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CERTIFICATE OF LIABILITY INSURANCE (139)
ACORE CERTIFICATE OF LIABILITY INSURANCE 7 DATE(MM/DD/YYYY) M 5/11/2010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Inc. Willis of Illinois ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE , HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 233 S . Wacker Dr ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Ste 2000 Chicago IL 60606 INSURERS AFFORDING COVERAGE NAIL # INSURED INSURERA:Lexington Insurance Company 19437 H. W . Lochner, Inc. INSURER B: N Mr. Paul Blachowicz i INSURERC: te 1200 20 N. Wacker Drive, Su Chica o IL 60606 INSURER D: g W INSURER E: rnVFRAr.FC 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 DD' ... BER U POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR N TYPE POLICY N M DAT DATE (MINDgIrn GENERAL LIABILITY EACH OCCURRENCE $ DAMAG TORENTED ---- - - -- - -GO;?MERGI?.?GENEW4L{IABIiIF-Y- ---.._:._.___...._.-: CLAIMS MADE F1 OCCUR MED EXPSAny one personLu $ ?..?._ PERSONAL &ADV INJURY $ GENERALAGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER; PRODUCTS-COMP/OPAGG $ PR O LOG POLICY AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANYAUTO ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULEDAU705 HIRED AUTOS BODILY INJURY (Peraccident) $ NON-OWNED AUTOS PROPERTYDAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY- EAACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTOONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR FICLAIMS MADE AGGREGATE $ , DEDUCTIBLE $ WC STATU- OTH- WORKERS COMPENSATION AND I TORY LIMITS EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE- EA EMPLOYEE $ If yes,desaibe under SPECIAL PROVISIONS below E-L. DISEASE- POLICY LIMIT $ A OTHER 044177432 5/1/2010 5/1/2011 $1,000, 000 Per Claim Professional Liability $1,000,000 Aggregate DESCRIPT)ON OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS Except for Non-Payment, 10 Days. (_FRTIFIrATF wni nFR CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER City of Clearwater WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN NOTICE TO THE Attention: City Clerk CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO P.O. Box 4748 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON Clearwater FL 33758-4748 THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVACORD 25 (2001/08) ©ACORD'GORPORATION 1998