CERTIFICATE OF LIABILITY INSURANCE (112)A? °® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYY10
03/25/2011
PRODUCER AON RISK SERVICES CENTRAL
INC. 308375 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
, ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1000 N. MILWAUKEE AVENUE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
GLENVIEW, IL 60025 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PHONE - 1-866-283-7122 FAX 1-847-953 5390
INSURERS AFFORDING COVERAGE NAIC #
INSURED AON CORPORATION AND INSURERA: LEXINGTON INSURANCE COMPANY 19437
AON CONSULTING INSURER B:
200 EAST RANDOLPH
INSURER C:
CHICAGO, IL 60601
INSURER D:
INSURER E:
nnVFRArFA
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. LIMITS SHOWN ARE AS REQUESTED
INSR DD'
NSR
TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE
Y _Y POLICY EXPIRATION
E LIMITS
GENERAL LIABILITY EACH OCCURRENCE $
6AM90 75"RER
COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $
CLAIMS MADE F70CCUR MED EXP An one person $
PERSONAL & ADV INJURY $
If certificate is no longer req please fax to
ired CS at GENERAL AGGREGATE $
,
GEN'L AGGREGATE LIMIT APPLIES PER: 1-847-953-5390 to have remo ved from our list. PRODUCTS - COMP/OP AGG S
MPOLICY PRO LOC
AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT
$
ANY AUTO (Ea accident)
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS E ?F
, i
F?
(Per parson) $
HIRED AUTOS h--a - BODILY INJURY
NON-OWNED AUTOS (Per accident) $
PROPERTY DAMAGE
(Per accident) $
GAR AGE LIABILITY r
0,' a IC I p
RE -'-) AUTO ONLY - EA ACCIDENT $
ANY AUTO LEGISLA F-. 'i',%VCS D .J _ OTHER _ THAN EA ACC $
AUTO ONLY: AGG $
EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $
-
ICLAIMS MADE
OCCUR F AGGREGATE $
$
DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION WC STATU- OTH.
AND EMPLOYERS' LIABILITY TORY LIMITS FR
Y / N
ER/EXECUTIVE
ANY E.L. EACH ACCIDENT $
OED?
OFFICER/MEMBER ER EXCLU
-----.. ^?
ry )
aniia'to""1'ril?1H . . _.. _. _ _..?.._....._.__..,....--?._?.._?.?_ - .L. DTSEASE ?OYE $
If yes, describe under
SPECIAL PROVISIONS below E.L. DISEASE- POLICY LIMIT S
A OTHER ERRORS & OMISSIONS 01-589-61-34 03/01/2011 03/01/2015 EACH CLAIM: $1,000,000
SIR APPLIES PER POLICY
TERMS & CONDITIONS
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION 308375
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
P.O. BOX 4748 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
CLEARWATER, FL 33758-4748 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
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