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CERTIFICATE OF LIABILITY INSURANCE (9)a ,4CC>R" CERTIFICATE OF LIABILITY INSURANCE DATE JMM/DDNYYY) 9/27/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER CONTACT Laura Stowers NAME: AHM Financial Group, LLC PNON o t^ (314) 523-8800 ?W 1a . N0)_ (314) 453-7555 11975 Westline Industrial Dr ADDRESS_lstowers@ahmfinancialgroup.com PRODUCER 00009706 CUSTOMER I Saint Louis MO 63146 INSURERS AFFORDING COVERAGE NAIC # INSURED - - er Oak Fire Ins CO A:Chart INSURER 5615 _ _ INSURER B:Travel ers Indemnity Co of CT Civil Air Patrol INSURER C Maxwell Air Force Base Bldg 714r INSURER D.... ?,._-..._. ...,..._..., ....._.........._ INSURER E : Montgomery AL 36112-6332 INSURER F : COVERAGES CERTIFICATE NUMBER:10/11 REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. YY) POLICY EXP I ?L LTR TYPE OF INSURANCE YYY MMlDD/YYYY LIMITS POLICY NUMBER MM DDNY GENERAL LIABILITY EACH OCCURRENCE $ DAMA E TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE E70CCUR MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ i r--i POLICY PRO• f-- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 I'X (Ea accident) i ANY AUTO BODILY INJURY (Per person) E I 810750K8747COF10 AOS 10/1/2010 110/1/2011 A ?ALL OWNED AUTOS ? UTDS J ? • Per aooident) BODILY INJURY R RTY AM(A P $ `? A _ X HREDAU70S A750K876010CAG TX 6 WA ;10/1/2010 '10/1/2011 OPE D GE f dent) X ! NON-OWNED AUTOS Underinsured motorist $ 1,000,000 B 010 01112011 P810750KB7591ND10 HI ',101112 111 Basic PIP --.._--_-_-- $ UMBRELLA LIAR OCCUR s Q , EACH OCCURRENCE $ r EXCESS LIAR CLAIMS-MADE' ' E?65?a ? 1?n !-? _G_G_R_EG_ATE ^ ' ? _ $ ' f DEDUCTIBLk' ....... i... .,. ....,. ..... ... .,$.. . ..... -- ..... ....... RETENTION $ $ 1 WORKERS COMPENSATION WC STATU- OTH-' ! AND EMPLOYERS' LIABILITY ITORY YIN Y PR RlPARTNER/EXECUTIVE ? AN , t y f-CP y 1 N t ' R S ANC C? FI E L EACH ACCIDENT IMEM E N A FFI 1 ? r , I 4 1 I L ` ? n NH (Mandatory 11 y des cribe under I T e / CS DEPT LE GISLKnVE SRR tl EMPLOYEE .E. _ ??..._. $ ` DESCR PION OF OPERATIONS below E.L DISEASE - POLICY LIMIT I$ I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Clearwater Clear ate M i i l M i w r un pa ar na c 25 Causeway Blvd. AUTHORIZED REPRESENTATIVE Clearwater, FL 33767 John Anderson/CARRIE ACORD 25 (2009109) © 1988-2009 ACORD CORPORATION. All rights reserved. INS025 r9nn9not The ACORD name and loon are registered marks of ACORD