INSURANCE CERTIFICATES
.. . . ....... ..... .... . ........-- .............
. THIS CERTIRCATE IS ISSUED AS A MAlTER OF INFORMATION ONLY AND
. CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
. DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
uP<JJHIT3B~L1'Nd19A~~ AFFORDING COVERAGE
.....~~~~~~~~~t~;d....
u~~aQleIC~~lii~u International Surplus
D()-~c2P
PRODUCER
~,. ~~:-~-~-~~i:~~::~7~~r'?~~:-'~0~~~:~.f~~.~~~f~~~>~,
INSURANCE ADVANrAGEAGENCfn\itc-1
3545 Chain Bridge Rd. Suite 208
Fairfax, VA 22030
(703) 273-4246
INSURED
PSI International, Inc.
10306 Eaton Place
Fairfax, VA 22030
COMPANY C
LETlER
COMPANY D
LETIER
COMPANY E
LETTER
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
- --lNGiGATEG,-NEHWI:r1'ISTAN8:NG-AN'(~Q\JIRE-MEN+, TERM OR smJOmG!'.j~-G-,}N:mACT-OR OTWEflQQO-JMal:::-\-'JHfJ. RESPECTTC W!-!!C~TH!S---
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.
CO:
LYR:
TYPE OF INSURANCE
POLICY NUMBER
..............._.....____d.............
. POLICY EFFECTlVEPOLlCY EXPIRA l10N
DATE (MMJDDIYY) DATE (MMIDDIYY)
UMrrs
X : COMMERCIAL GENERAL L1ABILllY
BINDER
............... .... ................ - - - -..........
04/01/95
: GENERAL AGGREGATE uSuu:2u'u900'u90uO
. PRODUCTS-COMP/OP AGG. .. usw1,900,000
. 04/ 01/ 96 PERSONAL & ADV. INJURYu.uSuu~..u(}(}9,0(} 0
· EACH OCCURRENCE S1..(}()()LOO 0
FIRED~AGE(Anyon~fire)uu$ . . u. u3uOu(}'u(}00
. .
: MED. EXPENSE (Anyone pe,son):$ 5,900
A: GENERAL UABIUTY
: CLAIMS MADE X OCCUR..
: OWNER'S & CONTRACTOR'S PROT
04/01/95
: COMBINED SINGLE
: LIMIT
$ 1,000,000
: AUTOMOBILE UA811.rrt
A: X : ANY AUTO
. ALL (lWNED AU',OS
: SCH~DULED AUTOS
. X HIRED AUTOS
X · NON.OWNED AUTOS
: GARAGE L1ABILllY
BINDER
04/ 01/ 96~ODILYI~~~~~
: (Per person)
s
· BODILY INJURY
: (Per accident)
s
: PROPERlY DAMAGE
s
: EXCESS UABIUTY
: EACH OCCURRENCE
:s
. UMBRELLA FORM
......................
: AGGREGATE
s
: OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION
nA'--n-n-nn-
AND
';-BtNaER---n--
. . . . . . . . . . . . . . . . . . . .. ...... . .
. . ..X. u.. uSTATUTORYLlM.ITS.... u.. ............ ....... ....... .................. ..............
----c.. :o-4101-j9'S ~-~(t4fOlfg-Ek~cH...A~-::-:~~::-:-~-::-::=--=~~~r{}{)G. _n..
. . DISEi\SE:POLICY UMIT.. .... ns..5..O()..O 0 0
.....u..u uu.. u............................ DI~EASE. '..EA.C.H .EMPL.o.YEE Su..~()O,()()O
EMPLOYERS' UABIUTY
: OTHER
BPROFESSIONAL
. LIABILITY
2430783
OS/23/95
OS/23/96 Aggregate
. Wrongful Act
1,000,000
1,000,000
DESCRIPTION OF OPERA l1ONSILOCA l10NSlVEHICLESlSPECIAL I1DIS
RE: ADDITIONAL INSURED: CITY OF CLEARWATER
NOTE: Professional liability coverage has a $5,000 deductible,
CITY OF CLEARWATER DEPT OF POLICE~
DEPUTY CHIEF DEWEY WILLIAMS
644 PIERCE STREET
CLEARWATER FL 34618
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL 030 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
REPRESENTATIVE
A:j' ~---t-i PA d"
H..2I:;i8i'~~q9ijfqJjfiigQijL
00 -/ :J ~;.--()()
1~~~,~~_I_IE~~~~:;"
PRODUCER _iTHIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
..~...,-- ~"-~-- --- .c..'-' ..~~< ~.. -~~~ : CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
IN?URANCEA.DVANTAGEAGENq'lNC.l: . ~g~~I~~TB:~;~' EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
.\'".~.'~-" ....'3545.... chaiIi .".Brldge'. Rd: ~;.stiit~'-.208'_;;,~~:'~~li
..... Fairfax, VA 22030
(703) 273-4246
COMPANIES AFFORDING COVERAGE
- -a ZSnn?;nlH.~~.~~~~n
.iNSUiiEii..................,..........................................................................................R.E.~&~~C~....~~~.~.~~.~...
PSI International, Inc. OA!1.4NY(lf
10306 Eaton Place POLlnnCHlEFn
Fairfax, VA 22030 . COMPANY D
, LETTER
International Surplus
COMPANY E
LETTER
THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD
INDICATED, NOlWlTHSTANDING 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 POUCIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS,
......... ~CLUSI()~S.. AN [). q()f'J[)I:n.()~:s. OF. SUCf:i. .~OLlql~~... .L1~I:r:s.. :s!:l()If>'f'l. .tv1P:o ~ .f:iAIj.E. BE!:~.. REl?~q~(). BY .P,6J D.. qL,6J'-1S....
CO : TYPE OF INSURANCE POLICY NUMBER ' POLICY EFFEC11YE :POUCY EXPlRA110N
LlR: : DATE (MMIDDIYY) DATE (MMIDDIYY)
UIIITS
. .
. A.. GENERAL. UABIUTY.. ................................ .,................... n........ n........................................
X : COMMERCIAL GENERAL L1ABILJlY i BINDER
. CLAIMS MADE X OCCUR.:
...................
: OWNER'S & CONTRACTOR'S PROT.
Gel~. .A~.~REGATI:........ .....:~....:?..'. 9'<>'0.,..9'<>'9
'PRODUCTS-COM~IO~AGG. nnn~n1'nQOO,QO 0
:04/01/95 . 04/ 01/ 96L~~s.?~f\Ln~~?~...I.~J~~~n n.n.$n..~~nO.<>..<>.,O.<>.Q
: EACH OCCURRENCEnnn nnn$nn~LO()Q!O()O
L.F.I~~. ?~~E..(~y' .o.n~.~re)n.....: ~...... .....~.<>.O .,..<>..<>..<>.
nnnnn:.~ED. EXPENSE (Anyone person) $ nnnnnnn5,OO 0
: AUTOMOBILE UABIUTY
A: X ..' ANY AUTO
. ALL OWNED AUTOS
. . . . . . . . .
, SCHEDULED AUTOS
X . HIRED AUTOS
X . NON-OWNED AUTOS
BINDER
: COMBINED SINGLE
, LIMIT
$ 1,000,000
:04/01/95 · 04/ 01/ 96r~()~IL~I~~~~u
. : (Per person)
$
.................. ....... - .
· BODILY INJURY
: (Per accident)
$
. GARAGE L1ABILllY
... .........-......................... ........-........... ..................
: EXCESS UABIUTY
. UMBRELLA FORM
PROPERlY DAMAGE : $
. .
. .
-...... ..........-...........-..................... --...........
: EACH OCCURRENCE $
.......................................
. AGGREGA1E$
. OTHER THAN UMBRELLA FORM
...._.......,.,",...,.,.,...,.,.,...,-,..........
," ---......._,.........
.......-..-,.......
...._--...."..,---....
._--.........,._-...-.
.--..--..-."...,.......
....,.-.-.-.-........,.,-.-.-...'.',.............
... .-- -..........
.----......-.-............
._, ""'__d_.. ,.......
...-........................... ...--.......
.........-.------.....
.-.......----..--..
.......-.-..-.......
......._--.-.....
....-..............
A
AND
BINDER
. 'uXuuSTArur.~RY LIMITS
:04/01/95 . 04/ 01/ 96L~C.Hu~~~J~~r..
.___u_._ :!lJSl<A'lE c Eill.!CY-LlMlI__
WORKER'S COMPENSA11ON
. .
. .
....~.............-.................................-...............................................................................
. .
DISEASE . EACH EMPLOYEE
$ uuuuu~..<>.9~uq.<>.9.
-J....~~5()()?ll4-9 -----
$ .u~.9(),.QOO
.-.-- - EiiMYERS' iJAiiIUTY---
. alliER
B:PROFESSIONAL
. LIABILITY
2430783
. .
. .
:06/19/95 : 06/19/96: Aggregate
. iWrongful Act
1,000,000
1,000,000
................................................... ..n..............._.....
DESCRIPTION OF OPERA11ONSILOCA11ONSlVEHICLESJSllECIAL ITBIS
RE: ADDITIONAL INSURED: CITY OF CLEARWATER
NOTE: Professional liability coverage has a $5,000 deductible.
Coverage includes full prior acts back until 1977. Coverage provides
rotection for PST Inc. for its work for PSI on Clearwater ro'ect.
CITY OF CLEARWATER DEPT OF POLICE
DEPUTY CHIEF DEWEY WILLIAMS
644 PIERCE STREET
CLEARWATER FL 34618
::'-~9.m1...::.:i(t.1ij.::::::i.::::i:I:::.
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE
u EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAlL 030 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAlLURE TO MAlL SUCH NOTICE SHALL IMPOSE NO OBUGATION OR
... UABIUlY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
.............. ..... .......................'.................
. n.........................
:::::::::::::::::::::::::::::::::::::::;:;:::::;:;:;:;:::::::::::::::;:::;::::::::::::::::::::
........- ::::::;:::::::::::::::::;:::::.:::;:;:::;:;:::::::::::::;:::::::::::;:::::::::::::::::::::::::;.:.:.:.:.:...:.
::~;..,....::::::.tll:}'.::::I.I'I:::b.:::.'::.:::::i:~,::::::;jj:i.:;::.::.:::::I?i~::I:':::'::::i;;il:::x::li:I:.::::::::.:;.::.,:.::::.::.::.::.::.::.::.::.::..:.':.::.::.::.::.::.::.:.:::.':.':.::.:.::.1""':.:.::..:.:.. ..... :::::::';::::::::.::::::::::m::l::::::::::\;~mt~l~i"\MMIDOiVYj.... .
.. A....I.I.qp......g ....0::'1:::111' Uft:::f::E..,...."Pi..... IN. .. u:n.ftl..g ...............,.,...".,......... .... .::,:,:,.:,:"".,:,:,:",:,:""""."
::: . . .. ... .... ..... .:::::::::::::::::::::::::::::::::::::::'::':;::::::::::::t:::::I::i\:::i::::::::::::::::::::t:t::::::::::::::::::t{::::i::::::::::::::::::::::::::::::::::::::::'::t:::::::::;:;::t:::@:::::::;::::i\mi:\:::::':::;:::::::::::::::::::::::::::::::::::::::::::::,:::,::,;;,.:::ij:::i::::'):::::::j:i:::::::.: ..7./.. ..~ .I.~~. ~.5..
PRODUCER : THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
: CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
: DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
· POLICIES BELOW. .
....................................COMPANI~(A~O~bl~~.fI)~AGE..
~~ANY A.~~~~.~.~ii~S{)#j~~~.~Insu~~~~e.c~..
co..."" ammmmmPbUC E. C H~~Fmm..... m
LET1ER
....~...5J?P:~;.?:!;..2.c-;:0~~~);.t:.~..;i~L~;~~~,;;..~
'~.INSURANCE;'AbVANTAGE~A.GENCY:INCA,
. ..............",..,.....>c'x....".,...,,' .. ....,{
'. 3545 Chain Bridge' Rd.'.Suite:208 :
Fairfax, VA 22030"
(703) 273-4246
INSURED
Logistic Systems, Inc.
3000 Palmer St.
Missoula, MT 59802
COMPANY C
LET1ER
COMPANY 0
LET1ER
COMPANY E
LET1ER
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
iN6IeA'TED;--NO'rvViTH5-TANBfNG-ANY n[QU;n[ML:l~T, TL:RM OR-eeNBllION or AH'r CONT;lA01'OR6'fHERBOOUMEi'H-WffH-RESPEe'f-T&WHI€H '!"HiS---.-
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 MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTlVE EllPIIA lION
DAlE (MMlDDIYY) DAlE (MMIDDIYY)
UMITS
WORKER'S COMPENSAllON
AND
GENERAL AGGREGATE
PRODUCTS-COMPIOP AGG.
PERSONAL & ADV. INJURY
EACH OCCURRENCE
OCCUR.
AUTOMOBILE UABIUTY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
MED. EXPENSE (Anyone
COMBINED SINGLE
LIMIT
BODILY 'NJURY
(Per person)
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
EXCESS UABIUTY
UMBRELLA FORM
OlHER lHAN UMBRELLA FORM
EMPLOYERS' UABIUTY
DISEASE - POLICY LIMIT
DISEASE - EACH EMPLOYEE
alliER
A Professional
Liability
Binder #29879
/05/95
07/05/9 Aggregate
Claim
500,000
500,000
DESCRIP110N OF OPERA llONSILOCA lIONSlVEHICLESlSPECIAL ITEMS
ADDITIONAL INSURED: CitV of Clearwater, Florida
NOTE: Professional liab1lity insurance has a $25,000 deductible.
Policy is on a claims made basis, with the retroactive date
bein the ince tion date of the olic ,
:glilRD!lQ,$1!:H"".t:m::t::::m:: ....... ..........:.. :::::(::::::::::fP:~"~_::::): ............ .:::::.....:::::::::::':':,,':::::::::::::::::::::'.,'",,>....
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY.WIll ENDEAVOR TO
MAIL 030 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
Police I LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
::::::::! LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
City of Clearwater Dept. of
Deputy Chief Dewey Williams
644 Pierce St.
Clearwater FL 34618
,.........., .._....,_" ,........H ,.....
.'.'...'.'.....'.................'.'.2S';iS......'.'.....'.,.(....1J...190...........~..,.,.,
." . .. ~ '" ..
::AG9!m:::::...:,..} .:..,.. ,{
-,-......................
...................................................
..........................
. . . . . . . . . . . . . . . . . . . . . . . . .
..........................
...................................................
...................................................
.........................
................ ........
....................:.:.:.:.:.:.:.:-:.:.:.:.:.:.:.:.:.:.:.:.:.:.:
~.:W.,~9~:qgijf9ij..\jQ~j~.....
, ,
I
I
CITY OF CLEARWATER
Interdepartment Correspondence Sheet
TO:
Cyndie Goudeau, City Clerk
FROM:
Deputy Chief Williams, Services Bur
COPIES:
Risk Management, File
SUBJECT: Certificate of Insurance - PSI International, Inc.
r
00 -ddF/
DATE: April 15, 1996
Attached is an original copy of a Certificate of Insurance fL
Inc. who is the Police Department's computer systems contractor. This
certificate of insurance should be attached to the contract you have on file
which was awarded by the City Commission on May 15, 1995. This is a
renewal certificate.
Please let me know if you have any questions.
DMW/lh
Attachment
RECEIVED
APR 1 7 1996
CITY CLERK DEPT.
A.~'..lllt"
Qi!;~ml~I~~m'~~I~~~I~~~~~;FlCA TE IS IS ED AS A~~~~~;.' OF INFO:;::'~~;';~
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
APR 15
2 16 PH '96
COMPANY
A
Zurich American Ins Co of IL
PRODUCER
The Insurance Exchange, Inc.
751 Rockville Pike, #3A
Rockville MD 20852
Stephen J. Mey
Phone No. 3 01- 279 - 5 500
INSURED
Fax No.
COMPANY
B
o F ;:'1 'J F
POLICE CHIEF
P.S.I. International, Inc.
10306 Eaton Place Suite 400
Fairfax VA 22030
COMPANY
C
qqVEI'lAGEl)
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
CERTIFICA TE MAYBE ISSUED OR MA Y 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.
COMPANY
D
CO TYPE OF INSURANCE POLICY NUMBER i POLICY EFFECTIVE i POLICY EXPIRATION LIMITS
lTR I DATE IMM/DDIYY) i DATE (MM/DDIYYJ
GENERAL LIABILITY GENERAL AGGREGATE $2,000,000
-"---~-_._-_...-
A X COMMERCIAL GENERAL LIABILITY PKG4196ZURTF 04/01/96 04/01/97 PRODUCTS. COMP/OP AGG $2,000,000
CLAIMS MADE ~ OCCUR PERSONAL & ADV INJURY $1,000,000
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 1 d~_Q.QLO_Q.9_
FIRE DAMAGE IAny one fire) $ 1, 0 0 0.!..Q_9_Q_
MED EXP (Anyone person) ,$10,000
AUTOMOBILE LIABILITY
04/01/96 04/01/97 COMBINED SINGLE LIMIT !$1,000,000
A X ANY AUTO AUT04196ZURTF
ALL OWNED AUTOS BODIL Y INJURY
SCHEDULED AUTOS (Per person)
X HIRED AUTOS BODILY INJURY
X NON.OWNED AUTOS (Per accident)
PROPERTY DAMAGE
GARAGE LIABILITY , AUTO ONLY. EA ACCIDENT
ANY AUTO L_ OTHER THAN AUTO ONLY:
EACH ACCIDENT i $
.T---.-------.--..~--..--....
AGGREGATE $
EXCESS liABILITY L EACH OCCURRENCE $10,000,000
---_.__."-------,-----
A X UMBRELLA FORM UMB4196ZURTF 04/01/96 04/01/97 AGGREGATE ':..1 0 , 0 0 0 ...QO.Q...
OTHER THAN UMBRELLA FORM
A WORKERS COMPENSATION AND X STATUTORY LIMITS
A EMPLOYERS' LIABILITY $500,000
EACH ACCIDENT
THE PROPRIETOR/ INCL WC4196ZURTF 04/01/96 i 04/01/97 DISEASE. POLICY LIMIT $500,000
PARTNERS/EXECUTIVE I
OFFICERS ARE: EXCL WC4196ZURTF 04/01/96 04/01/97 DISEASE. EACH EMPLOYEE $500,000
OTHER
I
DESCRIPTION OF OPERATIONS/LOCATlONSNEHIClES/SPECIAL ITEMS
RE:
644 & 645 Pierce Street/Clearwater, FL
34616
CANCEL LA TION
PSIDEPU
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEllED BEFORE THE
EXPIRATION DATE THEREOF. THE ISSUING COMPANY WilL ENDEAVOR TO MAIL
030 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE lEFT,
BUT FAILURE TO MAil SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Stephen J. Mey '.~~-A.:":.C. .'0..- JIll ~
/V'~~ tbRPO"t~N1993
Deputy Chief Dewey Williams
Clearwater Police Department
644 Pierce Street
Clearwater FL 34616