CERTIFICATE OF LIABILITY INSURANCE 51460E I®61 REDO
E mwDD`yyYy'
0
DATE(MIAIDDYYYY�
CERTIFICATE O�F LIABILITY INSURANCE F 8116 2012
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Automatic Data Processing Insurance Agency, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1 ADP Boulevard HOLDER.
THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Roseland, NJ 07068 INSURERS AFFORDING COVERAGE NAIL #
S Of Mind Inc' f INSURERA Travelers Indemnity Company of Arneric45666,
1426 S Mik Jr,Avg
INSURER B!
Clearwater, FL 33756
INSURER C
INSURER I)'
INSURER E-
-TOVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED,TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATE[).NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO VVHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRI13ED HEREIN IS SUBJ E(,-,T TO ALL THE TERMS, EXCLUSIONS AND 0ONI--)ITf0NS OF SUCH
POLICIES.AGGREGATE LIMITS SHOON M-A`Y HAVE BEEN REDUCED BY PAID CL.AIMS,
— ---------- ———-----------
POLICY EFFECTIVE .POLICY EXPIRATION,'
IN,
SIR A16
LTR,INSR -jKEkDF IN,$U RAN CE POLICY NUMBER LIMITS
I GENERAL LIABILITY EACH OC13LYRRENCE
4 -�- I-[ ...........
I'll M1-
COMMERCIAL GENrRAL LIABILITY PREWSES(E@ occuren S
CLAIMS MADE OCCUR ME EXP(Any ono persor) _ S
PFR1,0NAI-R ArV INJI-Rv
GEN F PAL AGG R ECIATE
GENT AGGREGATE LINIff APPUES PER- FPoD1,jC1S-';om-piop d%GG
pOLICY 1--] PRO- i
AFCT
AUTOMOBILE LIABILITY COMBINED SINGLE 511MIT
N`.,TO
AL.1,OWNED AUTOS
130CAIN HNJORY
(Per P—�.
4
cf-izDLA-ED AUTOS
HIRED AUTOS BODILY INJURY
NONI-OWNIED A�fl-rk,
GARAGE LIABILITY AU'I 0 ONLY-EA ACCIDENT S
ANY AUTO
E= E ALL $
01-1-IER THAN
AUTO OWN:
9j3G S
EXCESS I UMBRELLA LIABILITY EACH QQCU R RENC E S
OCCUR CLAIMS MADE # AGGREGAIE $
DEDUCTIBLE j $
RETENTION $ $
-W0-RKFk$COMPENSATION X I VVC STATU-
AND EMPLOYERS'LIABILITY YIN TORY LI IA ITS
A ANY PRO PRIETCRIPARTNERIExEr,'Ll rwE D IHUB2C20187312 811412012 811412013 E.L EA(,H ACCIDENT 100,000
OFFICEWMEMBER EXCLUDED'
(Mandatory in NH) EL DISESE EA EMPUCIYE9 S 100,000
If ar,de�3uibe under
S F C,AL PR OVI SGONS b&16* E.L.DISEASE POUCY LIMIT I5 500,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES t EXCI USIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 - DAYS WRITTEN
City of Clearwater NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
1426 S,MILK Jr Ave IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
Clearwater, FIL 33756- REPKE5ENTATIVIE-S.
AUTHOR2ED REPRESENTATIVE
ACORD 25(20 9101) 019 8-2009 ACORD CORPORATION. Afl rights reserved.
The ACORD name and Iogo am registered marks of ACORD