CERTIFICATE OF LIABILITY INSURANCE (2)OP ID MF
ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MM/bD/YYYY)
NEIGH-2 12/04/08
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Scarr Insurance Group HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
8200 113th Street N Ste 202 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Seminole FL 33772
Phone : 727-393-5055 Fax: 727-392-0497 INSURERS AFFORDING COVERAGE NAIC 0
INSURED INSURER A: Nationwide Mutual Fire Ina Co 11111
INSURER B:
PINELXJkS GORE MANAGE 4ENT
SERVICES INC INSURER C:
.
4500 1401-H AVE N # ST 220
LEARWATER FL 33762-3803 INSURER D:
C
INSURER E:
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.
IN.5K
LTR AIPQ'?
NSR
TYPE OF INSURANCE
POLICY NUMBER POLICY EFFECTIVE
DATE MMIDDIYY ICY
PDATE M DOlYY N
LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A X COMMERCIAL GENERAL LIABILITY 77BO4807433001 09/10/08 09/10/09 PREMISES Eaoccursma $ 50 000
CLAIMS MADE OCCUR MED EXP (Any one person) $ 5, 000
PERSONAL & ADV INJURY $1,000,000
J u y
-~ .__.
ry ^T _GENERs4LAGGREGATE .,__. _-$ ,aO_L,..QIDO---.
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $1,000,000
X POLICY PRO
JECT LOC
AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT
$
ANY AUTO (Ea accident)
ALL OWNED AUTOS 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: AGG $
EXCESS/UMBRELLA LIABILITY
I EACH OCCURRENCE $
OCCUR F-1 CLAIMS MADE ?? -LIB- --- - AGGREGATE $?
$
DEDUCTIBLE I FE 2009 $
RETENTION $ $
WORKERS COMPENSATION AND '? --- TORY LIMITS ER
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
•
-•-
•=..... ,•-•--•- E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? .
E.L. DISEASE - EA EMPLOYEE
$
If yes, describe under
SPECIAL PROVISIONS below - E.L. DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Subject to policy terms, conditions & exclusions
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLil) BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSU$ER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLfR NAMED TO LFT, BUT FAILURE TO DO SO SHALL
City of Clearwater IMPOSE NO OBLIGATION OR LlAg(LITY OP A?WKI UIJ aO bIFyNSURER, ITS AGENTS OR
c/o Parks and Recreation
PO Box 4748 REPRESENTATIVES. ! 7v'Ir
Clearwater FL 33758--4748 AUTHORIZED FtIEPRESE?hAtW:.1
Bar Scarr
ACORD 25 (2001108) 0 ACORD CORPORATION 1988