CERTIFICATE OF LIABILITY INSURANCE (213)Client#: 3970 JONEEDM3
ACORD.� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)
06/27/2012
THIS CERTIFICATE IS ISSUED AS A MA7TER 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 certi�cate 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
NAME:
ISU Suncoast Insurance Assoc PHONE g13 289-5200 Fj0'X 8132894561
P.O. BOX 22665 MAi�° �' A/C, No :
ADDRESS:
Tampa, FL 33622-2668 CUSTOMERID#:
813 289-5200
INSURER(S) AFFORDING COVERAGE NAIC #
INSURED
Jones Edmunds � Associates, Inc.
730 N.E. Waldo Road
Gainesville, FL 32641
COVERAGES
CERTIFICATE NUMBER:
iNSUReRn: Travelers Indemnity Company of
iNSUReR e: Travelers Indemnity Company
iNSUReR c: XL Specialty Insurance Company
iNSUReR �: Travelers Property Cas Co of Am
INSURER F :
REVISION NUMBER:
25674
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.
DDL UBR POLICY EFF POLICY EXP LIMITS
TYPE OF INSURANCE R POLICY NUMBER MM/DD MM/DD
A GENERAL LIABILITY 6801951 L902 06/30/2012 06/30/207 EACH OCCURRENCE $� ��� �0�
X COMMERCIAL GENERAL LIABILITY DAMAGE O RENTED
PREMISES Ea occurtence $� ��0����0
CLAIMS-MADE � OCCUR MED EXP (My one person) $� O�OOO
PERSONAL & ADV INJURY $� �OOO�OOO
GENERAL AGGREGATE $2,000�000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $Z,OOO,OOO
POLICY PRO- LOC $
p auTOMOai�e uaei�m'r BA1958L737 012 06/30/201 COMBINED SWGLE LiMIT
(Ea accident) $� ��� �Q�
X ANY AUTO BODILY INJURY (Per pereon) $
ALL OWNED AUTOS JUN 2$ 012 BODILY INJURY (Peraccident) $
SCHEDULED AUTOS
PROPERTY DAMAGE $
X HIRED AUTOS (j � ! A' /�� �y (Per accident)
X NON-OWNEDAUTOS �+fFICIHL REW {JS �� g
LE��LqTIyE SR CS DEPT $
B X UMBRELLA LIAB X OCCUR CUP6513Y228 06/30/2012 06/30/201 EACH OCCURRENCE $rJ ��0 ��0
EXCESS LIAB CLAIMS-MADE AGGREGATE $S OOO OOO
DEDUCTIBLE $
X RETENTION � O OOO $
B WORKERS COMPENSATION UB3911T035 6/30/2012 06/30/201 X WC STATU- OTH-
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVEY/ N E.L. EACH ACCIDENT $� �OOO�OOO
OFFICERlMEMBER EXCLUDED? N�A`
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $� ����,���
If yes, describe under �DO ��O
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $� , ,
C Professional DPR9702230 06/30/2012 06/30/201 $5,000,000 per claim
Liabilit $5,000,000 annl a r.
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additlonal Remarks Schedule, if more space is required)
Professional Liability coverage is written on a claims-made and reported basis.
Project: 2009 Engineer of Record
City of Clearwater is listed as additional insured with respect to the General and Auto Liability policies.
City of Clearwater
Attn: City Clerk
PO Box 4748
Clearwater, FL 33758-4748
N
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
0�-�' 'M- Ot9--OL.� ,�,�--�-
O 1988-2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009109) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S39Z017/M392004 MRL