CERTIFICATE OF LIABILITY INSURANCE (10)
M;ORQM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNYYY)
12/27/2005
PRODUCER (813)282-1965 FAX (813)282-9374 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Icassiter-Ware Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
5600 Mariner Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Suite 215
Tampa, Fl 33609 INSURERS AFFORDING COVERAGE NAIC#
INSURED H & H Mechanical, Inc. INSURER A Admiral Insurance Company 24856
P.O. Box 1196 INSURER B Continental Casualty Co 20443
Brandon, FL 33 509 INSURER C Great American Insurance Group
INSURER D Amerisure Insurance Companies
INSURER E Transportation Insurance Co
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.
I~i': ~~?;~ TYPE OF INSURANCE POLICY NUMBER Pt?l-~~Y EFFECTIVE POLICY EXPIRATION LIMITS
GENERAL LIABILITY CAOOOO07575-01 09/01/2005 09/01/2006 EACH OCCURRENCE $ 1,000,000
-
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 50,000
- ~ CLAIMS MADE 00 OCCUR
MED EXP (Anyone person) $ Excluded
A X Contractual Liab. PERSONAL & ADV INJURY $ 1,000,000
-
X XCU Included GENERAL AGGREGATE $ 2,000,000
f--
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,000
n POLICY [Xl jr~T n LOC
AUTOMOBILE LIABILITY C2011511693 09/01/2005 09/01/2006 COMBINED SINGLE LIMIT
f-- $
X ANY AUTO (Ea accident) 1,000,000
f--
ALL OWNED AUTOS BODILY INJURY
f-- $
SCHEDULED AUTOS (Per person)
B f--
X HIRED AUTOS BODILY INJURY
f-- (Per accident) $
X NON-OWNED AUTOS
f--
f-- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
R ANY AUTO OTHER THAN EAACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY SBE5965954-01 09/01/2005 09/01/2006 EACH OCCURRENCE $ 5,000,000
o OCCUR D CLAIMS MADE AGGREGATE $ 5,000,000
C $
R DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND WC-2025973-01 01/01/2006 01/01/2007 X I WC STATU- I IOJ~-
EMPLOYERS' LIABILITY $ 500,000
D ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? EL. DISEASE - EA EMPLOYEE $ 500,000
If yes, describe under EL. DISEASE - POLICY LIMIT $ 500,000
SPECIAL PROVISIONS below
OTHER 2077252374 09/01/2005 09/01/2006 $40,000 Per Disaster limit
nstallation/Builders
E Risk - $5,000 Transit $40,000 Any Single location
Li mi t_ $1. 000 Ded/5%Wi nd/Hai 1 Oed.
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
1E: All Operations
C
City of Clearwater
PO Box 4748
Clearwater, Fl 34618-4748
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
-1L DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
~
Kirk Bramlett/CSMITH
ACORD 25 (2001/08)
@ACORDCORPORATION 1988
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
The Certificate of Insurance on the reverse side of this form 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 25 (2001/08)