CERTIFICATE OF LIABILITY INSURANCE (17)
,ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY)
TM 03/16/2006
PRODUCER (813)933-6691 FAX (813)932-6287 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Adcock & Adcock Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
315 W. Fletcher Ave. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Tampa, FL 33612-3414
Jeffrey Kemp INSURERS AFFORDING COVERAGE NAIC#
INSURED Hardeman Landscape Nursery Inc INSURER A: Southern-Owners Insurance Co. 10190
POBox 1980 INSURER B: Auto-Owners Insurance Co. 18988
Seffner,FL 33583-1980 INSURER c: Zenith Insurance Co. .
INSURER 0:
INSURER E: .'
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR DD'L TYPE OF INSURANCE POLICY NUMBER PRH~Y EFFECTIVE POLICY EXPIRATION LIMITS
GENERAL LIABILITY 20599539 04/01/2006 04/01/2007 EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,000
I CLAIMS MADE 0 OCCUR MED EXP (Anyone person) $ 10,000
A X $250 PO Oed PERSONAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000
~ n PRO- nLOC
POLICY JECT
AUTOMOBILE LIABILITY 4273681700 04/01/2006 04/01/2007 COMBINED SINGLE LIMIT
'-- (Ea accident) $
X ANY AUTO 1,000,000
'--
ALL OWNED AUTOS BODILY INJURY
'-- (Per person) $
SCHEDULED AUTOS
B "x-
HIRED AUTOS BODILY INJURY
"x- (Per accident) $
NON-OWNED AUTOS
r--
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
RANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY 4273681701 04/01/2006 04/01/2007 EACH OCCURRENCE $ 2,000,000
~'OCCUR D CLAIMS MADE AGGREGATE $ 2,000,000
B $
~ DEDUCTIBLE $
X RETENTION $ 10,000 $
WORKERS COMPENSATION AND Z067945601 01/01/2006 01/01/2007 I T~~~T f;.1~<: I 10Jbl-
EMPLOYERS' LIABILITY EL. EACH ACCIDENT $ 1,000,000
C ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? EL. DISEASE - EA EMPLOYEE $ 1,000,000
~~~M~s~Wov'js?o~s beiow ---- - ..- -- ---
EL. DISEASE - POLICY LIMIT $ 1,000,000
OTHER WI-( .r-I "ED
. ,.-. 'lnn>:>
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ,- '"\.\ '0' , L.UUU
OFHCIAl RECORDS AND
lEGISLATIVE SRVCS DEPT
City of Clearwater
OCL Oept
POBox 4748
Clearwater, FL 33758
L I N
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
---.!L DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Jeffre
ACORD 25 (2001/08)
@ACORD CORPORATION 1988