INSURANCE CERTIFICATES FOR YEARS 1996-1998
I
I
CITY OF CLEARWATER
Interdepartment Correspondence Sheet
TO:
Cyndie Goudeau, City Clerk
FROM:
Dewey M. Williams, Deputy
COPIES:
File
SUBJECT:
Certificate of Insurance - PSI International, Inc.
DATE:
November 5, 1996
Please include the attached certificate of insurance in your contract file for PSI
International, Inc. (Police computer system vendor). The original contract was
awarded by the City Commission on May 15, 1995.
DMW / sh
Attachment
~RECEI""~~
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NOV 1 ~I 1996
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........~.E.am.I..f=.I.~AmE.j[.O.F.......,.I.S.t.J.RA.H.1.~.............................................................' .............................~~.~fi~.[......................... DA~~7~;;;~
THISC:ERTIFICATE IS ISS~ _D 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.
COMPANIES AFFORDING COVERAGE
PRODUCER
The Insurance Exchange, Inc.
751 Rockvi1le Pike, #3A
Rockville Me 20852
Stephen J. Mey
Phone No. 301- 27 9 - 55 00 Fax No.
INSURED
COMPANY
A
Travelers Indemnity Co.
COMPANY
B
P.S.I. International, Inc.
10306 Eaton Place Suite 400
Fairfax VA 22030
COMPANY
C
COMPANY
D
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.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRA nON LIMITS
LTR DATE (MMIDDIYYI DATE IMM/DDIYYI
GENERAL LIABILITY GENERAL AGGREGATE $5,000,000
A COMMERCIAL GENERAL LIABILITY PCKG4197TRABINDER 04/01/97 04/01/98 PRODUCTS - COMP/OP AGG $2,000,000
CLAIMS MADE ~ OCCUR PERSONAL & ADV INJURY $1,000,000
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $1,000,000
FIRE DAMAGE (Anyone fire) $1,000,000
MED EXP (Anyone person) $5,000
AUTOMOBILE LIABILITY
04/01/97 04/01/98 COMBINED SINGLE LIMIT $1,000,000
A X ANY AUTO AUT04197TRABINDER
ALL OWNED AUTOS BODILY 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 OTHER THAN AUTO ONLY:
EACH ACCIDENT
AGGREGATE
EXCESS LIABILITY EACH OCCURRENCE $10,000,000
A X UMBRelLA FORM UMB4197TRABINDER 04/01/97 04/01/98 AGGREGATE
OTHER THAN UMBRELLA FORM
A WORKERS COMPENSATION AND STATUTORY LIMITS
EMPLOYERS' LIABILITY
EACH ACCIDENT $500,000
-THE PROPRIETOR/ INCL WC4197TRABINDER 04/01/91 04/01/98 DISEASE - POLICY LIMIT $ 500,-000
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL DISEASE - EACH EMPLOYEE $500,000
OTHER
A Professional Liab. PROF4197TRAV 04/01/97 04/01/98 Limit $1,000,000
Ded. $5,000
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
RE: 644 &: 645 Pierce Street/Clearwater, FL 34616
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
Deputy Chief Dewey Williams
Clearwater Police Department
644 Pierce Street
Clearwater FL 34616
C ERJI.F1CAtEO F.INSURANCE I .... DATE IMM/DDIYYI ,
At~..I!I." ,
CSR TF
PSIIN-1 04/11/96
PRODUCER THIS CERTIFICATE IS ISSUED AS A MAHER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
The Insurance Exchange, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
751 Rockvi1le Pike, #3A AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Rockville MD 20852 COMPANIES AFFORDING COVERAGE
Stephen J. Mey COMPANY
A Zurich American Ins Co of IL
Phone No. 301-279-5500 Fax No. --"- ".--------,------
INSURED I COMPANY
B
I COMPANY
P.S. I. International, Inc. C
10306 Eaton Place Suite 400 COMPANY
Fairfax VA 22030 D
COVERAGES .... ............ .. ..... ...... .... .
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 REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICA TE MAYBE 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 TYPE OF INSURANCE POLICY NUMBER I POLICY EFFECTIVE i POLICY EXPIRATION LIMITS
LTR : DATE (MM/DDIYYI i DATE (MM/DDIYY)
GENERAL LIABILITY GENERAL AGGREGATE '$2,000,000
A !xl COMMERCIAL GENERAL LIABILITY PKG4196ZURTF 04/01/96 04/01/97 PROOUCTS ' COMP/OP AGG . $ 2 , 000 , 000
p:=g CLAIMS MAOE ~ OCCUR PERSONAL & ADV INJURY 1$1,000,000
H OWNER'S & CONTRACTOR'S PROT I EACH OCCURRENCE 1$1,000,000
FIRE DAMAGE (Anyone firel I $ 1, 000 , 000 m_ .
! I MED EXP (Anyone person) 1$10,000
AUTOMOBILE LIABILITY 1$1,000,000
0- COMBINED SINGLE LIMIT
A ~ ANY AUTO AUT04196ZURTF 04/01/96 04/01/97
i
ALL OWNED AUTOS I BODILY INJURY
0- 1 $
SCHEDULED AUTOS ,
f-- (Per person~
X HIRED AUTOS I BODILY INJURY : $
0-
~ NON-OWNED AUTOS i (Per accldentl i
I PROPERTY DAMAGE -~--
, i
~ I $
i
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT I $
---, I
I ! ANY AUTO OTHER THAN AUTO ONLY: I
~ EACH ACCIDENT i $
I ,
AGGREGATE ! $
EXCESS LIABILITY EACH OCCURRENCE ! $ 10,000,000
A M UMBRELLA FORM UMB4196ZURTF I 04/01/96 04/01/97 AGGREGATE 1$10,000,009_
OTHER THAN UMBRELLA FORM I , $
A WORKERS COMPENSATION AND X I STATUTORY LIMITS ,
I
A EMPLOYERS' LIABILITY '$500,000
EACH ACCIDENT
THE PROPRIETOR/ HINCL ---..-
PARTNERS/EXECUTIVE WC4196ZURTF 04/01/96 04/01/97 i DISEASE, POLICY LlM!T 1$500,000
OFFICERS ARE: i . EXCL WC4196ZURTF 04/01/96 04/01/97 DISEASE, EACH EMPLOYEE i $ 500,000
OTHER I I
I
I I
I j
!
DESCRIPTION OF OPERATIONS/LOCATJONSNEHICLES/SPECIAL ITEMS
RE: 644 & 645 Pierce Street/Clearwater, FL 34616
CERTlFICA TEHbLDER ..... CANCELLA TION
PSIDEPU SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Deputy Chief Dewey Williams 030 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.
Clearwater Police Department
644 Pierce Street BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
Clearwater FL 34616 OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTA~ @~D C~~N 1993
Stephen J. Mey
ACORD 25-S (3/93)
U
it....., .. ... ............ "'mr::}/:::':::::}:::'::::':::::::{:::::::::::':':::~~::~(::::~:J::::~:::'::::'::::::::::::::::::::}:::\::::::;:;:i.:;:J::::::::{':::Ii::::::r:::::::~:::::::f:~t::::t:::/::::::::::::::;::fm:::fl:::W:filr:t:::rr::r:umrr', t:f:~:}rrrrr}r;~:r~:::::~~:;.:~1:;;:'::::'~;;:;;;:;::::<:
~~!~ ~1111~1111.:::I",.",.,~~,~~~,~.~..
PRODUCER ~ THIS CER11F1CATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
""""'\~~~~~~:~~~~~~~i.",,~~:T"i1 ' gg~~E~gl2M~~r:~~~ ~EA~~;r~:~o~~~~~~' W~~;De:.r~~A~
INsrn;:<Z~~~A~ ~~~ INC., iP'!lf'i"rLYd:isAFI'ORD'NGCOVERAGE
Fairfax, VA 22030 :.
(703) 273-4246 'H~~$?k~f~~~dH H
H'H'H~:'U"'H:~~'H:HH'HH:'::::~:'~=~'~:::'~'::"HHHHHHH,UH~lEJ'C~~fii~ In terna tional Surplus
INSURED
PSI International, Inc.
10306 Eaton Place
Fairfax, VA 22030
~ANY C
COMPANY D
LETTER
COMPANY E
LETTER
THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD
INCICATED, N01WITHSTANC:NG ANY REQUIREMENT, TERM OR CONDITION OF A.W C0NTRACT OR OTHER DO:UM'ONT WITH RESPECT TO WHIC'" TI-ns
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POUCIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID ClAJMS,
CO:
LTR:
TYPE OF INSURANCE
POLICY NUMBER
: POLICY EFFEC11VEPOLICY EXPIRAllON
: DATE (MM/DDIYY) DATE (MM/DDIYY)
UMrTS
A ~ GENERAL UABIUTY
X : COMMERCIAL GENERAl LIABILITY BINDER
. CLAIMS MADE · X OCCUR. ~
. OWNER'S to CONTRACTOR'S PROT.
04/01/95
. . . - - . . . . . . . . . . . . . . . . . . . . - - . - . . . . .
,~Etl~HA~GREGATE ......H.$..:2J900H'900
~ PRODUCTS-COMP/OP AGG. $ ..1,900, 000
04/01/96: PERSo.NAln~~DV.I~~~'Hnnn$H~'.,q99,Oq()
. EACH OCCURRENCE $~'.O()()'. 000
. FIRE D~~E(Any one fore) $ 'HH,3gq'n900
: MED, EXPENSE (Anyone person). $ 5, 0 0 0
· COMBINED SINGLE
. LIMIT $ 1, 0 0 0 , 0 0 0
I
$
AUTOMOBILE UABILITY
A. X . ANY~UTO BINDER
. ALl OWNED AU'iOS
. SCHEDULED AUTOS
X . HIRED AUTOS
X : NON-OWNED AUTOS
: GARAGE LIABILITY
.04/01/95
04/ 01/ 9 6H~~DIL YI~~~
: (Per person)
· BODILY INJURY
: (Per accident)
$
. PROPERTY DAMAGE
$
, UMBRELLA FORM
: EACH OCCURRENCE
: AGGREGATE
'$
$
. OTHER THAN UMBRELLA FORM
....................................................... .........................h........
A;
WORKER'S COMPENSAllON
ANO
EMPLOYERS' UABIUTY
BINDER
04/01/95
.XSTAru!ORYLlMITS n.n .n
. 04/ 01/ 96'n~~n~~~I~Etl!nnHnn.nH'nn"$~()9'.O()0
· DISEASE - POLICY LIMIT $ ...nn.500,00 0
· DISEASE - EACH EMPLOYEE $ HHnn~()On'H()OO
. OTHER
BPROFESSIONAL 2~7~
.LIABILITY
...............................-............ ...............................................
OS/23/95
OS/23/96 Aggregate
:Wrongfu1 Act
1,000,000
1,000,000
DESCRIPllON OF OPERA llONSILOCA llONSlVEHICLESlSPECIAL lI'EMS
RE: ADDITIONAL INSURED: CITY OF CLEARWATER
NOTE: Professional liability coverage has a $5,000 deductible.
:.9~gq@M:m:~9fP~~l}::}}:::m:::tt:::::::~..:::::}}::::t:::::tr:t::.:::::.}t)ttt:tt~.:.:::::~:::}:::~:::~:.:aWS~9,.:::::}:((:}::~tt}::/:::::::~
.................
......... .......
....
....._-. ..
... ....................
........................
.................. .
CITY OF CLEARWATER
DEPUTY CHIEF DEWEY
644 PIERCE STREET
CLEARWATER FL 34618
:Ai#.9.ijp::~$.:(tJ@j:
DEPT OF POLICE" II
WILLIAMS :~::
H
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES 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 OBUGATION OR
UABIU1Y OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
.~.............................-..
. ........................-......
..................... ............
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