CERTIFICATE OF LIABILITY INSURANCE (8)
~M CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDIYYYY)
05/17/2005
PRODUCER (910) 509-9000 FAX (910)509-9006 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Walker Taylor Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1430 Commonwealth Drive #302 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Wilmington, NC 28403
INSURERS AFFORDING COVERAGE NAlC#
INSURED McKim 8r Creed, PA INSURER A: Hartford Fire Insurance Co
P.O. Box 806 INSURER B: Hartford Ins Co of the Midwest
Wilmington, NC 28402 INSURER c:
INSURER 0:
INSURER E:
cnVERAGES
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.
I!,,~~ ~~~~ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
GENERAL LIABILITY 22UUNIA9447 05/15/2005 05/15/2006 EACH OCCURRENCE $ 1,000,000
f--- DAMAGE TO RENTED 300,000
X COMMERCIAL GENERAL LIABILITY $
I CLAIMS MADE 0 OCCUR MED EXP (Anyone person) $ 10,000
A X PERSONAL & ADV INJURY $ 1,000,000
- 2,000,000
GENERAL AGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COM~OPAGG $ 2,000,000
~ POLICY m ~r8T n LOC
AUTOMOBILE UABlLlTY 22UENAM0684 05/15/2005 05/15/2006 COMBINED SINGLE LIMIT
ex- ANY AUTO (Ea accident) $
- 1.000.000
ALL OWNED AUTOS BODILY INJURY
- (Per person) $
SCHEDULED AUTOS
A X X
HIRED AUTOS BODILY INJURY
X (Per accident) $
NON-OWNED AUTOS
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
R ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY 22XHUUA0618 05/15/2005 05/15/2006 EACH OCCURRENCE $ 4,000,000
tKJ OCCUR 0 CLAIMS MADE AGGREGATE $ 4,000,000
A X $
~ DEDUCTIBLE $
X RETENTION $ 10 , ooe $
WORKERS COMPENSATION AND 22WBIG6643 05/15/2005 05/15/2006 X I T"/,~~T~J#~ I TOJ~-
EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 1,000,000
B ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? E,L. DISEASE - EA EMPLOYEE $ 1,000,000
If yes, describe under E.L. DISEASE - POLICY LIMIT $ 1,000,000
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Policy Conditions and Exclusions apply.
City of Clearwater
Engineering Dept - Suite 220
Attn: Dina Katsougrakis
P.O. Box 4748
Clearwater, Fl 33756-4782
SHOULD ANY OF THE ABOVE DEseRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAlL
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAlL SUCH NOTleE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE b 6b ~ C-h
Deborah Church DC
ACORD25(2001/08) FAX: (727)562-4755
@ACORDCORPORATION 1988