CERTIFICATE OF INSURANCE (23)
Client#: 6108
GRIMCRA3
ACORDru
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDNY)
OS/27/05
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.
PRODUCER
Suncoast Insurance Associates
P.O. Box 22668
:rampa, FL 33622.2668
813289-5200
INSURERS AFFORDING COVERAGE
Grimail Crawford, Inc.
5444 Bay Center Dr., Suite 204
Tampa, FL 33609
INSURER 1.; United States Fidelity & Guaranty
INSURER B: St. Paul Fire & Marine
INSURER c: Hudson Insurance CO.
INSURER 0:
INSURER E:
INSURED
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.
~:: TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE P~~l EXPIRATION LIMITS
A ~NERAL LIABILITY BK01231322 10/14104 10/14/05 EACH OCCURRENCE $1 000.000
X. COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $300,000
- :=J CLAIMS MADE [i] OCCUR MED EXP (Anyone person) $10 000
PERSONAL & ADV INJURY $1.000.000
I--
GENERAL AGGREGATE $2,000.000
I--
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS .COMP/OP AGG $2.000.000
n POLICY n ~~g: n LOC
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)
f--
f-- ALL OWNED AUTOS BODILY INJURY
(Per person) $
f-- SCHEDULED AUTOS
f-- HIRED AUTOS BODILY INJURY
(Per accident) $
f-- NON.OWNED AUTOS
f-- PROPERTY DAMAGE $
(Per eccident)
RGE LIABILITY AUTO ONLY. EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $
o OCCUR D CLAIMS MADE AGGREGATE $
$
~ DEDUCTIBLE $
RETENTION $ $
B WORKERS COMPENSATION AND WVA7153374 05122/05 OS/22/06 X I we STATU. I IOJ,!;'-
EMPLOYERS' LIABILITY $100,000
E.L EACH ACCIDENT
E.L DISEASE. EA EMPL OYEE $100,000
E.L DISEASE - POLICY LIMIT $500 000 .
C OTHER AEE7137100 05129/05 OS/29/06 $1,000,000 Each Claim
Professional $1,000,000 Ann Aggr
iability
DESCRIPTION OF OPERATIONSlLOCA TIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Professional Liability is written on a claims made and reported basis.
CERTIFICATE HOLDER I I ADDITlONALINSURED'INSURERLETTER: CANCELLATION
SHOULD lIMYOf' THE ABOVE DESCRIBED POLICIES BE CIIMCELLED BEFORE THE EXPIRATION
City of Clearwater DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAlL30..-DAYSWRITTEN
Engineering Department NOTlCETOTHE CERTIFICATE HOLDER NAMED TO THE LEFT, BUTFAlLURE TODOSOSHALL
Suite 220 IMPOSE NO OBLIGATION OR L1AB ILlTY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
PO Box 4748 REPRESENTATIVES.
Clearwater, FL 33758-4748 AUTHORIZED REPRESENTATIVE
I ~ h\- ^-'11 ~ I:J ......
ACORD 25-8 (7/97)1 of 2
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@ ACORD CORPORATION 1988