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CERTIFICATES OF INSURANCE VARIOUS DATES ,m: Melanie Paul At: Roger Bouchard Insurance ro: Alice Fax.: (727) 447.3132 Date: 1/2/01 09:01 AM Page ACORD.. CERTIFICATE OF LIABILITY INSURANCE OP ID MP DATE (MMlDDlYYJ KINGE-1 01/02/01 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. ~RODUCER Roger Bouchard Insurance, Inc. 101 Starcrest Drive PO Box 6090 Clearwater FL 33758-6090 Phone: 727-447-6481 Fax: 727-449-1267 INSURERS AFFORDING COVERAGE INSURED NSURER A CONTINENTAL CASUALTY COMPANY TRANSPORTATION INSURANCE CO INSURER B King Engineering Assoc, Inc. 4921 Memorial HWy, Ste. 300 Tampa FL 33634 NSURER C INSURER 0 NSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING !>JoN REQUIREMENT. TERM OR CONDITION OF !>JoN 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 TY~E OF INSURANCE ~OLICY NUMBER ~~::~~ ~~:iY~~::~ LIMITS LTR GENERAL LWlILITY EACH OCCURRENCE $ f--- COMMERCIAl GENERAl LlABlUlY FIRE o.ow.GE (Air( one nre) $ I CLAIMS MADE D OCCUR MED El<P (Air( one person) $ PERSONAl & WoIINJURY $ f--- GENERAl AGGREGATE $ f--- GEN'L AGGREGATE UMIT APPUES PER PROOUCTS - COMPtOP AGG $ II n PRO- nLOC POUCY JECT AUTOMOBILE LIABILITY COMBINED SI'lGLE LIMIT f-- $ IWY AUTO (Ea aCCident) f--- A.I....L OWNED AUTOS BODILY IN...IURY f--- $ SCHEDULED AUTOS (Per person) f--- HIRED AUTOS BODlL y l'oIJlRY f-- $ NON-OWNED AUTOS (Per accident) f--- PROPERTY DAMAGE $ (Per acclljent) QARACE LIAIlILITY AUTO ONLY - EA ACCIDENT $ R ANY AUTO OTHER THAN EAACC $ AUTO ONLY AGG $ EXCESS LIABILITY EACH OCCURRENCE $ =.J OCCUR D CLAIMS MADE AGGREGATE $ $ ==j DEDUCTIBLE i $ RETENTION $ $ I 1 wc STAWl uT om WORKERS COM~ENSATION AND X TORY lIMI~S ER B EMPLOYERS'LIABILITY WCC163672015 01/01/01 I 01/01/02 $ 500000 E L EACH ACCiDENT I $ 500000 E L DlSEASE EA EMPLOYEE E L DISEASE POUCY UMIT $ 500000 OTHER I A PROFESSIONAL AEEl13805181 I 01/01/01 01/01/02 PER CIAIM $3,000,000 LIABILITY CLAIIIB IIl\DI!: III!:TRO 1/1/94 AGGREGATE $3,000,000 OSSC_TION Of Ol'ERATlDNllILOCATIONSNeHlCLI!M!XCLUSIONS ADDEO BY ENDOftseMENTISPEcw..I'ftOVlSlONS FAX 562-4755 CERTIFICATE HOLDER I N I ~ INSURED; INSURER LETTER: CANCELLATION CITOFCL SHOULD.,.., Of THE ABOVE OEllCRIBEll POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUlNO INSURER WILL ENDEAVOR TO MAIL 30 DAYS _TTEN - CITY OF CLEARlfATER NOTICE TO THE CERTI'ICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO EHALL ATTN ALICE IMPOSE NO OBLIGATION OR LIABILITY OF />HY KIND UPON THE INSURER, ITS AOENTS OR 100 S MYRTLE AVE 1220 CLEARWATER FL 33758 REPRESENT&l'IVES. I Q'~ ACORD 25-S (7/97) @ACORD CORPORATION 1988 Jan-04-99 12:01P Roger Bouchard Insuranae 8134491267 P.01 , ACORD~ CERTIFICA E OF LIABILITY INSUR.,AJ PRODUCER Roger Bouchard Insurance, 101 Starereat Drive PO Box 6090 Clearwater FL 33758-6090 Inc. C~PID MP KXNGB-~ 01/04/99 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. COMPANIES AFFORDING COVERAGE DATE (MM/DDIYV) Phone No. 727,:-447 -6i!!-f~~No. 727-449 -1267 INSUR.ED COMPANY . A TRANSPORTATION INSURANCE CO 1 COMP~;---~--'-" ..--- l-- B CNA INSURANCE (VO S~~NNERE~) I COMPANY , C ~- COMPANY D King Bngineering Assoe, Inc. 4921 Memorial Hwy, Ste. 300 Tampa Ji'L 33634 COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED AIlOVE FOR THE POLICY PERIOD INDICATED, NOlWlTHSTANDING ANY REQUIREMENT, TER'" OR. CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO w.iICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURAt4CE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUflJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO I TYPE OF INSU~'NCE . --. --- "I POLICY EFFECTI';; I POLICY ~PIRATION L TR . "'" POLICY NUMBER DATE IMM.DQiYY) DATE (MM/DQiYY) LIMITS GENERAL LIABILITY .] (;?,~MERCIAL GENERAL l:lABILlTY I ~_ m I CLAIMS MADE I OCCUR OWNER'S & CONTAACTOR'S PROT GENERAL AGGREGIloTE 1 $ PRODUCTS, COMP/OP AGG I s r :::::~U::~:~:JUR: -~ . ,-- FIRE D;MA.GE (Any .,.;~ f:re!~ S -.. MED EXP (Any 0"" person) $ I AUTOMOBILE LIABILITY "lA/llYAUTO . ALL OWNED AUTOS I. SCHEDULED AUTOS , HIRED AUTOS I NON-OWNED AUTOS ~_~CESS LIABILITY I UMBRELLA FORM I' . OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND I EMPLOYERS' LIABILITY A ,THE PROPRIETOR! INCL \. PARTNERSiEXECUTNE OFFICERS ARE: EXCL OTHER WCC16367201S 01/01/99 0~/01/00 I COMBINED SINGLE L14 I BOOllYINJURY" . S .--- :::~~:URY '-+: I (Per aCCldentj -- .'----J ~____ I PROPERTY DAMAGE $ .' AUTO O. NLY.. ~A. CCIDENT. ..~_. OTHER THAN AlJTO ONLY L-.. f-=- EAC:~~~:~1 ~:== ,EACHOCCUR~ENCE =t..---.. I AGGR.EGATE '..-. $ '.-'.._ $ X t5R~T~1~i-L...JOJ~' .,!L EACH ACCIDENT_ ,I $ 50000 O. EL DISEASE '.POLlCY,L1MIT ,!, 500000 _. I El DISEASE, EA EMPLOYEE I s 500000 L~~AAGE LIABILITY ~,. I ANY AUTO ! )~ I .[ B ! PROPESS:IONAL ! LIABIL.ITY ABNl13805181 01/01/99 01/01/00 PER CLA.IM AGGR.EGATE $3,000,000 $3,000,000 DESCRIPTION OF OPEAATIONS/lOCATIONSNEHICLESlSPEClAlITEMS PAX 562-4755 CERTIFICATE HOLDER CITY OF CLEARWATER A'M'N ALICE 100 S MYRTLE AVE #220 CLBARWATER FL 33758 CANCELLATION CITOFCL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ~ DAYS WRmEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO MAil SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES. AUTHO:fZ7Y V/~ . .. ACORD CORPORATION 1988 ACORD 25-$ (1195) ;I/; ACORD~ . .....R.~...fK]..I...~..,..~.~[I.....Il.~.......~.,.~;.r..~.,.]~.....~..IJ.I._.......... ........I..~iI~Gi;.i............................ DA;~;;/;~^;~ 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. COMPANIES AFFORDING COVERAGE Inc. PRODUCER Roger Bouchard Insurance, 101 Starcrest Drive PO Box 6090 Clearwater FL 33758-6090 r.. Phone No. INSURED r 727-447-6481 Fax No. 727-449-1267 COMPANY A CONTINENTAL CASUALTY COMPANY COMPANY B TRANSPORTATION INSURANCE CO King Engineering Assoc, Inc. 4921 Memorial Hwy, Ste. 300 Tampa FL 33634 COMPANY C THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE INDICATED, NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE (MMlDDIYY) DATE (MM/DDIYY) GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG $ CLAIMS MADE D OCCUR PERSONAL & ADV INJURY $ OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ FIRE DAMAGE (Anyone fire) $ MED EXP (Anyone person) $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT AGGREGATE EXCESS LIABILITY EACH OCCURRENCE UMBRELLA FORM AGGREGATE OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND ,I;Mf'LOYERS'..lI!\BllIIY B THE PROPRIETOR! INCL WCC163672015 01/01/00 01/01/01 EL DISEASE - POLICY LIMIT PARTNERS/EXECUTIVE OFFICERS ARE: EXCL EL DISEASE - EA EMPLOYEE OTHER A PROFESSIONAL AEE113805181 01/01/99 01/01/01 PER CLAIM $3,000,000 LIABILITY CLAIMS MADB RBTRO 1/1/94 AGGREGATE $3,000,000 DESCRIPTION OF OPERA TIONSlLOCA TIONSNEHICLES/SPECIAL ITEMS FAX 562-4755 CITOFCL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ~ 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 COMPANY, ITS AGENTS OR REPRESENTATIVES. CITY OF CLEARWATER ATTN ALICE 100 S MYRTLE AVE #220 CLEARWATER FL 33758