CERTIFICATE OF LIABILITY INSURANCE (5)??? CERTIFICATE OF LIABILITY INSURANCE OP ID MH DATE (MRDDNYM
'
CLEAR42 11
8 09
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Carlisle Fields & Company, LLC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND 00
P.O. Box 1027 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOIIV.
Clearwater FL 33758-7910
Phone : 727-797-0441 Fax : 727-725-3663 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A: Auto Owners ansurenoe coupmy 18:88
Clearwater Regional Chamber of INSURER B: southern own.ra ansurana. Co. 10300
C
merce
ommerce
Com INSURER C: Ahilad.lphia ans. Coxgmaies
1130 Cleveland Street
Cl
FL 33755-4841
t ._, _
INSURER D: _.?...?
earwa
er -
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.
N
L1'p
TYPE OF INSURANCE
POLICY NUMBER
DA Ip POLICY EXPIRATION
DATE MM1DD/Y
LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1, 006,!, 000
B MERCIALGENERALLIABILITY 2069833109 08/01/09 08/01/10 PREMISES Eaoccurence s 5000,
1 MADE LIOCCUR
7CLAIMS MED EXP (Any one person) s5000,
C PHSD381753 01/24/09 01/24/10 PERSONAL & ADV INJURY $ 1 001_L_000
GENERAL AGGREGATE $ 2 00(11, 000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS • COMP/OP AGG $ 2, 00II, 000
X POLICY JPEROCT LOC
AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT $100060o
D ANY AUTO 2069833109 08/01/09 08/01/10 (Ea accident)
ALL OWNED AUTOS BODILY INJURY
$
X SCHEDULED AUTOS (Per person)
X 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 $
E AUTO ONLY: AGG $
EXCESS IUMBRELLA LIABILITY EACH OCCURRENCE
000
$ 2,0001000
A K I OCCUR F7CLAIMSMADE 4346391200 08/01/09 08/01/10 AGGREGATE $
DEDUCTIBLE $
X RETENTION $10,000 $
OR
AND ERS COMPENSATION
EMPLOYERS' LIABILITY
I 101H
7OFY STATU
ER
YIN - - `
ANY PROPRIETORIPARTNERIEXECUTIVE E.L. EACH ACCIDENT $
[:]
OFFICERIMEMBEREXCLUDED? ?f
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE --
$
II yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
The certificate holder is also named as additional insured with respect to
the general liability policy.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THO EXPIRATION
CITYOC2 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYkb WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO Db SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KND UPON THE INSURER, rM AOaNTS OR
City of Clearwater
Pier City Welcome Center REpREgf'NTATIVES.
Pier 60 AUTHORIZED MATIVE
/? .C
learwater Reach FL 33767 J /_ 1 /V
L
ACORD 25 (2009/01) 01
The ACORD name and logo are registered marks of ACORD
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 25 (2009101)