7 OCCUR IVIED EXP (Any one person) $10,000
PERSONAL & ADV INJURY $110001000
GENERAL AGGREGATE s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $2,000,000______
POLICY ER PRO- LOC
AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT
ANY AUTO
1 (Ea accident) $
S
ALL OWNED AUTO
I BODILY INJURY
SCHEDULED AUTOS
L "
. •
(Per Parson) $
HIRED AUTOS BODILY INJURY
1 JAN _ 7 20
H 09 (Per accident) $
NON-AWNED AUTOS
L
PROPERTY DAMAGE
_
(Per accident) $
GARAGE LIABILITY ??, I-? - ..:._ .-_.... .-._.R .•-_•---- -? AUTO ONLY - EA ACCIDENT S
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG S
A EXCESS/UMBRELLA LIABILITY CUP7798Y577 11/08/08 11/08/09 EACH OCCURRENCE $4 000 000
X OCCUR FICLAIMS MADE AGGREGATE s4,000,000
S
DEDUCTIBLE $
X RETENTION $ 10000 $
B WORKERS COMPENSATION AND UB523BY87909 01/01/09 -01/01/10
O7H-
X WCSTATU-
T II
EMPLOYERS' LIABILITY
C
E
E.L. EACH ACCIDENT
$110001000
ANY PROPRIETOR/PARTNER/EXE
UTIV
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $1,000,000
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT 1
$1,000,000
C OTHER Professional DPR9613427 06/30/08 06/30/09 $3,000,000 per claim
Liability $3,000,000 annl aggr.
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Professional Liability is claims made and reported.
RE: City of Clearwater
Certificate holder is listed as an additional Insured with respects to the
General Liability policy.
CERTIFICATE HOLDER CANCELLATION
City of Clearwater
Engineering Dept.
100 S. Myrtle Ave.
Clearwater, FL 33756
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 4_ 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
V-%,;P _ -
ACORD 25 (2001/08) 1 of 2 #M177959 KEB ® ACORD CORPORATION 1988