CERTIFICATE OF LIABILITY INSURANCE��� �qP ID: KE
'`��.°R°� CERTIFICATE OF LIABILITY INSURANCE °ATE`M�°°"'�'
07 /23l'2013
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDI::R. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE P�DLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTEIORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, siubject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer righ�ts to the
certificate holder in lieu of such endorsement s.
PRODUCER CONTACT �
Phone: 703-777-7774 NAME:
Independentlnsurance Center PHONE Fnx
P.O. eox 2303 Fax: 703-777-7156 ac N 6ct : A/C No : .
Leesburg, VA 20177 E-MAII
Suter, Haycraft & Simmons PRODUCER w .1
rucrnuco �n e• VMN�C' 1 � �
INSURED Van 5coyoc Associates, Inc.
101 Constitution Ave NW # 600
Washington, DC 20001
INSURER(S) AFFORDING
A:Travelers
e : Chubb Insurance Gro
NAIC A
25�515
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLIC`!' PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WFIICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE'c, TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR npE OF INSURANCE � POLICY NUMBER MM/DDY EFF 'P�DI �Y� LIMITS
LTR �� .
GENERAL LIABILITY EACH OCCURRENCE $ ��ODO�OO
A X COMMERCIAL GENERAL LIABILITY 63086399167 ��/�i/2�i2 07/01/2013 pREMISES Ea occurrence $ . 300,��
CLAIMS-MADE � OCCUR MED EXP (My one person) $ � 0,��
PERSONAL & ADV INJURY $ i �OOO,OO
X per project agg GENERALAGGREGATE $ . 2��00��0
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ Z,OOO�OO
POLICY PR� LOC $ ,
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ��OOO�OO
A X ANYAUTO 8708B399167 07/01/2012 07/01/2013 �Eaaccident)
BODILY INJURY (Par person) $
ALL OWNED AUTOS ,�; � , �, ^�� �, BODILY INJURY (Per accidentj $ .
����� � �� �: -��� PROPERTY DAMAGE
SCHEDULED AUTOS $
(Per accident)
X HIRED AUTOS .
X NON-OWNED AUTOS � � ` � � . ° °`� $ �
9�§�. &. R.trt'�
$
X UMBRELIA LIAB X OCCUR �'? -�r' r''. ° � t"' - EACH OCCURRENCE $ .$,OOO,OO
�d:�6 L'is�,i"'m� ��L �„° kx't ,f�
EXCESS LIAB CLAIMS-MADE �i�y' r•z R �4,`` � AGGREGATE $ S�OOO�OO
A CUP8B399�.��� d `v � ;�' ����� ,'�7/01/2013 -
DEDUCTIBLE $ _
$
RETENTION $ � .
WORKERS COMPENSATION X WC STATU- OTH-
AND EMPLOYERS' LIABILITY ORY LIMIT$
A ANY PROPRIETOR/PARTNER/EXECUTIVE Y� N� A U68B399167 07/01I2012 07/01/2013 E.L. EACH ACCIDENT $ 5�����
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ $�0,��
If yes, dascribe under 500,��
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ .
B Errors & Omission 68026778 07/01/2012 07/0112013 50000 ded 2,000,00
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ANaeh ACORD 101, Additional Remarks Schedule, ii more spaee Is requlred) .
CERTIFICATE HOLDER
City of Clearwater, Florida
PO Box 4748
Clearwater, FL 34618
ACORD 25 (2009109)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLEI[I BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEIIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHOR¢ED REPRESENTATIVE
I �i��„���(� .
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O 1988-2009 ACORD CORPORATION. All rights r�aserved.
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