CERTIFICATE OF INSURANCE (6)
PRODUCER (910) 509-9000
Walker Taylor Agency, Inc.
1430 Commonwealth Drive #302
Wilmington, NC 28403
FAX (910)509-9006
DATE (MMlDDlYYYY)
08/01/2003
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.
. A09RQ. CERTIFICATE OF LIABILITY INSURANCE
INSURED McKim & Creed, PA
P.O. Box 806
Wilmington, NC 28402
INSURERS AFFORDING COVERAGE
INSURER A: Hartford Fi re Insurance CO
INSURERB: Hartford Ins Co of the Midwest
INSURER C:
INSURER D:
INSURER E:
NAIC#
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDINI
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITfi 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 fiAVE BEEN REDUCED BY PAID CLAIMS.
1f'J41: ~~,?;I TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
GENERAL LIABILITY 22UUNIA9447 05/15/2003 05/15/2004 EACH OCCURRENCE $ I,OOO,OO(]
rx- COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 300,000
I CLAIMS MADE [K] OCCUR MED EXP (Anyone person) $ 10,00(]
A X PERSONAL & ADV INJURY . $ 1,000,000
f--
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS.COMP~PAGG $ 2,000,000
II POLICY rxl ~~8i n LOC
AUTOMOBILE L1ABILrrY 22UENAM0684 05/15/2003 05/15/2004 COMBINED SINGLE LIMIT
~ (Ea accident) $ 1,000,000
ANY AUTO
f--
ALL OWNED AUTOS BODILY INJURY
f-- (Per person) $
SCHEDULED AUTOS
A X "X
HIRED AUTOS BODILY INJURY
~ (Per accident) $
NON.OWNED AUTOS
r--
PROPERTY DAMAGE $
(Per accident)
GARAGE L1ABILrrY AUTO ONLY. EA ACCIDENT $
~ ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESSIUMBRELLA LIABILITY 22XHUUA0618 05/15/2003 05/15/2004 EACH OCCURRENCE $ 4,000,000
:KJ OCCUR D CLAIMS MADE AGGREGATE $ 4,000,000
A X $
~ DEDUCTIBLE $
X RETENTION $ 10,OO(] $
WORKERS COMPENSATION AND 22WBIG6643 05/15/2003 05/15/2004 X IlX<6~T ~II~;' I IOJ~-
EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 1,000,000
B ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? E.L. DISEASE. EA EMPLOYEE $ 1,000,00(]
If yes, describe under E.L. DISEASE. POLICY LIMIT $ 1,000,00(]
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS' LOCATIONS' VEHICLES' EXCLUSIONS ADDED BY ENDORSEMENT' SPECIAL PROVISIONS
,
Policy Conditions and Exclusions apply.
E
City of Clearwater
Attn: Dina Katsougrakis
Muni ci pa lServi ces Building
100 South Myrtle
Clearwater, FL 33756
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
3L DAYS WRITTEN NOTICE TO THE CERTIRCATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE bth~ ~
Deborah Church DC
ACORD25(2001/08) FAX: (727)461-3827
@ACORD CORPORATION 1988