CERTIFICATE OF LIABILITY INSURANCEACORO�
�
DATE (MMVDD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 4/11/2013
PRODUCER (2O1) iE>i-liOO FAX: (2O1) i6i-%S].O
Fenner & Esler
467 Kinderkamack Road
P. O. Box 60
Oradell NJ 07649-0060
INSURED
Timothy Haahs & Asaociates
550 Township Line Road
Suite 100
Blue Be 1 PA 19422
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CER7IFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIG #
INSURERA:Ndt�l Fire Ins. Co of zoa�ti
iNSUReR e: Valley Forge Insurance zoso�i
iNSUReRC:Continental Casualty Company 2044:t
INSURER D:AZ'CI11t2Ct8 & Engineers Ins Co 00994@
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTIMTH:iTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE IISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUStONS AND CONDITIONS 05UCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR DD' POLICY NUMBER POLICY EFFECTiVE POLICY EXPIRATION LIMITS
GENERALLIABILITY EACH OCCURRENCE $ 1, 000, 000
X COMMERCIAL GENERAL LIABILITY PREM SES Ea occurtence $ 300 000
A CLAIMSMADE �OCCUR 024368244 12�31�2012 12/31/2013 MEDEXP(Anyoneperson) $ . 10 ���
X Completed Operations PERSONAL&ADVINJURY $ 1�0�0 ODU
X Contractual GENERALAGGREGA7E S 2,000 000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2 OOO OOO
POLICY X PR� X LOC
AUTOMOBILE LIA&LITY
COMBINED SINGLE LIMIT $ 1,, OOO, OOO
X ANY AUTO (Ea accident)
B ALLOWNEDAUTOS 024368258 12�31�2012 12/31/2013 gODILYINJURY
SCHEDULED AUTOS (Per person) $
HIRED AUTOS
BODILY INJURY $
NON-0WNED AUTOS (Per accident) ,
PROPERTY DAMAGE $
(Per accidenq
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $ ,
AUTO ONLY: AGG $
EXCESS/UMBRELLALIABILITY EACHOCCURRENCE $ 5 OOO,OOO
X OCCUR � CLAIMS MADE AGGREGATE $ 5. 000 � 000
S
C DEDUCTIBLE 4024368339 12�31�2012 12/31/2013 S .
X RETENTION $ 0 $
B WORKERSCOMPENSATION X WC STATU- OTH-
AND EMPLOYERS' LIA&LITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y� E.L. EACH ACCIDENT $ 1, OOO � OOO
OFFICER/MEMBER EXCLUDED?
(MandatoryinNH) C 424368275 12�31�2�12 12/31/2013 E.L.DISEASE-EAEMPLOYE $ 1,��0,0��
If yes, desaibe under
SPECIAL PROVISIONS below E.L. DISEASE -POLICY IIMIT $ 1, 000, 000
D oTHERprofessional ICPG-12 6/30/2012 6/30/2015 aer cisim Ltmic $5, 000, 000
Liability Aggregate Limit $5y 000, 000
50 000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICIES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
ABditioaal Insured - Certificate Holder as respects geaeral liability where required by writtea coatract.
CERTIFICATE
City of Clearwater
Attn; Michael D. Quillen, P.E.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELIED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 � DAYS WRITTEN
NOTICE TO THE CERi1FICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO UO SO SHALL
IMPOSE NO OBLIGATION OR LIA&LITY OF ANY KIND UPON THE INSURER, IT.S AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ITimothy 8sler/1CATHY ' �'�
) 25 (2009/01) O 1988-2009 ACORD CORPORATION. All rights reserved.
�zoosoi�.oi The ACORD name and logo are registered marks of ACORD
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized
representative or producer, and the certificate holder, nor does it affirmatively or negatively amend,
extend or alter the coverage afforded by the policies listed thereon.
ACORD 25 (2009/01)
INS025 (2oosoi ).oi