CERTIFICATE OF INSURANCE (3)
NYC-002334777-01
Marsh USA Inc.
1166 Avenue of Americas
New York, NY 10036
Attn: NewYork.Certs@Marsh.Com 212-948-0500
COMPANY
109513-ALL-CAS-04-05FEDERAL INSURANCE COMPANY
COMPANY
PricewaterhouseCoopers LLP
300 Madison Avenue
COMPANY
New York, NY 10017
COMPANY
1
This certificate supersedes and replaces any previously issued certificate for the policy period noted below.
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY
PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE
LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
09/30/0409/30/05
7350-84-16
$2,000,000
A
GENERAL AGGREGATE
X$1,000,000
COMMERCIAL GENERAL LIABILITY
PRODUCTS - COMP/OP AGG
X$1,000,000
CLAIMS MADEOCCURPERSONAL & ADV INJURY
1,000,000
$
OWNER'S & CONTRACTOR'S PROTEACH OCCURRENCE
$250,000
FIRE DAMAGE (Any one fire)
$1,000
MED EXP (Any one person)
7497-74-1809/30/0409/30/05
A
1,000,000
$
COMBINED SINGLE LIMIT
ANY AUTO
ALL OWNED AUTOSBODILY INJURY
$
(Per person)
SCHEDULED AUTOS
X
HIRED AUTOSBODILY INJURY
$
(Per accident)
X
NON-OWNED AUTOS
$
PROPERTY DAMAGE
$
AUTO ONLY - EA ACCIDENT
ANY AUTOOTHER THAN AUTO ONLY:
$
EACH ACCIDENT
$
AGGREGATE
$
EACH OCCURRENCE
$
AGGREGATE
UMBRELLA FORM
$
OTHER THAN UMBRELLA FORM
WC STATU-OTH-
7170-68-12
A
09/30/0409/30/05
X
TORY LIMITSER
$2,000,000
EL EACH ACCIDENT
$2,000,000
THE PROPRIETOR/
EL DISEASE-POLICY LIMIT
INCL
PARTNERS/EXECUTIVE
X2,000,000
$
EL DISEASE-EACH EMPLOYEE
OFFICERS ARE:
EXCL
SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,
THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL _______ DAYS WRITTEN NOTICE TO THE
CITY OF CLEARWATER
CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
FINANCE DEPARTMENT
ATTN: CAROL BARDEN
LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES, OR THE
100 S. MYRTLE AVE.
ISSUER OF THIS CERTIFICATE.
CLEARWATER, FL 33756
Jenn Cowan
06/21/05