CERTIFICATE OF INSURANCE
ACORDN
CERTIFICATE OF LIABILITY INSURANCI;IN8~~~ MP DA~Ed~~~D~)2
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
Bouchard-Starcrest
101 Starcrest Drive
POBox 6090
Clearwater FL 33758-6090
Phone: 727-447-6481 Fax:727-449-1267
INSURERS AFFORDING COVERAGE
King Engineering Assoc, Inc.
and King Engineering Assoc,
Inc. dba King + Rob1nson
4921 Memorial Hwy Ste 300
Tampa FL 33634
COVERAGES
INSURER A:
INSURER B:
INSURER C:
INSURER 0:
INSURER E:
CONTINENTAL CASUALTY COMPANY
TRANSPORTATION INSURANCE CO
INSURED
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.
INSR TYPE OF INSURANCE POLICY NUMBER ~~HfrMiXb5~YE P~.k+~~~~6~J:.?N LIMITS
LTR
GENERAL LIABILITY EACH OCCURRENCE $
-
COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $
I CLAIMS MADE n OCCUR, MED EXP (Anyone person) $
PERSONAL & ADV INJURY $
-
GENERAL AGGREGATE $
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $
~ nPRO- h
POLICY JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- (Ea accident) $
ANY AUTO
-
ALL OWNED AUTOS BODILY INJURY
f-- (Per person) $
SCHEDULED AUTOS
f--
HIRED AUTOS BODILY INJURY
f-- $
NON-OWNED AUTOS (Per accident)
r--
1--- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
==l ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $
:=J OCCUR D CLAIMS MADE AGGREGATE $
$
==l DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND X I TORY LIMITS I IU~~'
B EMPLOYERS' LIABILITY WCC163672015 01/01/03 01/01/04 $ 500000
E.L. EACH ACCIDENT
---.- , -"- " - , - --~ -. , - ---~ '-' $ 5-60-06-0'
'E,t:OISEAse-'1:A EMPLOYEE ---~- c.___~.
E.L. DISEASE - POLICY LIMIT $ 500000
OTHER
A PROF.LIAB.- AEAl13805181 01/01/03 01/01/04 PER CLAIM $2,000,000
CLAIMS MADE FORM RETRO DATE 1/1/94 AGGREGATE $5,000,000
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
FAX 562-4755
CERTIFICATE HOLDER 1 N T ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
CITOFCL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
CITY OF CLEARWATER NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
ATTN ALICE IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
100 S MYRTLE AVE #220
CLEARWATER FL 33758 REPRESENJ./I.TIVES.
I AUTHOR\!yt::::Z
ACORD 25-5 (7/97)
@ ACORD CORPORATION 1988