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CERTIFICATE OF LIABILITY INSURANCE (10)
From: Alvina Davis At: Roe Insurance FaxlD: To: Marie Orsello Date: 101112010 03:27 PM Page: 2 of 3 ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID OP10 ? PATE (MMIPPIYYYY) FO r . 10/01/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Greg Roe Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 9851 State Road 54 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. New Port Richey FL 34655 Phone:727-376-0030 Fax:727-376-2262 INSURERS AFFORDING COVERAGE NAICA INSURED INSURER A Rivazpvzt Ineuzanca Company 04377 INSURER B: Underwriters at Lloyd's Foundation Village Neighborhood Fa=ly Ctr, Inc. INSURER C: 918 Woodlawn St. Cl t FL 33756-2157 INSURER 1) earwa er INSURER E. 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 RESPECTTO 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 LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE (MMIDDIY`n DATE (MW DlVY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1, 000 , 000 A X COMMERCIALGENERALLIABILITY NIA1816799 10/01/10 10/01/11 RREMISes Eaoccurence) $ 100,000 CLAIMS MADE 7x I OCCUR MED EXP (Any one person) $ 5 ,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 3,000,000 POLICY JECT PRO- LOC AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1 000 000 A ANY AUTO NIA1816799 10/01/10 10/01/11 (Ea accident) , , ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) $ X J HIRED AUTOS BODILY INJURY $ }[ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC. $ AUTO ONLY AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ? CLAIMS MADE AGGREGATE $ J? DEDUCTIBLF. .$ RETENTION $ WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS' LIABILITY ANY PROPRIETOWPARTNER/EXECUTIVE E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED E.L. DISEASE - EA EMPLOYEE $ If yes, describe Under SPECIAL PROVISIONS below E.L. DISEASE- POLICY LIMIT $ OTHER A Crime NIA1816799 10/01/10 10/01/11 Bldg 303,000 B Property L13506 02/22/10 02/22/11 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS *30 DAYS NOTICE OF CANCELLATION, EXCEPT 10 DAYS NOTICE OF CANCELLATION FOR NON-PAYMENT OF PREMIUM. WORKERS COMPENSATION APPLIES TO FLORIDA OPERATIONS ONLY. CERTIFICATE HOLDER CANCELLATION CITY OF CLEARWATER FAX #727-562-4037 ATTN: MARIE ORSELLO 112 S. OSCEOLA AVENUE CLEARWATER FL 33756 ACORD 25 (2001/081 CITYCLE I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO $O SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. © ACORD CORPORA