CERTIFICATE OF LIABILITY INSURANCE (2)AC a� DA OBn/11/201�)
� CERTIFICATE OF LIABILITY INSURANCE
THIS CERTIFICATH IS IS5UED A5 A MA17ER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. 7HIS
--...- CER�fFICATE DOE3 NOT AFFIR#AATPVELY•OR NEGA7LY�L.Y AMENp, EXT�END OR ALTER THE .COVERAGE AFFORDED BY THE PdLICIES BELOW.
THIS CERTIFICATE QF INSURANCE DOES NOT CONSTRUTE A CONiRACT BE7WEEN THE ISSUING INSIJRER�S), AUTHORIZED
REPRESEPITATNE OR PRODUCER, AND THE CERTIFICATE HQLDER.
IMPORTANT: If the certiFicate holder is an ADDIi'IQNAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the
terms and condltlons of the policy, certain policies may requir� an endorsemant A statement on thls certlFlcabe does not confer rights to the
certiFicate holder in lieu of such endorsem�nt(s�.
PRODUCER CONTACT
aon kisk services, inc of Florida NAMN� FAX
7650 Courtney Camphel l �auseway (p/�, ryo, ��; C866) 283-7122 A� No :(847) 953-5390
Suite 1000 �-�A�
TdRlpd FL 33607 USA ADDRESS:
WSURED IN5URER A:
Pi nel l as county school soard ��R� s,
c/o Risk Management oepartment
301 4th street sw wsuR�c:
LdrgO FL 33770 USA wsuREttD:
WSURER E:
INSURER F-
IN5URER�S) AFFORDING COVERAGE I NAIC #
linois Union Insurance Company 27960
CQVERAGES CERTIFICAT� NUMBER: 57p043515829 REVI510N NUMBER:
'fHIS IS TO ERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THH INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY R�QUIREMENT, TERM OR CO.NDITIpN OF ANY CONTRACT OR OTHER DOCUMEN7 WITW RESPECT TO WHICH THIS
CER7IFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDEp BY TME POLICIES DESGRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCW POLICIES. I.IMITS SMOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as re uested
LTR n'PE�FINSURANCE IN R Wyp i°OLICYNUM6ER MMI�DDIYYYY M IDD UMRS
GENERAL LIABILITY PEP G A E.4CH OCCURRENCE $2 , OOO, 000
X COMMERCIAL GENERAL LIABILITY SIR appl i es per pol i cy ter & condi t OIlS sncl uded
PREMISES Ea occurrence
CLAIMSMApE X❑ OCCUR , MED EXP (Arry one person) EXC� uded
PER$ONAL&AOVINJURY zncluded
GEN'L AGQREGATE LIMI7
X POLICY PR6
E T
A AUTQMpBILE LIABILITY
X ANYAUTO
ALL OWNED
A11T0$
HIRE� AUTOS
IIM�RELLA LIAB
EXCES5 LIAB
PPLIES PER:
LOC
SCMEDULED
Al1TOS
NON-OWNED ,
aU70S
OCCUR
CLAIMS�MADE
EMPLOYER5 LW BLITY
ANY PROPRIETOR ! PPR'INER / EXECUTIVE
OFFICER/MEMBER EXCLU�ED7
(Mandatory In NH)
If �es. describe under � ��� �
Sirt applies per policy ter & condit ons
���EI�� .�
AUG 6
E.GV�S�IIYL. Ni\V� bJ��
NIA
GENERALAGGREGA7E
PROnUCTS-COMPIOPAGG
Siproeaucude
COMBINED SINGLE LIMIT
80DILY INJUI3Y ( Par person)
BODILV INJURY (Per accident)
PROPERTY �AMAGE
SIR
EACH OCCURRENCE
AGGREGATE
E.L EAGH ACCIDENT
E.L bISEASE-EA EMPLOYEE
EXCluded
$500,000
$Z,���,���
�5������
DESCR�7ION OF OPERATIONS I LOCATIONS I VEHICLE5 (Attach ACORD 107, Additional Remarks Schedule, if more spece is required)
The City of Clearwater is included as an ,additional Insured with respect to the General �iability and auto �iability policies.
Cancellation Provision shown herein is subject to shorter or longer time periods depending on the jurisdiction of, and reason
for, the cancellation.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE pESCR�E� PQLICIE5 9E CANCELLED BEFORE THE
p(PM12ATqN DATE THEREOF, NOTICE WILL BE DELNERED IN ACCORDANCE WITH THE
POLICY PROVI510NS.
ThE Ci ty of Cl earwater AUTHOR2ED REPRESENTATNE
,attn: City Clerk
PO BOX 474$
Clearwater FL 33758-4748 USA � � �����r ��l � ���
O'198&2010 ACQRD CpRPORATION. All rights reserved.
ACORD 25 (2D70/06) The ACQRD name and logo are registered marks of ACORD
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