CERTIFICATE OF LIABILITY INSURANCE (150)Client: 2962
SDIENVI3
ACORDTM CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDDJY
/01/2010 YYY)
09
PRODUCER
ISU Suncoast Insurance Assoc
P.O. Box 22668 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.
Tampa, FL 33622.2668
813 289-5200
INSURERS AFFORDING COVERAGE
NAIC #
INSURED INSURERA: Phoenix Insurance Company 25623
SDI Environmental Services, Inc. INSURER B: Travelers Indemnity Company 25658
3903 Premier North Drive INSURER c: Travelers Casualty and Surety C 19038
Tampa, FL 33618 INSURER D: American Safety Indemnity Compa 25433
INSURER E:
RA\/FRA2FC
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
ANY REQUIREMENT
,
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.
S
LTR
NSR TYPE OF INSURANCE POLICY NUMBER DATEYMM/DDTNE POLITE MMMPIDD/TYIY) LIMITS
A GENERAL LIABILITY 680196OL23A 06/30/10 06/30/11 EACH OCCURRENCE $1,000,000
COMMERCIAL GENERAL LIABILITY - -DAMAGE TO RENTED n $1 000 QOO
CLAIMS MADE ? OCCUR MED EXP (Any one person) $10,000
N PERSONAL BADV INJURY $1110001000
GENERAL AGGREGATE s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000
POLICY PRO LOC
JECT
B AUTOMOBILE LIABILITY BA25621_144 07/29/10 07129/11 COMBINED SINGLE LIMIT
d
t 000
$1
000
ANY AUTO en
)
(Ea acci ,
,
RE ENEa
ALL OWNED AUTOS BODILY INJURY
$
SCHEDULED AUTOS (Per person)
X HIRED AUTOS L+C O 2010 BODILY INJURY
$
X NON-OWNED AUTOS
?JG
(Peraccident)
FICi RECORDS D PROPERTY DAMAGE $
OF (Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
B EXCESS/UMBRELLA LIABILITY CUP6416Y164 06/30110 06/30/11 EACH OCCURRENCE $1,000,000
X OCCUR D CLAIMS MADE AGGREGATE $1,000,000
$
DEDUCTIBLE $
X RETENTION $10,000 $
49/0 11 WC STATIJ- OTH-
y1FOytyCERgCnneo?nice?pu eun _ _ _ _
EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $1,000,0QO
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
E.L. DISEASE - EA EMPLOYEE
$1,000,000
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$1,000,000
D OTHER professional ENV0106241006 09/02/10 09/02111 $1,000,000 per claim
Liability $1,000,000 annl aggr.
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Professional Liability is written on a claims made and reported basis.
City of Clearwater
Attn: City Clerk
PO Box 4748
Clearwater, FL 33758-4748
rol
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 31l_ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
AUiFjORIZEDe ft 0 p1TA 1,-
ACORD 25 (2001108) 1 of 2 #S269270/M269267 MRL 0 ACORD CORPORATION 1198S
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
The Certificate of Insurance on the reverse side of this form 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.
ACORD 25-S (2001/08) 2 of 2 #S269270/M269267