CERTIFICATE OF LIABILITY INSURANCE (132)
CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
5/4/2010
(201)262-1200 FAX: (201)262-7810
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
PRODUCER
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Fenner & Esler
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
467 Kinderkamack Road
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P. O. Box 60
OradellNJ07649-0060
INSURERSAFFORDINGCOVERAGENAIC#
Charter Oak Fire Insurance
INSURED
INSURER A:
Biller Reinhart Structural Group, Inc.Everest National Insurance
INSURER B:
4014 Gunn Highway, Suite 248
INSURER C:
INSURER D:
TampaFL33618
INSURER E:
COVERAGES
THEPOLICIESOFINSURANCELISTEDBELOWHAVEBEENISSUEDTOTHEINSUREDNAMEDABOVEFORTHEPOLICYPERIODINDICATED.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 OFSUCH
POLICIES.AGGREGATELIMITSSHOWNMAYHAVEBEENREDUCEDBYPAIDCLAIMS.
INSRADD'L
POLICYEFFECTIVEPOLICYEXPIRATION
POLICYNUMBERLIMITS
TYPEOFINSURANCEDATE(MM/DD/YYYY)DATE(MM/DD/YYYY)
LTRINSRD
2,000,000
GENERALLIABILITY
EACH OCCURRENCE$
DAMAGE TO RENTED
X
1,000,000
COMMERCIAL GENERAL LIABILITY$
PREMISES (Ea occurrence)
A
X
3/1/20103/1/201110,000
680-8783L610-COF-10
CLAIMS MADEOCCURMED EXP (Any one person)$
2,000,000
PERSONAL & ADV INJURY$
4,000,000
GENERAL AGGREGATE$
4,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:PRODUCTS - COMP/OP AGG$
PRO-
X
POLICYLOC
JECT
AUTOMOBILELIABILITY
COMBINED SINGLE LIMIT
1,000,000
$
(Ea accident)
ANY AUTO
A
3/1/20103/1/2011
680-8783L610-COF-10
ALL OWNED AUTOS
BODILY INJURY
$
(Per person)
SCHEDULED AUTOS
X
HIRED AUTOS
BODILY INJURY
$
X
(Per accident)
NON-OWNED AUTOS
PROPERTY DAMAGE
$
(Per accident)
GARAGELIABILITY
AUTO ONLY - EA ACCIDENT$
ANY AUTOEA ACC$
OTHER THAN
AUTO ONLY:
AGG$
EXCESS/UMBRELLALIABILITY
EACH OCCURRENCE$
OCCURCLAIMS MADEAGGREGATE$
$
DEDUCTIBLE$
RETENTION$$
WC STATU-OTH-
WORKERSCOMPENSATION
TORY LIMITSER
ANDEMPLOYERS'LIABILITY
Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT$
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE$
If yes, describe under
E.L. DISEASE - POLICY LIMIT$
SPECIAL PROVISIONS below
B
Professional
OTHER
3/1/20103/1/2011$1,000,000
79AE000318-101
Per Claim Limit
Liability
$1,000,000
Aggregate Limit
DESCRIPTIONOFOPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONSADDEDBYENDORSEMENT/SPECIALPROVISIONS
Additional Insured - Certificate Holder as respects general liability where required by written contract.
CERTIFICATE HOLDERCANCELLATION
SHOULDANYOFTHEABOVEDESCRIBEDPOLICIESBECANCELLEDBEFORETHEEXPIRATION
30
City of Clearwater
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAILDAYSWRITTEN
Municipal Services Building,
NOTICETOTHECERTIFICATEHOLDERNAMEDTOTHELEFT,BUTFAILURETODOSOSHALL
Room #220
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
100 S. Myrtle Ave.
Clearwater, FL 33756-5520 REPRESENTATIVES.
AUTHORIZEDREPRESENTATIVE
Timothy Esler/KATHY
ACORD25(2009/01)1988-2009ACORDCORPORATION.Allrightsreserved.
INS025
(200901)
TheACORDnameandlogoareregisteredmarksofACORD
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.
ACORD25(2009/01)
INS025
(200901)
CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
5/4/2010
(201)262-1200 FAX: (201)262-7810
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
PRODUCER
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Fenner & Esler
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
467 Kinderkamack Road
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P. O. Box 60
OradellNJ07649-0060
INSURERSAFFORDINGCOVERAGENAIC#
Charter Oak Fire Insurance
INSURED
INSURER A:
Biller Reinhart Structural Group, Inc.Everest National Insurance
INSURER B:
4014 Gunn Highway, Suite 248
INSURER C:
INSURER D:
TampaFL33618
INSURER E:
COVERAGES
THEPOLICIESOFINSURANCELISTEDBELOWHAVEBEENISSUEDTOTHEINSUREDNAMEDABOVEFORTHEPOLICYPERIODINDICATED.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 OFSUCH
POLICIES.AGGREGATELIMITSSHOWNMAYHAVEBEENREDUCEDBYPAIDCLAIMS.
INSRADD'L
POLICYEFFECTIVEPOLICYEXPIRATION
POLICYNUMBERLIMITS
TYPEOFINSURANCEDATE(MM/DD/YYYY)DATE(MM/DD/YYYY)
LTRINSRD
2,000,000
GENERALLIABILITY
EACH OCCURRENCE$
DAMAGE TO RENTED
X
1,000,000
COMMERCIAL GENERAL LIABILITY$
PREMISES (Ea occurrence)
A
X
3/1/20103/1/201110,000
680-8783L610-COF-10
CLAIMS MADEOCCURMED EXP (Any one person)$
2,000,000
PERSONAL & ADV INJURY$
4,000,000
GENERAL AGGREGATE$
4,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:PRODUCTS - COMP/OP AGG$
PRO-
X
POLICYLOC
JECT
AUTOMOBILELIABILITY
COMBINED SINGLE LIMIT
1,000,000
$
(Ea accident)
ANY AUTO
A
3/1/20103/1/2011
680-8783L610-COF-10
ALL OWNED AUTOS
BODILY INJURY
$
(Per person)
SCHEDULED AUTOS
X
HIRED AUTOS
BODILY INJURY
$
X
(Per accident)
NON-OWNED AUTOS
PROPERTY DAMAGE
$
(Per accident)
GARAGELIABILITY
AUTO ONLY - EA ACCIDENT$
ANY AUTOEA ACC$
OTHER THAN
AUTO ONLY:
AGG$
EXCESS/UMBRELLALIABILITY
EACH OCCURRENCE$
OCCURCLAIMS MADEAGGREGATE$
$
DEDUCTIBLE$
RETENTION$$
WC STATU-OTH-
WORKERSCOMPENSATION
TORY LIMITSER
ANDEMPLOYERS'LIABILITY
Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT$
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE$
If yes, describe under
E.L. DISEASE - POLICY LIMIT$
SPECIAL PROVISIONS below
B
Professional
OTHER
3/1/20103/1/2011$1,000,000
79AE000318-101
Per Claim Limit
Liability
$1,000,000
Aggregate Limit
DESCRIPTIONOFOPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONSADDEDBYENDORSEMENT/SPECIALPROVISIONS
Additional Insured - Certificate Holder as respects general liability where required by written contract.
CERTIFICATE HOLDERCANCELLATION
SHOULDANYOFTHEABOVEDESCRIBEDPOLICIESBECANCELLEDBEFORETHEEXPIRATION
30
City of Clearwater
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAILDAYSWRITTEN
PO Box 4748
NOTICETOTHECERTIFICATEHOLDERNAMEDTOTHELEFT,BUTFAILURETODOSOSHALL
Clearwater, FL 33758-4748
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZEDREPRESENTATIVE
Timothy Esler/KATHY
ACORD25(2009/01)1988-2009ACORDCORPORATION.Allrightsreserved.
INS025
(200901)
TheACORDnameandlogoareregisteredmarksofACORD
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.
ACORD25(2009/01)
INS025
(200901)