CERTIFICATE OF LIABILITY INSURANCE (7)rrorn.uo xayasone t-axlu: H'age [ of [ Ua1e!1+1LL/LU I I VV:U I MNI rage:/ or c
OP ID: GX
'4?RO' CERTIFICATE OF LIABILITY INSURANCE nAT04121D/vYVr)
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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 endorsement s
PRODUCER
727-733-9385
NNAAMEcT
Bob Barber EnteWe s, Inc. 727-734252
2321 State Road PHONE FAX
c o Ert : A/C No
Clearwater, FL 33763 AE-MAL
DDRESS: _
Bob Barber PRODUCER HAR80-1
CUSTOMER ID *
INSURER(S) AFFORDING COVERAGE NAIC f
INSURED Harbor Barber & Beauty Salon INSURERA:Zurich Insurance Company
25 Causeway Blvd INSURER B:
Clearwater Beach, FL 33767 INSURER C:
INSURER D
WSURER E
INSURER F
COVERAGES CERTIFICATE NUMBER: 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR TYPE OF INSURANCE POLICY NUMBER MMA)OO? MMA??
LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,0001
A X COMMERCIAL GENERAL LIABILITY X PAS00848160 04123!11 04/23/12 PRDAMAO E TO RENTED
EMISES Ee occurrence
$ 50,00
CLAIMS-MADE I-XI OCCUR MED EXP (Any one person) $ 5,00
PERSONAL & ADV INJURY $ Include
GENERAL AGGREGATE $ 2,000,00
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS- COMP/OP AGO $ 1,000,00
X 'POLICY PRO LOC $
AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT
(Ea accident) $
ANY AUTO
C
BODILY IN.AJRY (Per person)
$
ALL OWNEDAUTOS h , ?.,w BODILY IN.URY (Per accident) $
SCHEDULED AUTOS
HIREDAUTOS PROPERTY DAMAGE
(Pereccldent)
$
NON-OWNEDAUTOS ?J
$
J UMBRELLA LIAS OCCUR `V '."7:CIAL REC ORDS
A
ND
EACH OCCURRENCE
$
EXCESSLIAB
H
CLAIMS-MADE
E?ISLATI'v'
R
s
AGGREGATE
$
DEDUCT 16LE . !d f $
RETENTION $ $
WORKERS COMPENSATION
' WC STATU- OTH-
TORY LIMITS ER
AND EMPLOYERS
LIABILITY Y I N
ANY PROPRIETORIPARTNER/EXECUTIVE E.L. EACH ACCIDENT $
?
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH) NIA
El DISEASE - EA EMPLOYEE
$
IF yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE -POLICY LIMIT
$
DESCRIPTION OF OPERATIONS /LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required)
The below named certificate holder Is named an additional Insured as their
Interests may appear.
CERTIFICATE HOLDER CANCELLATION
CLEARWC
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Clearwater ACCORDANCE WITH THE POLICY PROVISIONS.
25 Causeway Blvd
Clearwater, FL 33767 AUTHORIZED REPRESENTATIVE
O 1988-2009 ACCIRD CORPORATION. All rights reserved.
ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD