CERTIFICATE OF LIABILITY INSURANCE (6)_ r6orn:uo Aayasone t-axlu:l3arber Agency Page 2 of 2 Date:6/32010 09:08 AM Page:2 of 2
°O? CERTIFICATE OF LIABII
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EX
BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT., If the certificate holder Is an INSURED, ADDITIONAL the po
the terms and conditions of the policy, certain policies may require an on,
certificate holder In lieu of such endorsement(s).
IODUCER
Bob Barber Enterprises, Inc.
2321 State Road 580
Clearwater FL 33763
Phone:727-733-9385 Fax:727-734-5252
IN4v KCu
Harbor Barber S Beauty Salon
25 Causeway Blvd
Clearwater Beach FL 33767
NUMBER:
(MM/DONYYY)
OPID GX
.ITY INSURANCE 7
1
6/02/10
0
ID CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
SEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
cy es must be endorsed. WAIVED, If SUBROGATION 18 subject to
lorsement. A statement on this certificate does not confer rights to the
NAME:
PHONE rAA
C, No EKIII: (A/C, No):
ADDRESS:
PRODUCER
CUSTOMER ID is HARBO-1
INSURER(S) AFFORDING COVERAGE NAIC i
INSURERA: Zurich Insurance company
INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUI
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIt
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
N5R AD
DIYWY) (MMIDD /YYYY
LTR TYPE OF INSURANCE 17LIM POLICY N UMBER (MMID
.1%;y rpt' L11
GENERAL LIABILITY
MERCIALGENERALLIABILITY 00848160 04/23/10 04/23/1.
CLAIMS-MADE (571
OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER
POLICY I I JECT F-1 LOC
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
UMBRELLA LIAR OCCUR
EXCESS LIAR CLAIMS-MADE
UtUUCTIBLE
RETENTION $
X
AND EMPLOYERS' LIABILITY Y / N
ANY PRO PRIETOR/PARTNERUEXECUTIV
OFHCER/MEMBER EXCLUDED? /A
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
RECE D
JUN 0 4 2010
LEGISLATIVE
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remake Schedule, It more space Is required)
The below named certificate holder is named an additional insured a
interests may appear.
CERTIFICATE HOLDER
CANCELLATION
K=Vl*lVN NUMestK:
ED ABOVE
LENT W ITH RESPECT TO WHICH THIS
IS SUBJECT TO ALL THE TERMS,
LIMITS
EACH OCCURRENCE $ 1,000,000
• PREMISES(Eeoceurrence) $50,000
MED EXP (Any one person) $5,000
PERSONAL & ADV INJAJRY s Included
GENERAL AGGREGATE $2,000,000
PRODUCTS - COMP/OPAGG s 1 0001000
COMBINED SINGLE LIMIT $
(Ea accident)
BODILY INJURY (Per person) $
BODILY INJURY (Per aocident) $
PROPERTY DAMAGE $
(Per eccldsnt)
$
$
EACH OCCURRENCE $
AGGREGATE $
s
TORY LIMITS ER
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYE $
E.L. DISEASE-POLICY LIMIT
$
s their
CLEf1RI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
WC THE EXPIRATION DATE THEREOF, NOTICE WALL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
city of Clearwater
25 Causeway Blvd
(Clearwater FL 3376
ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD