CERTIFICATE OF LIABILITY INSURANCE- AC�R[�M CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
09/10/2010
PRO�UCER (727�797_5193 FAX (727)797-8605 7HIS CERTIFICATE IS 15SUED AS A MATTER QF INFORMA710N
Al l ey, Rehbaum & Capes Assurance, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
2433 Gul f to Bay Bl vd. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 4620 --
C7earwater, FL 33758 INSURERS AFFORDING COVERAGE NAIC #
IN5URED �anus Researc � I11C. INSURERA: WdPtfOf'LI I�1S. CO. of S.E. (FL) 38261
1107 N. Ward Street �r,suREaa: Hartford Underwriters Ins. Co. 30104
Tampa, FL 33607 �r,suReRC: Bridgefield Employers Ins. Co.
INSURER D: HOIlSt011 Casual ty Company �
. INSURER �:
COVERAGES
-- -•. • �,��� �civ ioovcu i v i nr irvaurttu rv�+,mtu Atiuvt rUK 1 NE PpLICY PERIQD INDICATED. NOTWITMSTANDING �
ANY RE UIREMENT, TERM QR CONbITION OF ANY COhrfRACT Of��STFi�R DQ(;t�ME1V'f` fNITFrRESpECTT(7qVPIt�P1 i�3��r�y�}�E-�tR�g{—}�.gLEp{��___...,�r
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJEC7 TO ALL 7H� TERM5, �XCLUSIQNS AND CONpITIONS OF SUCH I
PQLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
.TR NSR TMPE OF INSURANCE POLICY NUMBER pATE MMl�D/YYYV DATE MM1DD/YYYY LIMITS
GENERAL LIABILITY 21SBABN8767 OZ�ZZ��OlO O��ZZ�ZO11 EACH OCCURRENCE $ ], � OOO � OO
X COMMERCIAL GENER.4L LIABILITY PR�MI5ES Ea occurrence $ 3OO � OO
CI.AIMS MA�E � OCCUR ME� EXP (Any ona person) $ 10 ���
A '
B
GEN'L AGGREGATE �IMIT APPLIES PER:
X POLICY PRO-
JECT �DC
AUTOM091LE LIpBILITY
X ANY AU70
ALL OWNED AUTOS
SCHEDULED AUTOS
MIRED AUTO5
NON-OWNE� ALITOS
GARAGE LIABILITY
� ANY AUTO
EXCESS! UMBRELLA LIABILITY
] qCCUR ❑ CLAIMS MADE
DEDUCTIBLE
RETENTION $
AN� EMPLOYERS' LIABILITY Y I N
ANY PROPRIETORIPqRTNER/EXECUTIVF�—�
C OFFICER/MEMBER EXCLUDED� u
(Mandatory in NFI)
If yea, d0scribe und�r
5PECIAL PROVISIONS below
ro�essianal Liability
ziuECUVOisa�oz�zz�zoio �oz�z
Rua"'
PERSONAL & A�V INJURY $ �. � OOO
GENER4L AGGREGATE $ 2 � OOO
PRODUCTS - COMPlOP AGG $ Z� OOO
O1� COMBINED SINGLE LIMIT
(Ea accident) $ � � o00
8D[DILY INJURY $
(Perperson)
BOf]ILY INJURY .�
(Per accident)
PROPERTY �AMAGE $
(Per accident)
AUTO ONLY - Eq ACCIDENT $
y� OTHER THAN EA AGC $
�i �t,t,Il►D� AUTO ONLY: AGG $
Ir L. EACH OCCURRENCE $
AGGREGATE $
$
$
$
083022755�01/O1/2p10 p1/Ol/2011
E.L. EACH ACCIDENT $
E.L. pISEASE - EA EMPLOYEE $
E.l. DISEASE - POLICY LIMI7 $ �
H70913549 08/Q9/2010 08/09/Z011 Qccurrence
� Aggregate
DESCRIPTION OF OPERATION$ / LOCATIONS / V�HICLES ! FJCCLUSIQN5 A�DEb BY EN�ORS�MENT / SPECIAL PROVISIONS ��4 ^
_ertificate Ha7der is being listed as an Additi�nal Tnsured in respects to General Liabi'lity
CERTIFICATE HOLpER
City af Clearwater
Attn: City Clerk
PO Box 4748
C1 arwater, FL 33758-474
ACORD 25 (2009101)
i,000,oao
1,000,p00
1�����0��
$1,000,000
$1,00O,OOQ
CANCELLATION
SHOULD ANY OF THE ABOVE DE5CRIBEd POLICIE5 9E CANCELLED BEFORE 7HE EXPIRA710N
pATE THEREOF, THE IS5UING IN5URER WILL ENDEAVOR Tp MAIL 1� pAYS WRIT7EN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMpOSE NO OBLIGATION OR LIABILITY OF ANY KINp UPON THE INSURER, ITS AGENTS OR
REPRE3ENTATIVE3.
AUTNORIZED REpRESEN7ATIVE
� Si nature on file w/co an
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