CERTIFICATE OF LIABILITY INSURANCE (11)
AcoFiDN CERTIFICATE OF LIABILITY INSURANCE OP ID S~ DATE (MM/DDIYYYY)
HEADS-2 12/28/05
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Brown & Brown Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
17757 US Highway 19 N, Ste 660 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 2456 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Clearwater FL 33757-2456
Phone: 727-461-6044 Fax:727-442-7695 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Landmark American Ins. Co. 33138
INSURER B: Ace American Insurance Co 22667
Head Start Child Development INSURER C: Amarisure Insurance Company. 19488
& Famil~ Services
6698 68 h Avenue, North !D INSURER D:
Pinellas Park FL 33781-50 3
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.
LTR NSRC TYPE OF INSURANCE POLICY NUMBER DATE (MM/DDIYY) 'i5ATE' (MM/DDIYY LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1000000
~
B X X COMMERCIAL GENERAL LIABILITY G20400869 01/01/06 01/01/07 PREMISES (Ea occurence) $ 100000
... ---I CLAIMS MADE [~JOC.CUR ------ .- -"----- - ,. -- _.- , MED EXP (Anyone person) $ 5000 .~_~
--.
~ Prof/Sex Abuse PERSONAL & ADV INJURY $ 1000000
GENERAL AGGREGATE $ 2000000
~
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2000000
Xl .n PRO- nLOC
X POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $ 500000
B ANY AUTO H08123032 01/01/06 01/01/07 (Ea accident)
-
ALL OWNED AUTOS BODILY INJURY
- $
~ SCHEDULED AUTOS (Per person)
~ HIRED AUTOS BODILY INJURY
$
X NON-OWNED AUTOS (Per accident)
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EAACCIDENT $
==l ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
=:JOCCUR D CLAIMS MADE AGGREGATE $
$
==l DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND X IT~~iLI~:i'S I IU~~'
C EMPLOYERS' LIABILITY WC132273407 01/01/06 01/01/07
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 100000
-- OFl"lCIiRIME-MSI::REXCLUDlill? ""_.-~--- .- - .~. --- ---- -... ~-- - E.L. DISE~Al:MPL()YEE $500000
If yes, describe under $ 100000
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT
OTHER
A Property Section LHD338747 01/01/06 06/01/06 On File With
Com'Panv
DESCRIPTION OF OPERATIONS / LOCA nONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Certificate holder is an additional insured for general liability only with
regard to 701 N. Missouri, Clearwater, FL
CERTIFICATE HOLDER
CANCELLATION
CITYOFC
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
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 SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHO D RESENT VE ~
@ ACORD CORPORATION 1988
City of Clearwater
ATTN: Earl Barrett
P.O. Box 4748
Clearwater FL 33758-4748
ACORD 25 (2001/08)