CERTIFICATE OF LIABILITY INSURANCE (5)I-rom:lcaren Gray FaXID:Barber Agency Page 2 of 3 Date:4r2912009 04:36 PM Page:2 of 3
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? CERTIFICATE OF LIABILITY INSURANCE OP
DATE (MMWA-tYYI
x
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? 04/2s/09
PRODUCER THIS CERTIFICATE IS ISSUED A A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Barber Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
2321 State Road 580 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Clearwater FL 33763
Phone:727-733-9385 Fax:727-734-5252 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Zurich Insurance COm any
INSURER 8:
Harbor Barber & Beauty Salon INSURER C:
2S Causeway Blvd INSURERD
Clearwater Beach FL 33767
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REOUIREMENT, 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.
LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE WINDD DATE (MMIDDNM) LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
A X X COMMERCIAL GENERAL LIABILITY PAS00848160 04/23/09 04/23/10 PREMISES (Ea occurence) $50,000
CLAIMS MADE a OCCUR WED EXP (Any one person) $ 5 , 0 0 0
PERSONAL & ADV INJURY $ Included
GENERAL. AGGREGATE s2,000,000
GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $1,000,000
POLICY P
JECT LOC
AUT OMOBILE LIABILrTY
COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS
(Per person) $
HIRED AUTOS
BODILVINJURY $
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE
P $
(
er accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
H ANY AUTO EA ACC
OTHER THAN $
AUTO ONLY: AGG $
EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR CLAIMS MADE AGGREGATE $
$
DEDUCTIBLE $
RETENTION $ $
WORKER S COMPENSATION
AND EMPL OYERS' LIABILITY YIN TORY LIMITS ER
ANY PROPRIETOR/PARTNERLEXECLMVE ?
OFFICERIMEMBER EXCLUDED? E.L. EACH ACCIDENT $
(Mandatory In NH)
If
e
d
b
d E.L. DISEASE - EA EMPLOYEE $
y
or
s,
escri
e un
SPECIAL PROVISIONS below
E.L. DISEASE- POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS! VE CLE I EXCLUSIONS ADDED BY ENDOROEiRf I SPECIAL PR39ISION8
The below named certificate holder is named an additional insured as their
interests may appear.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
CL`r DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 30 SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
City of Clearwater REPRESENTATNES.
25 Causeway Blvd AUTHOR VIED REPRESENTATIVE
,Clearwater FL 33767
M%% Vnu cV tcVVV1U I ) 0--V T&U-7UV9 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
From:Karen Gray FaxID:Barber Agency Page 3 of 3 Date:42912009 04:36 PM Pagei3 of 3_ _ -a
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s)-
DISCLAIMER
This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized
representative or producer, and the certificate holder, nor does it affirmatively or negatively amend,
extend or alter the coverage afforded by the policies listed thereon.
ACORD