CERTIFICATE OF INSURANCE (7)
Client#: 292011
80MCKIMCRE
<A CORDTM
CERTIFICATE OF LIABILITY INSURANCE
DATE (MMJDDNYYY)
09/08/2003
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.
PRODUCER
BB& T Insurance Services, Inc.
7823 National Service Road
2nd Floor
Greensboro, NC 27419
McKim & Creed, PA
243 N. Front Street
Wilmington, NC 28401
INSURERS AFFORDING COVERAGE
INSURER A: Security Insurance Company of Hartfo
INSURER B:
INSURER C:
INSURER 0:
INSURER E:
NAIC#
P&C
INSURED
COVERAGES
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.
L TR NSR TYPE OF INSURANCE POLICY NUMBER Prf}{~~ri~f6'8~\E Pg~fl,~~~~N LIMITS
GENERAL LIABILITY
I---
COMMERCIAL GENERAL LIABILITY
I CLAIMS MADE D OCCUR
I---
4GEN','L AGGR,nEGAT_E LIMIT A,.P rP=LIEyS PER:
PRO-
POLICY JECT LOC
~TOMOBILE LIABILITY
_ ANY AUTO
_ ALL OWNED AUTOS
~ SCHEDULED AUTOS
___ HIRED AUTOS
~ NON-OWNED AUTOS
nRAGE LIABILITY
~ ANY AUTO
L
,
~ESS/UMBRELLA LIABILITY
--.J OCCUR D CLAIMS MADE
I, DEDUCTIBLE
1 RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
OTHER Professional
Liability
AEE0703191
09/05/03
09/05/04
E.L. EACH ACCIDENT $
EL DISEASE. EA EMPLOYEE $
EL DISEASE - POLICY LIMIT $
Each Claim: $2,000,000
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A
I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
I
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,
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CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Clearwater
AU: Dina Katsougrakis
Municipal Services Building
100 South Myrtle
CI~arwater. FL 33756
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ---3.0- 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
REPRESENTATIVES.
AUTHORIZED REPRE\:C~~~~;i
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ACORD 25 (2001/08) 1 of 2
#S974314/M974288
AHR
@ ACORD CORPORATION 1988