CERTIFICATE OF LIABILITY INSURANCE (153)I
ACORO" DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 9/30/2011 9/22/2010
PRODUCER Lockton Companies, LLC-1 Kansas City THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
444 W. 47th Street, Suite 900 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Kansas City MO 64112-1906 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
(816) 960-9000 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURED POST, BUCKLEY, SCHUH AND JERNIGAN, INC.
1307320 DBA PBS&J
2001 NW 107 AVENUE
MIAMI FL 33172-2507
INSURERS AFFORDING COVERAGE NAIC #
INSURER A : Lloyd's of London
INSURER B
INSURER C :
INSURER D :
INSURER E :
rnVFRAnFC P]] TM?S ?'RTlrl( ATE UF-INS-UFWN4? UUtr NTM 11.121 n A UUNI NA[ k5 h I?W hN I HC ID`ut.lInit.
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.
INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION
LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/Ob/YY LIMITS
- GI=NERAL LIABILITY EACH OCCURRENCE $ XXxXXXX
COMMERCIAL GENERAL LIABILITY PRA MI E S (Ea occurence $ XXXXX)i`X
CLAIMS MADE 1:1 OCCUR NOT APPLICABLE MED EXP (Any one person) $ XXXXXXX
PERSONAL & ADV INJURY $ XXXXXXX
GENERAL AGGREGATE $ xxxxxXx
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ XXXXXXX
PRO-
POLICY JECT LOC
AUTOMOBILE LIABILITY RD CEN COMBINED SINGLE LIMIT
E
id
t $ XXX
ANY AUTO a acc
en
)
(
ALL OWNED AUTOS BODILY INJURY
2010
(Per person) $ XXXXXXX
SCHEDULED AUTOS NOT APPLICABLE S
HIRED AUTOS BODILY INJURY I
NON-OWNED AUTOS
OFFICI ?tr?
RECORDS
D
(Per accident) YIX-
kxxylx
$
1 E IS TIVE SR CS D EPT PROPERTY DAMAGE
L
(Per accident) $ XXXXXXX
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ XXXXXXX
ANY AUTO NOT APPLICABLE OTHER THAN EA ACC $ XXXXXXX
AUTO ONLY: AGG $ XXXXXXX
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE XXXXXXX
7 OCCUR EICLAIMS MADE AGGREGATE $ XXXXXXX
NOT APPLICABLE
UMBRELLA $ XXXXXXX
DEDUCTIBLE FORM $ XXXXXXX
-.- -RETENnOfI___$' _ - --.w -& XXXXX
WORKERS COMPENSATION AND WC 5TATU- OTH-
'
LIABILITY Y / N
EMPLOYERS TTY
ANY PROPRIETOR/PARTNER/EXECLIT
?
NOT APPLICABLE E.L. EACH ACCIDENT $ XXXXJ??X
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ XXXXXXX
If yes. describe under
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ XXXX=
A OTHER LDUSA1000811 9/30/2010 9/30/2011 $1,000,000 EACH CLAIM & $1,000,000
A CLAIMS-MADE FORM ANNUAL AGGREGATE.
PROFESSIONAL/POLLUTION 11/11/1961 RETRODATE.
LIABILrrY
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPEMAL PROVISIONS
RE: 2009-2012 CITY OF CLEARWATER ENGINEER OF RECORD.
!`CDTICIf'ATC' LJAI n1=0 ltA1Uf FI I ATIAN
10607446 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
CITY OF CLEARWATER DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
ATTN: CITY CLERK NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO $HALL
PO BOX 4748
CLEARWATER FL 33758-4748 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESS ACORD 25 (2009/01) - w 1988-2009 #CCftD, CORPORATION. All rights reserved
The ACORD name and logo are registered marks of ACORD
For questions regarding this certificate, contact the number 116 fed in the'Proucer section above.